TravelJoy

Terri Moore

Far Moore Travel

2022 Terri's Birthday Bucket List Greek Island Tour

Jun 23, 2022 to Jul 2, 2022

Santorini/Mykonos/Athens

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="2022 Terri's Birthday Bucket List Vacation Get-A-Way"/>&#13;
		<field type="header" subtype="h3" label="Complete one form per person when you are ready to make your deposit. Enter your Roommate's name in the form, Although a valid passport is required for travel, you do not need to fill in the Passport information in order to submit the reservation form, HOWEVER, you need to enter your &quot;first, middle, and last name (to include Jr. Sr. if applicable) as it will appear on your Passport.&amp;nbsp; &quot;Rates and availability are not guaranteed until booked and are subject to change.&amp;nbsp;"/>&#13;
		<field type="checkbox-group" required="true" label="Package Type" name="package-type">&#13;
			<option label="Tour W/Airfare" value="tour-wairfare">Tour W/Airfare</option>&#13;
			<option label="Tour Without Airfare" value="tour-without-airfare">Tour Without Airfare</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Departure Airport" name="departure-airport" other="true">&#13;
			<option label="Washington Dulles Int'l" value="washington-dulles-intl">Washington Dulles Int'l</option>&#13;
			<option label="N/A" value="na">N/A</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Room Occupancy" name="room-occupancy">&#13;
			<option label="Single (1 person in room)" value="single-1-person-in-room">Single (1 person in room)</option>&#13;
			<option label="Double (2 people in room)" value="double-2-people-in-room">Double (2 people in room)</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Passenger Info"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Middle name" description="If no middle name  type &quot;none&quot;" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" inline="true" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone Number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Roommate(s) Name" name="roommates-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="text" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="file" label="Passport photo" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Emergency Contact Information"/>&#13;
		<field type="text" required="true" label="Emergency Contact Name" name="emergency-contact-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Emergency Contact Number" name="emergency-contact-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="checkbox-group" label="Room Upgrades" description="Based on Availability" name="room-upgrade">&#13;
			<option label="Santorini- Sea View Room (1 Dbl Bed and 1 Sofa Bed Only)- Single Occupancy- $450" value="santorini-sea-view-room-1-dbl-bed-and-1-sofa-bed-only-single-occupancy-450">Santorini- Sea View Room (1 Dbl Bed and 1 Sofa Bed Only)- Single Occupancy- $450</option>&#13;
			<option label="Santorini- Sea View Room (1 Dbl Bed and 1 Sofa Bed Only)- Double Occupancy - $225 per person" value="santorini-sea-view-room-1-dbl-bed-and-1-sofa-bed-only-double-occupancy-225-per-person">Santorini- Sea View Room (1 Dbl Bed and 1 Sofa Bed Only)- Double Occupancy - $225 per person</option>&#13;
			<option label="Mykonos- Superior Ocean View Room (1 King Bed Only)- Single Occupancy- $530" value="mykonos-superior-ocean-view-room-1-king-bed-only-single-occupancy-530">Mykonos- Superior Ocean View Room (1 King Bed Only)- Single Occupancy- $530</option>&#13;
			<option label="Mykonos- Superior Ocean View Room (1 King Bed Only)- Double Occupancy- $265 per person" value="mykonos-superior-ocean-view-room-1-king-bed-only-double-occupancy-265-per-person">Mykonos- Superior Ocean View Room (1 King Bed Only)- Double Occupancy- $265 per person</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen/Twin" value="2-doublequeentwin">2 Double/Queen/Twin</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Middle" value="middle">Middle</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" 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"/>&#13;
		<field type="text" label="Food Allergies" name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Travel Insurance- Starting at $125 per person" description="Exact cost of insurance based on passenger's age and trip cost" name="cancel-for-any-reason-travel-insurance-110-per-person">&#13;
			<option label="Accepted- Please provide Quote" value="accepted-please-provide-quote">Accepted- Please provide Quote</option>&#13;
			<option label="Declined" value="declined">Declined</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Click to sign