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<html> <body> <form-template> <fields> <field type="paragraph" subtype="p" label="Bali is calling! š“āØ"/> <field type="paragraph" subtype="p" label="Dream Destinations by Asanteā is planning an unforgettable group experience to Bali, Indonesia in October 2028, and Iām currently gathering interest from travelers who may want to join us."/> <field type="paragraph" subtype="p" label="This is an interest form only and does not reserve your space."/> <field type="paragraph" subtype="p" label="Complete the form below so I can learn more about your travel needs, room preferences, budget readiness, and overall interest in the trip."/> <field type="paragraph" subtype="p" label="Travelers who indicate they are ready to move forward will receive information on the next steps to officially book and submit their deposit."/> <field type="header" subtype="h3" label="TRAVELER INFORMATION"/> <field type="header" subtype="h2" label="Full name"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <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" label="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-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="text" required="true" label="City &amp; State" name="text-1789173496217" subtype="text" className="form-control"/> <field type="header" subtype="h3" label="WHOāS TRAVELING?"/> <field type="radio-group" required="true" label="How many people are you interested in traveling with?" name="radio-group-1789173566298"> <option label="Just me" value="just-me">Just me</option> <option label="2 travelers" value="2-travelers">2 travelers</option> <option label="3 travelers" value="3-travelers">3 travelers</option> <option label="More than 3 travelers" value="more-than-3-travelers">More than 3 travelers</option> </field> <field type="radio-group" required="true" label="What type of room occupancy are you interested in?" name="radio-group-1789173660466"> <option label="Single Occupancy ā Just me" value="single-occupancy-just-me">Single Occupancy ā Just me</option> <option label="Double Occupancy ā 2 people in the room" value="double-occupancy-2-people-in-the-room">Double Occupancy ā 2 people in the room</option> <option label="Triple Occupancy ā 3 people in the room" value="triple-occupancy-3-people-in-the-room">Triple Occupancy ā 3 people in the room</option> <option label="Not sure yet" value="not-sure-yet">Not sure yet</option> </field> <field type="radio-group" required="true" label="Do you already know who you will be rooming with?" name="radio-group-1789173736993"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Not sure yet" value="not-sure-yet">Not sure yet</option> </field> <field type="header" subtype="h3" label="ROOMMATE MATCHING" className="field-hidden"/> <field type="radio-group" required="true" label="If you are traveling alone, would you be interested in being matched with a roommate?" description="Roommate matching may be offered as a courtesy to travelers interested in sharing accommodations. A roommate match is not guaranteed and will be based on availability and compatibility.If a suitable roommate is not available or a roommate cancels the traveler may be responsible for the applicable single-occupancy rate." name="radio-group-1789173882398"> <option label="Yes, Iām interested in a roommate match" value="yes-im-interested-in-a-roommate-match">Yes, Iām interested in a roommate match</option> <option label="Maybe ā Iād like more information" value="maybe-id-like-more-information">Maybe ā Iād like more information</option> <option label="No, I prefer my own room" value="no-i-prefer-my-own-room">No, I prefer my own room</option> <option label="No, I already have a roommate" value="no-i-already-have-a-roommate">No, I already have a roommate</option> <option label="Not applicable" value="not-applicable">Not applicable</option> </field> <field type="radio-group" required="true" label="What is your preferred bedding arrangement?" name="radio-group-1789174201886" className="field-hidden"> <option label="Separate beds required" value="separate-beds-required">Separate beds required</option> <option label="Iām flexible" value="im-flexible">Iām flexible</option> <option label="Not sure" value="not-sure">Not