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LaTisha Brittingham
Perfect Bliss Vacations
<html> <body> <form-template> <fields> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="How would you prefer to go over your cruise options?" name="how-would-you-prefer-to-go-over-your-cruise-options"> <option label="A face-to-face video call to discuss everything in detail" value="a-facetoface-video-call-to-discuss-everything-in-detail">A face-to-face video call to discuss everything in detail</option> <option label="A detailed proposal with a video walkthrough that you can review on your own time" value="a-detailed-proposal-with-a-video-walkthrough-that-you-can-review-on-your-own-time">A detailed proposal with a video walkthrough that you can review on your own time</option> <option label="A straightforward one-pager with just the essential information to help you decide" value="a-straightforward-onepager-with-just-the-essential-information-to-help-you-decide">A straightforward one-pager with just the essential information to help you decide</option> </field> <field type="header" subtype="h2" label="Let's find the best cruise for YOU!"/> <field type="radio-group" label="Is this your first cruise?" name="is-this-your-first-cruise"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="I'm a cruise PRO!" value="im-a-cruise-pro">I'm a cruise PRO!</option> </field> <field type="checkbox-group" label="The purpose of this cruise vacation is:" name="the-purpose-of-this-cruise-vacation-is"> <option label="Making Memories w/ Family and/or friends" value="making-memories-w-family-andor-friends">Making Memories w/ Family and/or friends</option> <option label="Romance" value="romance">Romance</option> <option label="Just For Fun!" value="just-for-fun">Just For Fun!</option> <option label="Relax & Recharge (Spa?)" value="relax-recharge-spa">Relax & Recharge (Spa?)</option> <option label="Celebrating a Special Occasion" value="celebrating-a-special-occasion">Celebrating a Special Occasion</option> <option label="Exploring new destinations" value="exploring-new-destinations">Exploring new destinations</option> </field> <field type="text" label="Which cruise lines have you sailed with before?" description="if this is your first cruise enter N/A" name="cruise-lines-youve-sailed-before" subtype="text" className="form-control"/> <field type="checkbox-group" label="Which cruise lines would you like us to research for your trip?" name="which-cruise-lines-would-you-like-us-to-research-for-your-trip" other="true"> <option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option> <option label="Carnival" value="carnival">Carnival</option> <option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option> <option label="Virgin Voyages" value="virgin-voyages">Virgin Voyages</option> <option label="Celebrity" value="celebrity">Celebrity</option> <option label="MSC" value="msc">MSC</option> <option label="Holland America" value="holland-america">Holland America</option> <option label="Explora Journeys" value="explora-journeys">Explora Journeys</option> <option label="Silversea" value="silversea">Silversea</option> </field> <field type="text" label="Which ports you prefer to depart from?" description="Examples include Florida, NJ/NY, New Orleans, Texas, Puerto Rico" name="which-ports-you-prefer-to-depart-from" subtype="text" className="form-control"/> <field type="text" label="Are there any ports you would prefer to avoid?" name="are-there-any-ports-you-would-prefer-to-avoid" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are any of these important?" inline="true" name="are-any-of-these-important"> <option label="Casino" value="casino">Casino</option> <option label="Adults-only pool" value="adultsonly-pool">Adults-only pool</option> <option label="Spa" value="spa">Spa</option> <option label="Nightly shows" value="nightly-shows">Nightly shows</option> <option label="Babysitting" value="babysitting">Babysitting</option> <option label="Kids/Teen Club" value="kidsteen-club">Kids/Teen Club</option> <option label="Sports court" value="sports-court">Sports court</option> <option label="Lots of specialty dining venues" value="lots-of-specialty-dining-venues">Lots of specialty dining venues</option> <option label="Rock wall" value="rock-wall">Rock wall</option> <option label="Zipline" value="zipline">Zipline</option> <option label="Flow Rider" value="flow-rider">Flow Rider</option> <option label="Water slide" value="water-slide">Water slide</option> <option label="Visit the cruiseline's private island" value="visit-the-cruiselines-private-island">Visit the cruiseline's private island</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> <option label="Golf" value="golf">Golf</option> </field> <field type="checkbox-group" label="What type of cabin are you interested in? " name="what-type-of-cabin-are-you-interested-in-" other="true"> <option label="We're splurging on a suite because we deserve it!" value="were-splurging-on-a-suite-because-we-deserve-it">We're splurging on a suite because we deserve it!