TravelJoy

Terri Moore

Far Moore Travel

2023- Australia: Melbourne and Sydney

Oct 29, 2023 to Nov 10, 2023

Australia: Melbourne and Sydney

<html>
  <body>
    <form-template>&#13;
	<fields>&#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="Departure Airport" name="departure-airport" other="true">&#13;
			<option label="Washington Reagan (DCA)" value="washington-reagan-dca">Washington Reagan (DCA)</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="text" label="Known Traveler Number (TSA Pre-Check or Global Entry)" name="known-traveler-numbertsa-precheck" subtype="text" 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="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="header" subtype="h1" label="Optional Add-Ons:"/>&#13;
		<field type="checkbox-group" required="true" label="Travel Insurance- Starting at $250 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;
		<field type="checkbox-group" label="Air Seat Upgrade (rate and availability subject to change until confirmed)" description="Additional deposit of $200 for Premium Economy and $300 for Business Class" name="air-seat-upgrade-rate-and-availability-subject-to-change-until-confirmed">&#13;
			<option label="Premium Economy" value="premium-economy">Premium Economy</option>&#13;
			<option label="Business Class" value="business-class">Business Class</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Golf ($200 per round)" name="golf-200-per-round">&#13;
			<option label="1 Round" value="1-round">1 Round</option>&#13;
			<option label="2 Rounds" value="2-rounds">2 Rounds</option>&#13;
			<option label="3 Rounds" value="3-rounds">3 Rounds</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Tour: Spirit of Melbourne Dinner Cruise- $130" name="tour-spirit-of-melbourne-dinner-cruise-130">&#13;
			<option label="Accepted" value="accepted">Accepted</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Tour: Melbourne Yarra Valley Wine and Winery Tour- $110" name="tour-melbourne-yarra-valley-wine-and-winery-tour-110">&#13;
			<option label="Accepted" value="accepted">Accepted</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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