sure</option> </field> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789174279726" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTczODgyMzk4Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Inllcy1pbS1pbnRlcmVzdGVkLWluLWEtcm9vbW1hdGUtbWF0Y2giLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiaGVhZGVyLTQiLCJyYWRpby1ncm91cC0xNzg5MTc0MjAxODg2Il0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoiaGVhZGVyLTQiLCJsYWJlbCI6IlJPT01NQVRFIE1BVENISU5HIn0seyJuYW1lIjoicmFkaW8tZ3JvdXAtMTc4OTE3NDIwMTg4NiIsImxhYmVsIjoiV2hhdCBpcyB5b3VyIHByZWZlcnJlZCBiZWRkaW5nIGFycmFuZ2VtZW50PyJ9XX0="/> <field type="radio-group" required="true" label="Which best describes you when traveling?" name="radio-group-1789174493745" className="field-hidden"> <option label="Early riser / early sleeper" value="early-riser-early-sleeper">Early riser / early sleeper</option> <option label="Night owl" value="night-owl">Night owl</option> <option label="Somewhere in between" value="somewhere-in-between">Somewhere in between</option> <option label="Very flexible" value="very-flexible">Very flexible</option> </field> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789174551194" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTczODgyMzk4Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Inllcy1pbS1pbnRlcmVzdGVkLWluLWEtcm9vbW1hdGUtbWF0Y2giLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicmFkaW8tZ3JvdXAtMTc4OTE3NDQ5Mzc0NSJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InJhZGlvLWdyb3VwLTE3ODkxNzQ0OTM3NDUiLCJsYWJlbCI6IldoaWNoIGJlc3QgZGVzY3JpYmVzIHlvdSB3aGVuIHRyYXZlbGluZz8ifV19"/> <field type="radio-group" required="true" label="What type of roommate would you prefer?" name="radio-group-1789174603783" className="field-hidden"> <option label="Social and outgoing" value="social-and-outgoing">Social and outgoing</option> <option label="Quiet and laid-back" value="quiet-and-laidback">Quiet and laid-back</option> <option label="No preference" value="no-preference">No preference</option> <option label="Somewhere in between" value="somewhere-in-between">Somewhere in between</option> </field> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789174665169" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTczODgyMzk4Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Inllcy1pbS1pbnRlcmVzdGVkLWluLWEtcm9vbW1hdGUtbWF0Y2giLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicmFkaW8tZ3JvdXAtMTc4OTE3NDYwMzc4MyJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InJhZGlvLWdyb3VwLTE3ODkxNzQ2MDM3ODMiLCJsYWJlbCI6IldoYXQgdHlwZSBvZiByb29tbWF0ZSB3b3VsZCB5b3UgcHJlZmVyPyJ9XX0="/> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789175147596" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTczODgyMzk4Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Inllcy1pbS1pbnRlcmVzdGVkLWluLWEtcm9vbW1hdGUtbWF0Y2giLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicmFkaW8tZ3JvdXAtMTc4OTE3NTExMjIwNSJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InJhZGlvLWdyb3VwLTE3ODkxNzUxMTIyMDUiLCJsYWJlbCI6IkRvIHlvdSBzbW9rZT8ifV19"/> <field type="radio-group" required="true" label="Do you smoke?" name="radio-group-1789175112205" className="field-hidden"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" required="true" label="Please list any roommate preferences, concerns, or dealbreakers we should know about." name="textarea-1789175210108" className="form-control field-hidden"/> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789175229362" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTczODgyMzk4Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Inllcy1pbS1pbnRlcmVzdGVkLWluLWEtcm9vbW1hdGUtbWF0Y2giLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsidGV4dGFyZWEtMTc4OTE3NTIxMDEwOCJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InRleHRhcmVhLTE3ODkxNzUyMTAxMDgiLCJsYWJlbCI6IlBsZWFzZSBsaXN0IGFueSByb29tbWF0ZSBwcmVmZXJlbmNlcywgY29uY2VybnMsIG9yIGRlYWxicmVha2VycyB3ZSBzaG91bGQga25vdyBhYm91dC4ifV19"/> <field type="header" subtype="h3" label="PASSPORT &amp; INTERNATIONAL TRAVEL"/> <field type="radio-group" required="true" label="Do you currently have a valid passport?" name="radio-group-1789175415027"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Expired-I plan to obtain/renew mine before the trip" value="expiredi-plan-to-obtainrenew-mine-before-the-trip">Expired-I plan to obtain/renew mine before the trip</option> </field> <field type="radio-group" required="true" label="Have you traveled internationally before?" name="radio-group-1789175482073"> <option label="Yes" value="yes">Yes</option> <option label="No ā Bali would be my first international trip" value="no-bali-would-be-my-first-international-trip">No