</option> <option label="We'd like to have a balcony where we can enjoy morning coffee in the fresh, sea air" value="wed-like-to-have-a-balcony-where-we-can-enjoy-morning-coffee-in-the-fresh-sea-air">We'd like to have a balcony where we can enjoy morning coffee in the fresh, sea air</option> <option label="We are open to an interior balcony if it is available" value="we-are-open-to-an-interior-balcony-if-it-is-available">We are open to an interior balcony if it is available</option> <option label="As long as we have a window to look out of, we're happy" value="as-long-as-we-have-a-window-to-look-out-of-were-happy">As long as we have a window to look out of, we're happy</option> <option label="An interior cabin is where we get the best sleep (no window)" value="an-interior-cabin-is-where-we-get-the-best-sleep-no-window">An interior cabin is where we get the best sleep (no window)</option> <option label="Tell me about some of the unique cabin options that are available" value="tell-me-about-some-of-the-unique-cabin-options-that-are-available">Tell me about some of the unique cabin options that are available</option> </field> <field type="text" label="What is the price range you are comfortable with? Please specify if it is per person or total." name="what-is-the-price-range-you-are-comfortable-with-please-specify-if-it-is-per-person-or-total" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Practical Information"/> <field type="radio-group" required="true" label="Does everyone in your party have a U.S. Passport that is in good condition (no damage), with at least 2 blank pages (endorsement pages don't count), and does not expire until at least 6 months beyond your intended return date?" name="does-everyone-in-your-party-have-a-us-passport-that-is-in-good-condition-no-damage-with-at-least-2-blank-pages-endorsement-pages-dont-count-and-does-not-expire-until-at-least-6-months-beyond-your-intended-return-date"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="paragraph" subtype="p" label="PLEASE NOTE:&nbsp; Passports may not be required, depending on the itinerary, but we strongly recommend traveling with valid passports in case of emergency.&nbsp; In the case of closed-loop cruises, U.S. citizens are allowed to enter or depart the country with proof of citizenship."/> <field type="paragraph" subtype="p" label="A closed-loop cruise is a cruise that departs and ends in the SAME U.S. port, for example, Cape Liberty, NJ to Cape Liberty, NJ, or round-trip to Alaska from Seattle."/> <field type="paragraph" subtype="p" label="According to U.S. Customs &amp; Border Protection, this includes a government-issued birth certificate (no photocopies or baptismal certificates), AND if 16 or older, a government-issued driver’s license or picture ID denoting photo, name, and date of birth."/> <field type="date" label="Earliest you can depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="earliest-you-can-depart" className="form-control"/> <field type="date" label="Latest you can return?" description="This just gives me a general idea of when you like to return; it can be flexible" name="latest-you-can-return" className="form-control"/> <field type="radio-group" label="Are your dates flexible?" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="How many nights would you like the cruise to be (can be a range)?" description="Typical cruises are 3 4, 5 and 7 days" name="how-many-nights-would-you-like-the-cruise-to-be-can-be-a-range" subtype="text" className="form-control"/> <field type="textarea" label="Number of travelers and their ages?" name="number-of-travelers-and-their-ages" className="form-control"/> <field type="textarea" label="Number of cabins and location preferences - Include which people/ages would be in each room. Would you like then to be connecting, side-by-side or nearby each other?" name="number-of-cabins-and-location-preferences-include-which-peopleages-would-be-in-each-room-would-you-like-then-to-be-connecting-sidebyside-or-nearby-each-other" className="form-control"/> <field type="radio-group" required="true" label="Is anyone in your party pregnant or planning to become pregnant before the cruise?&nbsp;" description="So that we can advise as each cruise line has its own pregnancy policy. All information is private." name="is-anyone-in-your-party-pregnant-or-planning-to-become-pregnant-before-the-cruise-" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="Are there any medical or dietary needs/preferences ? Does anyone in your party have mobility issues I should be aware of?" name="what-else-would-you-like-me-to-know-do-you-have-any-medical-or-dietary-needspreferences-does-anyone-in-your-party-have-mobility-issues-i-should-be-aware-of" className="form-control"/> <field type="radio-group" required="true" label="Is everyone in your party a US citizen?" description="If not we need to know so that we can advise you properly" name="is-everyone-in-your-party-a-us-citizen" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" label="Promotions you qualify for (if available):" name="promotions-you-qualify-for-if-available" other="true"> <option label="Senior (55 or older)" value="senior-55-or-older">Senior (55 or older)</option> <option label="Military" value="military">Military</option> <option label="Fire/EMT/Law Enforcement" value="fireemtlaw-enforcement">Fire/EMT/Law Enforcement</option> <option label="Teacher" value="teacher">Teacher</option> </field> <field type="text" label="What state do you live in?" name="what-state-do-you-live-in" subtype="text" className="form-control"/> <field type="text" label="Who can I thank for referring you? Or how did you hear about our travel agency?" name="how-did-you-hear-about-this-amazing-deal" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="I understand that it is vitally important that I read the information emailed to me by my advisor in order to be prepared for travel in the current climate. I also understand that I share the responsibility of remaining informed about the entry requirements for the destination(s) I am visiting. I will secure all necessary testing/vaccinations and complete all forms required for travel." name="i-understand-that-it-is-vitally-important-that-i-read-the-information-emailed-to-me-by-my-advisor-in-order-to-be-prepared-for-travel-in-the-current-climate-i-also-understand-that-i-share-the-responsibility-of-remaining-informed-about-the-entry-requirements-for-the-destinations-i-am-visiting-i-will-secure-all-necessary-testing-and-complete-all-forms-required-for-travel"> <option label="I agree" value="i-agree">I agree</option> <option label="I do not agree" value="i-do-not-agree">I do not agree</option> </field> </fields> </form-template> </body> </html>
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