TravelJoy

Team Travelooza

Travelooza

NEW LEADS

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    <form-template>
	<fields>
		<field type="header" subtype="h1" label="TRIP VITAL DETAILS FOR BOOKING"/>
		<field type="paragraph" subtype="p" label="Congratulations, we are to the booking stage of your vacation! We would like to make your vacation hassle free and finalizing accurate paperwork is an essential step. In an effort to ensure proper travel documentation requirements are met and security issues are avoided; please complete the following form fully and accurately. All submitted information is secure, properly protected, and used exclusively for your upcoming reservation. It comes only to Travelooza management, via email and then we will input to confirm the reservation."/>
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>
		<field type="text" 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="Suffix" name="suffix" 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="Phone number" name="phone-number" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>
		<field type="select" label="Agent Working With" name="agent-working-with" className="form-control">
			<option label="Jana" value="Huse" selected="selected">Jana</option>
			<option label="Kristen" value="Pfeifer">Kristen</option>
			<option label="Laurie " value="Willison">Laurie </option>
			<option label="Stephanie" value="Benson">Stephanie</option>
			<option label="Shonda " value="Meitler">Shonda </option>
			<option label="Tammie" value="Macias">Tammie</option>
			<option label="Jacquie" value="Lamm">Jacquie</option>
		</field>
		<field type="text" label="Please provide description and dates for trip you would like to reserve" name="please-provide-description-and-dates-for-trip-you-would-like-to-reserve" subtype="text" className="form-control"/>
		<field type="clientLoyaltyPrograms" label="Do you Frequent Flyer rewards card? Or TSA PreCheck or Known Traveler ID? Please provide the identifying number." name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>
		<field type="date" label="Will you be celebrating an anniversary?" name="wedding-anniversary" className="form-control"/>
		<field type="select" label="Bedding Preference" description="Please be advised that we submit your request to the hotel  resort or cruise line. Requests are not guaranteed and are based upon availability." name="bedding-preference" className="form-control">
			<option label="Double Queen" value="double-queen" selected="selected">Double Queen</option>
			<option label="King/Queen" value="kingqueen">King/Queen</option>
			<option label="Option 3" value="option-3">Option 3</option>
		</field>
		<field type="textarea" label="INFORMATION ON TRAVELERS" name="information-on-travelers" value="Please provide all information needed for booking flight and hotel reservations. Accuracy is key so enter carefully and double check! For international travel  please include passport information if available.... you can send later if you don't have yet.  There may be some entry and exit restrictions based on each country for visitors. These restrictions are set forth by the foreign governments and include DUI's  health concerns &amp; vaccinations  child safety and support, offensive actions or any felony arrest history. It is every traveler's full responsibility to check and verify entry, exit, passport and visa requirements. To avoid entry or exit issues please visit https://travel.state.gov/" className="form-control"/>
		<field type="text" label="TRAVELER #1-- Name exact as on passport or photo ID" description="Prefix  First  MIddle  Last, Suffix" name="traveler-1-name-exact-as-on-passport-or-photo-id" subtype="text" className="form-control"/>
		<field type="date" label="Birthday" name="birthday" className="form-control"/>
		<field type="text" label="#1 Passport Number" description="MM/DD/YYY" name="passport-number" subtype="text" className="form-control"/>
		<field type="text" label="TRAVELER #2-- Name exact as on passport or photo ID" description="Prefix  First  MIddle  Last, Suffix" name="traveler-2-name-exact-as-on-passport-or-photo-id" subtype="text" className="form-control"/>
		<field type="textarea" label="#2 Birthdate" description="MM/DD?YYYY" name="2-birthdate" className="form-control"/>
		<field type="text" label="TRAVELER #3-- Name exact as on passport or photo ID" description="Prefix  First  MIddle  Last, Suffix" name="traveler-3-name-exact-as-on-passport-or-photo-id" subtype="text" className="form-control"/>
		<field type="textarea" label="#3 Birthdate" description="MM/DD?YYYY" name="3-birthdate" className="form-control"/>
		<field type="text" label="TRAVELER #4-- Name exact as on passport or photo ID" description="Prefix  First  MIddle  Last, Suffix" name="traveler-4-name-exact-as-on-passport-or-photo-id" subtype="text" className="form-control"/>
		<field type="textarea" label="#4 Birthdate" description="MM/DD?YYYY" name="4-birthdate" className="form-control"/>
		<field type="textarea" label="Additional travelers full legal name and birthdays" name="additional-travelers-full-legal-name-and-birthdays" className="form-control"/>
		<field type="textarea" label="TRAVEL INSURANCE" name="travel-insurance" value="Now that you have arranged your trip  as your professional travel agent I feel that it is my responsibility to recommend travel insurance to protect your investment. Please read and review carefully the separate email providing insurance prices and details so you can make an informed decision concerning this important matter. Ask us or call us with any questions you may have.  AT THE TIME OF FIRST PAYMENT  I have been advised of the cancellation penalties for my purchase. I acknowledge receipt of the insurance email and details.  I understand that travel insurance can protect me from possible loss of money due to supplier bankruptcy/default  unexpected trip cancellation/interruption due to accident  sickness or death, baggage loss, medical expenses, and emergency air transportation costs.  I understand that I must purchase Travel Insurance immediately to obtain coverage for pre-existing conditions or by final payment for general coverage.  Visit https://www.travelooza.com/travelinsurance.html for more details." className="form-control"/>
		<field type="select" label="Our choice for travel insurance" name="our-choice-for-travel-insurance" className="form-control">