ā Bali would be my first international trip</option> </field> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789176388036" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTc1NDE1MDI3Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Im5vIiwidGhlbkFjdGlvbiI6ImhpZGUiLCJ0aGVuRmllbGRzIjpbInJhZGlvLWdyb3VwLTE3ODkxNzU0ODIwNzMiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJyYWRpby1ncm91cC0xNzg5MTc1NDgyMDczIiwibGFiZWwiOiJIYXZlIHlvdSB0cmF2ZWxlZCBpbnRlcm5hdGlvbmFsbHkgYmVmb3JlPyJ9XX0="/> <field type="radio-group" required="true" label="Have you ever taken a long-haul international flight?" name="radio-group-1789176504311" className="field-hidden"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Not sure what is considered long-haul" value="not-sure-what-is-considered-longhaul">Not sure what is considered long-haul</option> </field> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789176547438" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTc1NDgyMDczIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJyYWRpby1ncm91cC0xNzg5MTc2NTA0MzExIl0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoicmFkaW8tZ3JvdXAtMTc4OTE3NjUwNDMxMSIsImxhYmVsIjoiSGF2ZSB5b3UgZXZlciB0YWtlbiBhIGxvbmctaGF1bCBpbnRlcm5hdGlvbmFsIGZsaWdodD8ifV19"/> <field type="header" subtype="h3" label="FLIGHT EXPECTATIONS āļø"/> <field type="paragraph" subtype="p" label="Flights are not included in the land package and will be purchased separately.Travelers flying from the United States should prepare for a significant international flight investment. From Houston airfare could be approximately $1,500+ per person, depending on airline, routing, cabin, and when flights are purchased.Flights to Bali will also involve at least one connection, and some return itineraries may involve multiple connections.Knowing this, how comfortable are you with budgeting separately for airfare?I understand and am prepared to budget for airfareIāll need time to save for airfareIām interested, but airfare may affect my decisionI need more information before deciding"/> <field type="header" subtype="h3" label="YOUR BALI INTEREST"/> <field type="checkbox-group" required="true" label="What makes you interested in traveling to Bali?" description="Select all that apply." name="checkbox-group-1789177510988"> <option label="Bali is on my bucket list" value="bali-is-on-my-bucket-list">Bali is on my bucket list</option> <option label="Culture and sightseeing" value="culture-and-sightseeing">Culture and sightseeing</option> <option label="Beaches and relaxation" value="beaches-and-relaxation">Beaches and relaxation</option> <option label="Adventure and excursions" value="adventure-and-excursions">Adventure and excursions</option> <option label="Food and local experiences" value="food-and-local-experiences">Food and local experiences</option> <option label="Traveling with a group" value="traveling-with-a-group">Traveling with a group</option> <option label="Celebrating a special occasion" value="celebrating-a-special-occasion">Celebrating a special occasion</option> <option label="I just want an unforgettable international experience" value="i-just-want-an-unforgettable-international-experience">I just want an unforgettable international experience</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="Have you been to Bali before?" name="radio-group-1789177783982" className="field-hidden"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1789177825021" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzg5MTc1NDgyMDczIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJyYWRpby1ncm91cC0xNzg5MTc3NzgzOTgyIl0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoicmFkaW8tZ3JvdXAtMTc4OTE3Nzc4Mzk4MiIsImxhYmVsIjoiSGF2ZSB5b3UgYmVlbiB0byBCYWxpIGJlZm9yZT8ifV19"/> <field type="header" subtype="h3" label="HOW SERIOUS ARE YOU ABOUT BALI 2028? š"/> <field type="radio-group" required="true" label="Which statement best describes you right now?" name="radio-group-1789177965842"> <option label="Iām ready to move forward and pay the $100 per person deposit" value="im-ready-to-move-forward-and-pay-the-100-per-person-deposit">Iām ready to move forward and pay the $100 per person deposit</option> <option label="Iām interested ā Iām working on my budget" value="im-interested-im-working-on-my-budget">Iām interested ā Iām working on my budget</option> <option label="Iām just gathering information for now" value="im-just-gathering-information-for-now">Iām just gathering information for now</option> </field> <field type="header" subtype="h3" label="DEPOSIT &amp; PAYMENT PLANNING"/> <field type="paragraph" subtype="p" label="The initial deposit to reserve your space is expected to be $100 per person. One of the advantages of planning this far in advance is having plenty of time to make payments toward your trip."