TravelJoy

Marilyn Scott

Destinations For You Travel

202704 - Thailand

Apr 6, 2027 to Apr 15, 2027

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Reservation Form - Thailand"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="radio-group" required="true" label="Total Number of Guests in Room&amp;nbsp;" description="everyone staying in the room" name="total-number-of-guests-in-room-">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Roommate Name - enter N/A if you do not have one" name="roommate-name-enter-na-if-you-do-not-have-one" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How many travelers you are registering:" name="how-many-travelers-you-are-paying-for">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="WARNING: You are booking a Single Occupancy room . If this is not correct please select the correct number of guests in room.&amp;nbsp;" className="field-hidden"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;---------------------------"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1773118995804" rule="eyJ3aGVuRmllbGQiOiJ0b3RhbC1udW1iZXItb2YtZ3Vlc3RzLWluLXJvb20tIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6IjEiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicGFyYWdyYXBoLTIiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJwYXJhZ3JhcGgtMiIsImxhYmVsIjoiV0FSTklORzogWW91IGFyZSBib29raW5nIGEgU2luZ2xlIE9jY3VwYW5jeSByb29tIC4gSWYgdGhpcyBpcyBub3QgY29ycmVjdCBwbGVhc2Ugc2VsZWN0IHRoZSBjb3JyZWN0IG51bWJlciBvZiBndWVzdHMgaW4gcm9vbS4mbmJzcDsifV19"/>&#13;
		<field type="header" subtype="h1" label="RESERVATION DETAILS"/>&#13;
		<field type="radio-group" required="true" label="Length of Trip" name="do-all-guests-included-on-this-reservation-reside-in-the-same-house">&#13;
			<option label="8D/7N Core Trip Bangkok and Chiang Mai" value="8d7n-core-trip-bangkok-and-chiang-mai">8D/7N Core Trip Bangkok and Chiang Mai</option>&#13;
			<option label="11D/10N Full Trip: Bangkok, Chiang Mai and Koh Samui" value="11d10n-full-trip-bangkok-chiang-mai-and-koh-samui">11D/10N Full Trip: Bangkok, Chiang Mai and Koh Samui</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp; &amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="header" subtype="h3" label="Primary Guest"/>&#13;
		<field type="text" required="true" label="First name (**Must be as it appears on Passport**)" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name (**Must be as it appears on Passport**)" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" name="gender">&#13;
			<option label="Male" value="male">Male</option>&#13;
			<option label="Female" value="female">Female</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="State of Residence" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" 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="radio-group" required="true" label="T-Shirt Size" name="tshirt-size" other="true">&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="XLarge" value="xlarge">XLarge</option>&#13;
			<option label="Medium" value="medium">Medium</option>&#13;
			<option label="Small" value="small">Small</option>&#13;
			<option label="XXLarge" value="xxlarge">XXLarge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Guest 2"/>&#13;
		<field type="text" label="Guest 2: First Name (**Must be as it appears on Passport**)" name="text-1771007242371" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: Middle Name (**Must be as it appears on Passport**)" name="text-1771008145516" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: Last Name (**Must be as it appears on Passport**)" name="text-1771007344420" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: State of Residence" name="guest-2-state-of-residence" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: Email Address (**An Email Address is required to add them to the reservation**)" name="text-1771007546902" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Guest 2: Birthday (**Required for travel insurance and to determine if Guest is an adult or child**)" name="date-1771007907943" className="form-control"/>&#13;
		<field type="radio-group" label="Guest 2: Gender" name="guest-2-gender">&#13;
			<option label="Male" value="male">Male</option>&#13;
			<option label="Female" value="female">Female</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="T-Shirt Size" name="radio-group-1782229555478" other="true">&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="XLarge" value="xlarge">XLarge</option>&#13;
			<option label="Medium" value="medium">Medium</option>&#13;
			<option label="Small" value="small">Small</option>&#13;
			<option label="XXLarge" value="xxlarge">XXLarge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Payment Information"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1773191199086" rule="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"/>&#13;
		<field type="header" subtype="h1" label="Guests Paying Separately"/>&#13;
		<field type="radio-group" required="true" label="Are guests paying separately for this reservation?" name="are-guests-paying-separately-for-this-reservation">&#13;
			<option label="No, I will pay the amount that is due now to reserve this reservation." value="no-i-will-pay-the-amount-that-is-due-now-to-reserve-this-reservation">No, I will pay the amount that is due now to reserve this reservation.</option>&#13;
			<option label="Yes, we will pay separately and submit the additional card info " value="yes-we-will-pay-separately-and-submit-the-additional-card-info-">Yes, we will pay separately and submit the additional card info </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Minimum Deposit Amount-$500 per person"/>&#13;
		<field type="paragraph" subtype="p" label="An invoice for the deposit payment will be sent shortly and processed&amp;nbsp; 48-72 hours after you make your reservation.&amp;nbsp; You will receive confirmation, invoice and receipt to the email address you entered."/>&#13;
		<field type="radio-group" required="true" label="Please Select the Option Amount you are Authorizing" name="please-select">&#13;
			<option label="Pay $500 Per Person Now" value="pay-500-per-person-now">Pay $500 Per Person Now</option>&#13;
			<option label="Pay Full Amount of Room Reservation Now (Save 5%)" value="pay-full-amount-of-room-reservation-now-save-5">Pay Full Amount of Room Reservation Now (Save 5%)</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Payment Schedule"/>&#13;
		<field type="checkbox-group" required="true" label="Acknowledge Below (Required)" name="checkbox-group-1771034738287">&#13;
			<option label="I acknowledge that 50% of remaining balance is due September 15th 2026 and the final payment is due by December 15, 2026. Periodic Payments of at least $250 may be made at any time. I understand missed payments could result in my reservation being cancelled. " value="i-acknowledge-that-50-of-remaining-balance-is-due-september-15th-2026-and-the-final-payment-is-due-by-december-15-2026-periodic-payments-of-at-least-250-may-be-made-at-any-time-i-understand-missed-payments-could-result-in-my-reservation-being-cancelled-">I acknowledge that 50% of remaining balance is due September 15th 2026 and the final payment is due by December 15, 2026. Periodic Payments of at least $250 may be made at any time. I understand missed payments could result in my reservation being cancelled. </option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>