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="This form should only be used by those who are using their Dubai Travel Credit. If you are not using the credit please return to the booking page and select the other booking link."/>&#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="eyJ3aGVuRmllbGQiOiJ0b3RhbC1udW1iZXItb2YtZ3Vlc3RzLWluLXJvb20tIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6IjEiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicGFyYWdyYXBoLTMiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJwYXJhZ3JhcGgtMyIsImxhYmVsIjoiV0FSTklORzogWW91IGFyZSBib29raW5nIGEgU2luZ2xlIE9jY3VwYW5jeSByb29tIC4gSWYgdGhpcyBpcyBub3QgY29ycmVjdCBwbGVhc2Ugc2VsZWN0IHRoZSBjb3JyZWN0IG51bWJlciBvZiBndWVzdHMgaW4gcm9vbS4mbmJzcDsifV19"/>&#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="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="ACCEPTANCE AND SIGNATURE"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

By completing and submitting this form I agree to using my Future Travel Credit as payment for this trip:

The FTC will only apply to my individual travel costs

The FTC is strictly a credit and does not have a cash-value.
The FTC does not include any penalties or fees imposed.
The FTC Is a one-time use.
- If my selected experience is less than the FTC amount, any remaining balance will be forfeited.
- If my experience exceeds the FTC amount, the remaining balance will be my responsibility and subject to the standard payment terms.

I consent to provide an electronic typed signature rather than a handwritten signature. By submitting my typed signature I understand that my electronic signature will be binding as though I had physically signed this document by hand.

Click to sign