/> <field type="checkbox-group" label="If you decide to book, how would you prefer to pay for your trip?" name="checkbox-group-1789178127539"> <option label="Make monthly payments" value="make-monthly-payments">Make monthly payments</option> <option label="Make payments whenever I have extra funds" value="make-payments-whenever-i-have-extra-funds">Make payments whenever I have extra funds</option> <option label="Pay larger amounts periodically" value="pay-larger-amounts-periodically">Pay larger amounts periodically</option> <option label="Pay most or all of it at once" value="pay-most-or-all-of-it-at-once">Pay most or all of it at once</option> <option label="Iām not sure yet" value="im-not-sure-yet">Iām not sure yet</option> </field> <field type="header" subtype="h3" label="STAY IN THE KNOW"/> <field type="radio-group" required="true" label="Would you like to receive Bali 2028 updates, pricing, booking information, and important announcements from Dream Destinations by Asanteā?" name="radio-group-1789178257950"> <option label="Yes, keep me updated!" value="yes-keep-me-updated">Yes, keep me updated!</option> <option label="No, not at this time" value="no-not-at-this-time">No, not at this time</option> </field> <field type="header" subtype="h3" label="ANYTHING ELSE?"/> <field type="textarea" label="Is there anything you'd like me to know about your interest in Bali or anything you're hoping to experience on this trip?" name="textarea-1789178334655" className="form-control"/> <field type="header" subtype="h2" label="WHAT HAPPENS NEXT?"/> <field type="paragraph" subtype="p" label="Thank you for joining the Bali 2028 Interest List! š“Submitting this form does not reserve your room or guarantee availability. If you indicated that you are ready to move forward and submit your $100 per person deposit be on the lookout for your next steps from Dream Destinations by Asanteā. Those who are still working on their budget or gathering information will remain on the Bali Interest List and receive important trip updates as details are released. Bali 2028 is going to be an experience. Are you coming with us? š®š©āØDream Destinations by Asanteā"/> </fields> </form-template> </body> </html>
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Air Mauritius (Kestrelflyer)
Frasers Hospitality (Fraser World)
AirBerlin (business points)
Park-N-Go (Frequent Parker Rewards)
Localiza Rent a Car
Jurys Inn (Jurys Rewards)
Air Caraibes (Preference)
Bulgaria Air (Fly More)
Air Niugini (Destinations)
TUIfly.com
Cebu Pacific (Getgo)
Premier Hotels (Premier Club)
Jet2.com (My Jet2)
Air Austral (My Capricorne)
CAT (C-Club)
Opinion Miles Club
Ural Airlines (Wings)
Air Europa (SUMA)
Monarch (Vantage Club)
Stena Line (Extra)
La Compagnie (My Compagnie)
First Hotels (First Member)
Belavia (Leader)
Azerbaijan Airlines (Azal Miles)
Wizz Air (Discount Club)
Tunisair (Fidelys)
Paradores (Amigos de Paradores)
Vistara (Vistara Club)
Montenegro Airlines (Vision Team)
Asky Airlines (ASKY Club)
Jinling Hotels (Elite)
Moby Lines (Moby Club)
Jin Jiang Group (J-Club)
AtlasGlobal (AtlasMiles)
Qubus Hotel (Q-Club)
Braathens Regional Airlines (BRA Friends )
Hotelbooker.org
Flynas (NaSmiles)
Czech Airlines (OK Plus Corporate)
Uzbekistan Airways (UzAirPlus)
TAAG Angola Airlines (Umbi Umbi Club)
Yelloh! Village (Yelloh! Plus)
Future Inns (Rewards Club)
Nordavia (Golden Mile)
Air Arabia (Airewards)
Royal Brunei Airlines (Royal Skies)
Leonardo Hotels (AdvantageCLUB)
Air Moldova Club
Air Cote D'Ivoire (sMiles)
Air Macau (Privileges)
Etihad (BusinessConnect)
Gloria Hotels & Resorts (Gloria Partner)
Santos Hotels (Club Santos)
Known Traveler Number (KTN)
Global Entry ID
TSA PreCheck
NEXUS ID
SENTRI ID
American Automative Association (AAA)
Sandals Select Guest (SSG)
Mandarin Oriental Fan
Relais and Chateaux 5C
Four Seasons Preferred
Dorchester Diamond
Peninsula Pen
Belmond Bellini
Silversea Venetian
Oceania Cruise Lines
Regent Cruise Line
Seabourn Cruise Line
Lindblad Expeditions
SeaDream Yacht Club
Cunard
Virgin Voyages Sailing Club
AmaWaterways
Type
Draw
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