Share your information with Jacqueline Greely

Jacqueline Greely

Rhoyalty Destination Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Trip Cancellation Request"/>&#13;
		<field type="paragraph" subtype="p" label="I have agreed to all Terms &amp;amp; Conditions and the Cancellation Policy at the time of purchase.&amp;nbsp; I have previously been advised to obtain travel insurance to protect my trip.&amp;nbsp; The cancellation date will be considered the date I sign and submit this signed form.&amp;nbsp;&amp;nbsp; I agree to submit the cancellation fee of $50 including other fees associated with cancelling this reservation."/>&#13;
		<field type="date" label="Today&#39;s Date" name="todays-date" className="form-control"/>&#13;
		<field type="text" label="Booking Number or Trip Name" name="booking-number-or-trip-name" 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="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Reason for Cancellation" name="reason-for-cancellation" className="form-control"/>&#13;
		<field type="radio-group" label="Did you purchase travel insurance?" name="did-you-purchase-travel-insurance">&#13;
			<option label="Yes - I purchased insurance through my travel advisor" value="yes-i-purchased-insurance-through-my-travel-advisor">Yes - I purchased insurance through my travel advisor</option>&#13;
			<option label="Yes - I purchased insurance through a third party vendor (outside of Rhoyalty Destination Travel)" value="yes-i-purchased-insurance-through-a-third-party-vendor-outside-of-rhoyalty-destination-travel">Yes - I purchased insurance through a third party vendor (outside of Rhoyalty Destination Travel)</option>&#13;
			<option label="No- I declined all travel insurance" value="no-i-declined-all-travel-insurance">No- I declined all travel insurance</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="I understand that by submitting a request for a cancellation there is a non-refundable $50 fee to Rhoyalty Destination Travel due upon request." name="i-understand-that-by-submitting-a-request-for-a-cancellation-there-is-a-nonrefundable-25-fee-to-rhoyalty-destination-travel-due-upon-request">&#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="Furthermore, I understand that additional fees may be assessed and/or non-refundable by the supplier or property." name="furthermore-i-understand-that-additional-fees-may-be-assessed-andor-nonrefundable-by-the-supplier-or-property">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="By submitting this form, I understand that there might be a penality from the tour operator, airline, or hotel involved with this cancellation.&amp;nbsp; It is important to refer to policy documents in regards to &quot;covered reasons&quot; and understand that it is my responsibility to submit all appropriate documentation for the insurance claim."/>&#13;
		<field type="paragraph" subtype="p" label="IMPORTANT: If you have purchased travel insurance through an outside company and not through Rhoyalty Destination Travel, we will provide the cancellation documentation required and it will be your responsibility to file with the insurance company directly."/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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