Share your information with
Chalya Dugar
Moms at Sea Travel, A Dream Vacations Franchise
<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Let's Start Planning Your Cruise!&nbsp;"/> <field type="paragraph" subtype="p" label="Hello there! I’m excited to learn more about the cruise you’re imagining. Please complete this brief inquiry form so I can better understand what you’re looking for. Once submitted, I’ll review your information and contact you with the next steps."/> <field type="header" subtype="h3" label="Section 1: Guest Information&nbsp;"/> <field type="text" required="true" label="First name" description="As shown on your government-issued identification or passport." name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-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" 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="date" required="true" label="Birthday" description="This information may be used to locate an existing cruise-line loyalty account." name="birthday" className="form-control"/> <field type="radio-group" required="true" label="What is your preferred way to communicate?" description="Email is my primary method of communication because it keeps your vacation details organized and easy for us both to reference." name="radio-group-1784511382148"> <option label="Email - recommended" value="email-recommended">Email - recommended</option> <option label="Phone call, if needed" value="phone-call-if-needed">Phone call, if needed</option> </field> <field type="radio-group" required="true" label="Would you like a text when I've emailed my initial response?" inline="true" name="radio-group-1784511934419"> <option label="Yes, please text me" value="yes-please-text-me">Yes, please text me</option> <option label="No, email is fine" value="no-email-is-fine">No, email is fine</option> </field> <field type="header" subtype="h2" label="Section 2:&nbsp; Your Cruise Plans"/> <field type="checkbox-group" required="true" label="Which cruise line(s) are you interested in?" name="checkbox-group-1784512638511" other="true"> <option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option> <option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option> <option label="Royal Caribbean " value="royal-caribbean-">Royal Caribbean </option> <option label="MSC " value="msc-">MSC </option> <option label="I’m open to your recommendations " value="im-open-to-your-recommendations-">I’m open to your recommendations </option> </field> <field type="text" required="true" label="Have you started researching on your own?&nbsp; Is there a specific ship you have in mind?" name="text-1784513278859" subtype="text" className="form-control"/> <field type="text" required="true" label="Preferred sail date or travel range" description="Example: March 14 2027 or any week in June 2027" name="text-1784513484458" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="How flexible are your travel dates?" name="radio-group-1784513605673"> <option label="My dates are firm." value="my-dates-are-firm">My dates are firm.</option> <option label="I have a little flexibility." value="i-have-a-little-flexibility">I have a little flexibility.</option> <option label="I'm very flexible and would like help finding the best option." value="im-very-flexible-and-would-like-help-finding-the-best-option">I'm very flexible and would like help finding the best option.</option> </field> <field type="text" required="true" label="What state do you live in?" name="text-1784514143528" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="How are you willing to travel to your cruise departure port?" inline="true" name="checkbox-group-1784519098104"> <option label="Drive" value="drive">Drive</option> <option label="Fly" value="fly">Fly</option> <option label="I'm open to either driving or flying" value="im-open-to-either-driving-or-flying">I'm open to either driving or flying</option> <option label="I'm not sure yet." value="im-not-sure-yet">I'm not sure yet.</option> </field> <field type="text" required="true" label="What is your preferred departure port?" description="If you are unsure or open to recommendations you may enter that below." name="text-1784514047038" subtype="text" className="form-control"/> <field type="text" required="true" label="What destination or itinerary are you interested in?" description="Examples may include: Bahamas Caribbean Mexico Alaska Europe, Mediterranean, Australia, etc. If you are unsure enter, Open to recommendations." name="text-1784519854549" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Section 3:&nbsp; Who is traveling?"/> <field type="radio-group" required="true" label="How many guests will be traveling in total?" inline="true" name="radio-group-1784514286677"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7" value="7">7</option> <option label="8" value="8">8</option> <option label="9" value="9">9</option> <option label="10+" value="10">10+</option> </field> <field type="text" required="true" label="Please list the ages of all guests under 18 at the time of sailing." description="If no children are sailing enter N/A." name="text-1784514453230" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Section 4:&nbsp; Cruise Preferences"/> <field type="checkbox-group" required="true" label="What type of cabin or suite would you like to explore?" name="checkbox-group-1784517811926"> <option label="Interior" value="interior">Interior</option> <option label="Ocean view " value="ocean-view-">Ocean view </option> <option label="Balcony (Ocean View)" value="balcony-ocean-view">Balcony (Ocean View)</option> <option label="Neighborhood Balcony " value="neighborhood-balcony-">Neighborhood Balcony </option> <option label="Suite" value="suite">Suite</option> <option label="Cabin accommodating 5+" value="cabin-accommodating-5">Cabin accommodating 5+</option> <option label="Connecting Cabins" value="connecting-cabins">Connecting Cabins</option> <option label="Accessible Cabin" value="accessible-cabin">Accessible Cabin</option> <option label="Cruise line chooses my cabin location (Guarantee Cabin)" value="cruise-line-chooses-my-cabin-location-guarantee-cabin">Cruise line chooses my cabin location (Guarantee Cabin)</option> <option label="I'm open to your recommendation." value="im-open-to-your-recommendation">I'm open to your recommendation.