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Rachel Burhans
TRAVELMATION LLC
New Clients
<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Travel Quote Request"/> <field type="header" subtype="h2" label="As a travel advisor, I am compensated for my time and expertise when my clients book AND travel with me. I receive no payment for quotes but are compensated by the resorts, tour providers, and destinations for serving our mutual clients.*"/> <field type="checkbox-group" required="true" label="I understand that Rachel is not compensated for her time until I complete my travels on a booking executed by her." name="i-understand-that-rachel-is-not-compensated-for-her-time-until-i-complete-my-travels-on-a-booking-executed-by-her"> <option label="" value=""/> </field> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Middle name" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Best email to send quotes to? Please be sure to check your email 24-48 hours after requesting a quote!&nbsp;" placeholder="this will be the main form of communication" name="email" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Name, Date of Birth, &amp; gender as listed on identification for ALL travel parties including yourself, THIS A MUST FOR AN ACCURATE QUOTE." name="date-of-birth-gender-as-listed-on-identification-for-all-travel-parties-including-yourself" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Where Are You Wanting to Travel?" name="where-are-you-wanting-to-travel"> <option label="Universal (Orlando)" value="universal-orlando">Universal (Orlando)</option> <option label="Universal (California)" value="universal-california">Universal (California)</option> <option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option> <option label="Adventures by Disney (Land Tours)" value="adventures-by-disney-land-tours">Adventures by Disney (Land Tours)</option> <option label="Royal Caribbean Cruise" value="royal-caribbean-cruise">Royal Caribbean Cruise</option> <option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option> <option label="Virgin Voyages Cruise" value="virgin-voyages-cruise">Virgin Voyages Cruise</option> <option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option> <option label="Other Cruise Line" value="other-cruise-line">Other Cruise Line</option> <option label="All Inclusive Couples Resort" value="all-inclusive-couples-resort">All Inclusive Couples Resort</option> <option label="All Inclusive Family Resort" value="all-inclusive-family-resort">All Inclusive Family Resort</option> <option label="Non All-Inclusive Resort/International Destination" value="non-allinclusive-resortinternational-destination">Non All-Inclusive Resort/International Destination</option> <option label="River Cruises" value="river-cruises">River Cruises</option> <option label="Domestic Travel" value="domestic-travel">Domestic Travel</option> <option label="Other (Please state below)" value="other-please-state-below">Other (Please state below)</option> <option label="Disneyland" value="disneyland">Disneyland</option> <option label="Walt Disney World " value="walt-disney-world-">Walt Disney World </option> </field> <field type="text" label="If you selected 'other' above please state where you would like to go?" name="if-you-selected-other-above-please-state-where-you-would-like-to-go" subtype="text" className="form-control"/> <field type="date" required="true" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/> <field type="date" required="true" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/> <field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="What is your ideal budget excluding any flights / transportation??" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="Value (less than $1500 per person)" value="value-less-than-1500-per-person">Value (less than $1500 per person)</option> <option label="Moderate ($1500-$2500 per person)" value="moderate-15002500-per-person">Moderate ($1500-$2500 per person)</option> <option label="Deluxe ($2500+ per person)" value="deluxe-2500-per-person">Deluxe ($2500+ per person)</option> </field> <field type="radio-group" required="true" label="If cruising, what type of stateroom do you prefer?" name="if-cruising-what-type-of-stateroom-do-you-prefer"> <option label="Interior (no window)" value="interior-no-window">Interior (no window)</option> <option label="Oceanview (window)" value="oceanview-window">Oceanview (window)</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Suite" value="suite">Suite</option> <option label="Does not apply" value="does-not-apply">Does not apply</option> </field> <field type="checkbox-group" required="true" label="Would you like me to bundle air for your trip?&nbsp;" name="would-you-like-me-to-bundle-air-for-your-trip-"> <option label="Yes" value="yes">Yes</option> <option label="NO" value="no">NO</option> </field> <field type="text" label="If flights are needed, what is your preferred departure airport?" name="if-flights-are-needed-what-is-your-preferred-departure-airport" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="How soon are you wanting to book?" name="how-soon-are-you-wanting-to-book"> <option label="ASAP!" value="asap">ASAP!</option> <option label="Within 7-10 days of an agreeable quote" value="within-710-days-of-an-agreeable-quote">Within 7-10 days of an agreeable quote</option> <option label="In a few months" value="in-a-few-months">In a few months</option> <option label="I'm just considering options" value="im-just-considering-options">I'm just considering options</option> </field> <field type="text" required="true" label="Please state the number of rooms you are wanting for your travel party." placeholder="Be sure to include both number of beds and number of rooms" name="how-many-rooms-and-beds-are-you-requesting-for-your-traveling-party" subtype="text" className="form-control"/> <field type="radio-group" label="If international travel/cruising is desired: Do all members of your traveling party have their passports? Most locations require a passport to be good for 6 months after your planned trip.&nbsp;" name="if-international-travel-is-desired-do-all-members-of-your-traveling-party-have-their-passports"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="We are planning on getting them- Please allow several months for processing times on passport" value="we-are-planning-on-getting-them-please-allow-several-months-for-processing-times-on-passport">We are planning on getting them- Please allow several months for processing times on passport</option> </field> <field type="radio-group" required="true" label="How would you like to travel once at your destination?" name="how-would-you-like-to-travel-once-at-your-destination"> <option label="Rental Car" value="rental-car">Rental Car</option> <option label="Ride Share (Uber, Lyft, etc)" value="ride-share-uber-lyft-etc">Ride Share (Uber, Lyft, etc)</option> <option label="Private/Public Airport Transfer (if/when available)" value="privatepublic-airport-transfer-ifwhen-available">Private/Public Airport Transfer (if/when available)</option> <option label="I will be driving my own personal vehicle" value="i-will-be-driving-my-own-personal-vehicle">I will be driving my own personal vehicle</option> </field> <field type="text" label="If there is a specific resort or hotel you are interested in PLEASE list that here." name="if-there-is-a-specific-resort-or-hotel-you-are-interested-in-please-list-that-here" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy $" value="economy-">Economy $</option> <option label="Moderate $$" value="moderate-">Moderate $$</option> <option label="Luxury $$$" value="luxury-">Luxury $$$</option> <option label="Boutique $$$$" value="boutique-">Boutique $$$$</option> </field> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> </field> <field type="textarea" required="true" label="Do you or anyone in your travel party have any medical conditions or disabilities, currently pregnant, or any food allergies that I need to be aware of as a part of the planning process? Please note- for cruises, pregnant travelers cannot board after 24 weeks of pregnancy even with consent from a physician. All cruise lines have the right to refuse boarding based on this information.&nbsp;" name="do-you-or-anyone-in-your-travel-party-have-any-medical-conditions-or-food-allergies-that-i-need-to-be-aware-of-as-a-part-of-the-planning-process" className="form-control"/> <field type="text" required="true" label="Anything you absolutely must do or see? &nbsp;Are there any specific activities, excursions, restaurants, or locations you'd like to visit as a part of your vacation?&nbsp;" name="must-dos" subtype="text" className="form-control"/> <field type="textarea" required="true" label="What else would you like me to know? Are there any celebrations being celebrated during this trip?" description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="text" required="true" label="How did you hear about me? If a friend referred you- please include their name for incentives! I reward those who refer clients to me as well as those who were referred! :)&nbsp;" name="how-did-you-hear-about-me-if-a-friend-referred-you-please-include-their-name-for-incentives-i-reward-those-who-refer-clients-to-me-" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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