TravelJoy

Leticia Annett

Letty's Cuba Travel & Tours

Request for Travel to Cuba

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Traveler Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-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="radio-group" required="true" label="Are you a Travel Agent/Travel Advisor?" name="are-you-a-travel-agenttravel-advisor">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Agency Name" name="agency-name" 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="text" required="true" label="How many&amp;nbsp; people are traveling?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How Many Children Are Traveling Below the Age of 15 years old?" name="how-many-children-are-traveling-below-the-age-of-15-years-old" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Does everyone have a passport that is expiring 6 months or greater from your return date?" name="passport-expiring">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Does anyone traveling have Allergies? If Yes, please list allergy's name(s)." name="allergies" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Trip Information"/>&#13;
		<field type="text" required="true" label="Where would you like to go?" description="If you're not sure  just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your estimated budget PER PERSON?" name="budget-pp" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Which Cuba Travel Package are you interested in?" name="what-type-of-trip-do-you-prefer" other="true">&#13;
			<option label="4 Days Weekend Females Only Group" value="4-days-weekend-females-only-group">4 Days Weekend Females Only Group</option>&#13;
			<option label="5 Days Havana Highlights Group" value="5-days-havana-highlights-group">5 Days Havana Highlights Group</option>&#13;
			<option label="5 Days Havana and Splendid Varadero Beach Group" value="5-days-havana-and-splendid-varadero-beach-group">5 Days Havana and Splendid Varadero Beach Group</option>&#13;
			<option label="5 Days Havana and Breathtaking Viñales Group" value="5-days-havana-and-breathtaking-viales-group">5 Days Havana and Breathtaking Viñales Group</option>&#13;
			<option label="6 Days Havana, Best of Cuba" value="6-days-havana-best-of-cuba">6 Days Havana, Best of Cuba</option>&#13;
			<option label="4 Days Weekend Anytime Private" value="4-days-weekend-anytime-private">4 Days Weekend Anytime Private</option>&#13;
			<option label="8 Days Ultimate Cuba Anytime Private" value="8-days-ultimate-cuba-anytime-private">8 Days Ultimate Cuba Anytime Private</option>&#13;
			<option label="Customized Package Anytime Private" value="customized-package-anytime-private">Customized Package Anytime Private</option>&#13;
			<option label="Not Sure, Need Help with Suggestions" value="not-sure-need-help-with-suggestions">Not Sure, Need Help with Suggestions</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What best describes your accommodation preferences?" name="hotel-preference" other="true">&#13;
			<option label="Air BNB Accommodation with Private Bathrooms" value="air-bnb-accommodation-with-private-bathrooms">Air BNB Accommodation with Private Bathrooms</option>&#13;
			<option label="5 Star Grand Aston Habana Hotel" value="5-star-grand-aston-habana-hotel">5 Star Grand Aston Habana Hotel</option>&#13;
		</field>&#13;
		<field type="text" label="How Many Double Rooms 1 Bed" name="how-many-rooms-do-you-need" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How Many Double Rooms 2 Beds?" name="how-many-double-rooms-2-beds" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How Many Single Rooms 1 Bed?" name="how-many-single-rooms-1-bed" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Colonial Havana" value="colonial-havana">Colonial Havana</option>&#13;
			<option label="Museums" value="museums">Museums</option>&#13;
			<option label="Private Local Farm" value="private-local-farm">Private Local Farm</option>&#13;
			<option label="Classic Convertible Ride" value="classic-convertible-ride">Classic Convertible Ride</option>&#13;
			<option label="Photoshoot" value="photoshoot">Photoshoot</option>&#13;
			<option label="Cabaret Show" value="cabaret-show">Cabaret Show</option>&#13;
			<option label="Private Community Project (art &amp; music)" value="private-community-project-art-music">Private Community Project (art &amp; music)</option>&#13;
			<option label="Local Beach" value="local-beach">Local Beach</option>&#13;
			<option label="Souvenier, arts &amp; craft shopping" value="souvenier-arts-craft-shopping">Souvenier, arts &amp; craft shopping</option>&#13;
			<option label="Varadero Beach Day Tour (2 hours from Havana)" value="varadero-beach-day-tour-2-hours-from-havana">Varadero Beach Day Tour (2 hours from Havana)</option>&#13;
			<option label="Viñales Day Tour (2 hours from Havana)" value="viales-day-tour-2-hours-from-havana">Viñales Day Tour (2 hours from Havana)</option>&#13;
			<option label="Cienfuegos City (requires one night)" value="cienfuegos-city-requires-one-night">Cienfuegos City (requires one night)</option>&#13;
			<option label="Trinidad City (requires 2 nights)" value="trinidad-city-requires-2-nights">Trinidad City (requires 2 nights)</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Special Events &amp;amp; Instructions"/>&#13;
		<field type="textarea" label="Do you have any special instruction or anything you would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Acknowledgements"/>&#13;
		<field type="radio-group" required="true" label="I understand that airfare is Not Included in my rate." name="i-understand-there-is-a-nonrefundable-design-fee-to-everyone-collected-prior-any-work-down-for-your-trip-this-will-be-discussed-in-detail-during-our-appointment-included-in-the-booking-request-if-you-do-not-accept-i-will-not-book-your-travel-but-youre-welcome-to-book-your-own-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="I understand travel insurance is NOT INCLUDED in my rate." name="i-understand-travel-insurance-is-included-in-my-rate-if-i-do-not-want-travel-insurance-i-must-request-an-insurance-waiver">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>