</option> </field> <field type="text" label="How many cabins do you think your traveling party will need?" description="If you're unsure that's okay! The number of cabins may depend on your party size guests' ages cabin availability and how you'd like everyone arranged. You may enter "I'm not sure," and I'll help you explore the available options." name="text-1784517519796" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="These features are important:" description="Choose all that may apply." name="checkbox-group-1784518108336" other="true"> <option label="Waterslides" value="waterslides">Waterslides</option> <option label="Splash area for children in swim diapers" value="splash-area-for-children-in-swim-diapers">Splash area for children in swim diapers</option> <option label="Splash area for potty-trained children" value="splash-area-for-pottytrained-children">Splash area for potty-trained children</option> <option label="Nursery for infants and toddlers" value="nursery-for-infants-and-toddlers">Nursery for infants and toddlers</option> <option label="Kids' or teen clubs" value="kids-or-teen-clubs">Kids' or teen clubs</option> <option label="Adult-only relaxation areas" value="adultonly-relaxation-areas">Adult-only relaxation areas</option> <option label="Lots of included dining options" value="lots-of-included-dining-options">Lots of included dining options</option> <option label="Exciting entertainment and activities" value="exciting-entertainment-and-activities">Exciting entertainment and activities</option> <option label="Private island stop or cruise-line exclusive beach destination" value="private-island-stop-or-cruiseline-exclusive-beach-destination">Private island stop or cruise-line exclusive beach destination</option> <option label="Accessible features or accommodations" value="accessible-features-or-accommodations">Accessible features or accommodations</option> <option label="Exclusive suite areas or upgraded suite benefits" value="exclusive-suite-areas-or-upgraded-suite-benefits">Exclusive suite areas or upgraded suite benefits</option> <option label="No specific features - open to recommendations." value="no-specific-features-open-to-recommendations">No specific features - open to recommendations.</option> </field> <field type="header" subtype="h2" label="Section 5:&nbsp; Loyalty and Potential Offers"/> <field type="checkbox-group" label="Do any of the following apply to someone in your traveling party?" description="Eligibility and available offers vary by cruise line and sailing." inline="true" name="checkbox-group-1784515257177"> <option label="Military" value="military">Military</option> <option label="Law Enforcement" value="law-enforcement">Law Enforcement</option> <option label="EMT/First Responder" value="emtfirst-responder">EMT/First Responder</option> <option label="Firefighter " value="firefighter-">Firefighter </option> <option label="Age 55 or older" value="age-55-or-older">Age 55 or older</option> <option label="None of the options apply to anyone in my party" value="none-of-the-options-apply-to-anyone-in-my-party">None of the options apply to anyone in my party</option> </field> <field type="text" label="Do you have a loyalty number for a cruise line?" description="If applicable please provide the cruise line guest's name and loyalty number." name="text-1784515476401" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Section 6:&nbsp; Tell Me More"/> <field type="radio-group" required="true" label="Have you cruised before?" name="radio-group-1784516262264"> <option label="Yes" value="yes">Yes</option> <option label="No - This will be my first cruise!" value="no-this-will-be-my-first-cruise">No - This will be my first cruise!</option> </field> <field type="text" label="What else would you like me to know about your future vacation?" description="Feel free to share anything you'd like me to know (ie: what you're celebrating; your must haves; previous cruise experiences or anything that would make this trip especially meaningful.)" name="text-1784516615154" subtype="text" className="form-control"/> <field type="text" label="Is there anything I should consider when helping you plan?" description="This may include mobility or stamina dietary needs or allergies sensory preferences medical equipment or another accomodation." name="text-1784516725255" subtype="text" className="form-control"/> <field type="select" required="true" label="How did you hear about me?" name="select-1784516805579" multiple="multiple" className="form-control"> <option label="Facebook" value="facebook">Facebook</option> <option label="TikTok" value="tiktok">TikTok</option> <option label="Facebook cruise group" value="facebook-cruise-group">Facebook cruise group</option> <option label="Friend or family referral" value="friend-or-family-referral">Friend or family referral</option> <option label="Moms at Sea" value="moms-at-sea">Moms at Sea</option> <option label="Dream Vacations" value="dream-vacations">Dream Vacations</option> <option label="Met Chalya in person" value="met-chalya-in-person">Met Chalya in person</option> <option label="Past guest" value="past-guest">Past guest</option> <option label="Online search" value="online-search">Online search</option> <option label="Other" value="other">Other</option> </field> </fields> </form-template> </body> </html>
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