			<option label="Yes, I would like to purchase the supplier provided full travel credit policy as quoted., noting that once purchased I am not eligible for any cash refunds, but only future credit with the supplier." value="yes-i-would-like-to-purchase-the-supplier-provided-full-travel-credit-policy-as-quoted-noting-that-once-purchased-i-am-not-eligible-for-any-cash-refunds-but-only-future-credit-with-the-supplier" selected="selected">Yes, I would like to purchase the supplier provided full travel credit policy as quoted., noting that once purchased I am not eligible for any cash refunds, but only future credit with the supplier.</option>
			<option label="Yes, I would like to purchase the Allianz Cancel Anytime policy with Covid endorsement and 80% Cash back for non-refundable travel costs. (100% if a covered reason)" value="yes-i-would-like-to-purchase-the-allianz-cancel-anytime-policy-with-covid-endorsement-and-80-cash-back-for-nonrefundable-travel-costs-100-if-a-covered-reason">Yes, I would like to purchase the Allianz Cancel Anytime policy with Covid endorsement and 80% Cash back for non-refundable travel costs. (100% if a covered reason)</option>
			<option label="Yes, I would like to purchase Allianz Classic coverage that pays 100% only for covered reasons and includes the covid endorsement." value="yes-i-would-like-to-purchase-allianz-classic-coverage-that-pays-100-only-for-covered-reasons-and-includes-the-covid-endorsement">Yes, I would like to purchase Allianz Classic coverage that pays 100% only for covered reasons and includes the covid endorsement.</option>
			<option label="No, I decline to purchase any travel protection and acknowledge that I have been offered coverage and I choose to not accept it." value="no-i-decline-to-purchase-any-travel-protection-and-acknowledge-that-i-have-been-offered-coverage-and-i-choose-to-not-accept-it">No, I decline to purchase any travel protection and acknowledge that I have been offered coverage and I choose to not accept it.</option>
		</field>
		<field type="select" label="If flying, do you prefer aisle or window seat?" name="if-flying-do-you-prefer-aisle-or-window-seat" className="form-control">
			<option label="Aisle" value="aisle" selected="selected">Aisle</option>
			<option label="Window" value="window">Window</option>
			<option label="Option 3" value="option-3">Option 3</option>
		</field>
		<field type="header" subtype="h2" label="EMERGENCY CONTACT INFO"/>
		<field type="text" label="Emergency Contact Name" name="emergency-contact-name" subtype="text" className="form-control"/>
		<field type="text" label="Emergency Contact Phone" name="emergency-contact-phone" subtype="text" className="form-control"/>
		<field type="text" label="Emergency Contact Email Address" name="emergency-contact-email-address" subtype="text" className="form-control"/>
		<field type="textarea" label="Please confirm that you have review the terms &amp;amp; conditions and cancellation policy on the quote you received.....&amp;nbsp;" name="please-confirm-that-you-have-review-the-terms-conditions-and-cancellation-policy-on-the-quote-you-received-" value="By booking your arrangement with us  you are agreeing to be bound by the terms of this agreement and any additional terms and conditions of any supplier that are applicable to your booking arrangements. The lead passenger assumes the responsibility of sharing these terms and conditions with each passenger in their group  including payment of all amounts when due. It is the responsibility of each passenger to read our terms and conditions in its entirety. In addition  we reserve the right to modify these Terms and Conditions. If there is any part of these terms and conditions that you do not agree with, please do not use our travel services.  “Force majeure” means, in relation to our agency, in any circumstances beyond our reasonable control, (including, but without limitation, to acts of God, explosion, flood, forceful wind, fire or accident, war or threat of war declared or undeclared, acts of terrorism, sabotage, insurrection, riots, strikes, civil disturbance, sickness, epidemics, pandemics, quarantines, government intervention, weather conditions, defects in machinery and vehicles, delays or other unforeseeable event), we shall not be deemed to be in breach of these terms and conditions or otherwise be liable to you, and shall not provide any refund, by reason of delay in performance, or by non-performance, of any of our obligations hereunder to the extent that any such delay or non-performance is due to any force majeure. If our agency, and/or any of our travel suppliers, are affected by force majeure, they shall be entitled to, and may in their sole and absolute discretion, vary or cancel any itinerary or arrangement in relation to your trip." className="form-control"/>
		<field type="select" label="undefined" name="accept" className="form-control">
			<option label="Yes, I read the terms &amp; conditions." value="yes-i-read-the-terms-conditions" selected="selected">Yes, I read the terms &amp; conditions.</option>
			<option label="Option 2" value="option-2">Option 2</option>
			<option label="Option 3" value="option-3">Option 3</option>
		</field>
		<field type="textarea" label="CARDHOLDER AUTHORIZATION" name="cardholder-authorization" value="I have authorized Jana Huse with Travelooza to charge deposits/trip costs as listed below by processing with the appropriate Supplier to my credit card as detailed below:" className="form-control"/>
		<field type="text" label="Payment Amount authorized for the Initial Deposit." description="The deposit is the amount required to initiate a reservation on your behalf. This has been provided on the quote sent over prior to booking." name="payment-amount-authorized-for-the-initial-deposit" subtype="text" className="form-control"/>
		<field type="text" label="Remaining Balance authorized to be charged to this card by final payment deadline." description="This is the total remaining balance due. If unsure of the amount  enter 0.00. **If you intend to pay using a different card for final payment  a new credit card authorization form is required to be submitted at least 48 hours before the final payment due date." name="text-1650312531071" subtype="text" className="form-control"/>
		<field type="text" label="Date you want monthly payment to start, if any:" description="MM/DD/YYYY" name="date-you-want-monthly-payment-to-start-if-any" subtype="text" className="form-control"/>
		<field type="textarea" label="Comments/Questions:" name="commentsquestions" className="form-control"/>
	</fields>
</form-template>
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By signing below, I authorize TRAVELOOZA to charge deposits/trip costs as listed below by processing with the appropriate Supplier to my credit card as detailed.

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