Share your information with Alexandra Sherman

Alexandra Sherman

Travelmation LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Acknowledgement Required:"/>&#13;
		<field type="checkbox-group" required="true" label="By completing this form I certify that I am not working with another Travel Agent/Advisor or booking directly." name="by-completing-this-form-i-certify-that-i-am-not-working-with-another-travel-agentadvisor-or-booking-directly">&#13;
			<option label="I acknowledge" value="i-acknowledge">I acknowledge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Contact 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="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-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="checkbox-group" required="true" label="Preferred Method of Contact" inline="true" name="preferred-method-of-contact">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Trip Information"/>&#13;
		<field type="checkbox-group" label="Are you celebrating a special occasion on this trip?" name="are-you-celebrating-a-special-occasion-on-this-trip" other="true">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Wedding" value="wedding">Wedding</option>&#13;
			<option label="Bachelor/Bachelorette Party" value="bachelorbachelorette-party">Bachelor/Bachelorette Party</option>&#13;
			<option label="Graduation" value="graduation">Graduation</option>&#13;
			<option label="Family Reunion" value="family-reunion">Family Reunion</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Preferred Destination" name="preferred-destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Preferred Check-In Date" name="preferred-checkin-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Preferred Check-Out Date" name="preferred-checkout-date" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" inline="true" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How many guests ages 18 or older?" placeholder="Select One" name="how-many-guests-ages-18-or-older" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6+" value="6">6+</option>&#13;
		</field>&#13;
		<field type="select" label="How many guests ages 0-17?" placeholder="Select One" name="how-many-guests-ages-1017" className="form-control">&#13;
			<option label="0" value="0">0</option>&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6+" value="6">6+</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How many rooms would you like to book?" placeholder="Select One" name="select-1727830394967" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5+" value="5">5+</option>&#13;
		</field>&#13;
		<field type="textarea" label="First &amp;amp; Last Names of all Guests and Ages at Time of Travel for Guests Under 18" name="first-last-names-for-all-guests-and-birthdates-for-all-guests-under-18" rows="3" className="form-control"/>&#13;
		<field type="select" required="true" label="Estimated budget without airfare" placeholder="Select One" name="select-1726350309296" className="form-control">&#13;
			<option label="Under $500" value="under-500">Under $500</option>&#13;
			<option label="$500 - $1,500" value="500-1500">$500 - $1,500</option>&#13;
			<option label="$1,500 - $3,000" value="1500-3000">$1,500 - $3,000</option>&#13;
			<option label="$3,000 - $45,000" value="3000-45000">$3,000 - $45,000</option>&#13;
			<option label="$45,000+" value="45000">$45,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Is anyone in your party eligible for any of the following possible discounts?" name="are-you-eligible-for-any-of-the-following-possible-discounts" other="true">&#13;
			<option label="Loyalty Member" value="loyalty-member">Loyalty Member</option>&#13;
		</field>&#13;
		<field type="clientLoyaltyPrograms" label="If Loyalty Member, include number(s)" 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="Preferred Hotel Brand(s)" name="preferred-resorthotel" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred Room Type" name="text-1727831619751" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Additional Room Requests" name="additional-options" other="true">&#13;
			<option label="Roll-away Bed" value="rollaway-bed">Roll-away Bed</option>&#13;
			<option label="Crib" value="crib">Crib</option>&#13;
			<option label="Connecting Rooms" value="connecting-rooms">Connecting Rooms</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Will anyone in your travel party require accessibility accommodations?" placeholder="Select One" name="will-anyone-in-your-travel-party-require-handicap-accessible-accommodations" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Maybe" value="maybe">Maybe</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Preferred Amenities" name="checkbox-group-1727831862480" other="true">&#13;
			<option label="Free Breakfast" value="free-breakfast">Free Breakfast</option>&#13;
			<option label="Indoor Pool" value="indoor-pool">Indoor Pool</option>&#13;
			<option label="Outdoor Pool" value="outdoor-pool">Outdoor Pool</option>&#13;
			<option label="Fitness Center" value="fitness-center">Fitness Center</option>&#13;
			<option label="Valet Parking" value="valet-parking">Valet Parking</option>&#13;
			<option label="Free Self-Parking" value="free-selfparking">Free Self-Parking</option>&#13;
			<option label="Pet-Friendly" value="petfriendly">Pet-Friendly</option>&#13;
			<option label="Kitchen/Kitchenette" value="kitchenkitchenette">Kitchen/Kitchenette</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Additional Requests" name="checkbox-group-1727831925598" other="true">&#13;
			<option label="Dining Reservations" value="dining-reservations">Dining Reservations</option>&#13;
			<option label="Activities/Tours/Admissions/Events" value="activitiestoursadmissionsevents">Activities/Tours/Admissions/Events</option>&#13;
			<option label="Meeting/Event Space" value="meetingevent-space">Meeting/Event Space</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Transportation Needed" name="transportation-needed" other="true">&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Shuttle/Car Service from Airport to Hotel Round Trip" value="shuttlecar-service-from-airport-to-hotel-round-trip">Shuttle/Car Service from Airport to Hotel Round Trip</option>&#13;
			<option label="Rental Car" value="rental-car">Rental Car</option>&#13;
		</field>&#13;
		<field type="text" label="Departure Airport" name="departure-airport" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are you interested in travel insurance?&amp;nbsp;" name="are-you-interested-in-travel-insurance-">&#13;
			<option label="Yes" value="yes" selected="selected">Yes</option>&#13;
			<option label="Maybe" value="maybe">Maybe</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything additional you would like to include in your vacation package?" name="anything-additional-you-would-like-to-include-in-your-vacation-package" className="form-control"/>&#13;
		<field type="textarea" label="Please provide any additional information I need to know about this trip" name="please-provide-any-additional-information-i-need-to-know-about-this-trip" className="form-control"/>&#13;
		<field type="text" label="Who may I thank for referring you?" name="referred-by" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Travel advisors are only compensated for their time and expertise when their clients book AND complete their travel. TAs receive no payment for quotes but are compensated by the resorts, tour providers, and destinations for serving our mutual clients.&amp;nbsp;" inline="true" name="checkbox-group-1767156486699">&#13;
			<option label="I understand that Alexandra is not compensated for her time until I complete my travels on a booking executed by her." value="i-understand-that-alexandra-is-not-compensated-for-her-time-until-i-complete-my-travels-on-a-booking-executed-by-her">I understand that Alexandra is not compensated for her time until I complete my travels on a booking executed by her.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>