TravelJoy

Sherrelle D. Russell

LC Scursion Travel

Secured Passport Submission

🔒 Your privacy is our priority. Your passport will be used only for travel booking purposes and will not be shared or used for any other reason.

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Secured Passport Information Submission"/>&#13;
		<field type="date" required="true" label="Date Field" name="date-1754271527047" className="form-control"/>&#13;
		<field type="text" required="true" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" 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="header" subtype="h1" label="🔒 Your information is secure. All documents are stored safely and used only for travel-related purposes."/>&#13;
		<field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Acknowledgement Of Submission" name="i-understand-that-my-passport-will-be-securely-stored-and-used-solely-for-booking-and-travel-documentation-purposes">&#13;
			<option label="I understand that my passport will be securely stored and used solely for booking and travel documentation purposes." value="i-understand-that-my-passport-will-be-securely-stored-and-used-solely-for-booking-and-travel-documentation-purposes">I understand that my passport will be securely stored and used solely for booking and travel documentation purposes.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>