<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="eMITS New Travel Request"/> <field type="date" required="true" label="Date of Request" name="date-of-request" className="form-control"/> <field type="checkbox-group" label="Who will be doing your travel booking?" name="who-will-be-doing-your-travel-booking"> <option label="The Giving Traveler (TGT )" value="the-giving-traveler-tgt-">The Giving Traveler (TGT )</option> <option label="My company" value="my-company">My company</option> </field> <field type="radio-group" required="true" label="Are you requesting an estimate or a new booking?" name="estimate-or-booking"> <option label="Estimate " value="estimate-">Estimate </option> <option label="Booking" value="booking">Booking</option> </field> <field type="radio-group" required="true" label="Is this a RUSH request? (All estimates/bookings will be made within 48 hours of trip approval unless marked RUSH)." name="is-this-a-rush-request-all-estimatesbookings-will-be-made-within-48-hours-of-trip-approval-unless-marked-rush"> <option label="Yes, this is a RUSH request requiring soonest estimate/booking." value="yes-this-is-a-rush-request-requiring-soonest-estimatebooking">Yes, this is a RUSH request requiring soonest estimate/booking.</option> <option label="No, this is not a RUSH request, 48 hours is sufficient." value="no-this-is-not-a-rush-request-48-hours-is-sufficient">No, this is not a RUSH request, 48 hours is sufficient.</option> </field> <field type="text" label="RUSH Requests - How quickly do you need this estimate/booking?" name="rush-requests-how-quickly-do-you-need-this-estimatebooking" 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="Middle name (if none please say N/A)" 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" required="true" label="Cell Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Preferred Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Charge Code&nbsp; (if multiple charge codes, identify date range applicable to each; IE: if travel extension is planned)&nbsp;" name="charge-code" subtype="text" className="form-control"/> <field type="select" required="true" label="Company you work for?" name="company-you-work-for" className="form-control"> <option label="Rothe Development, Inc. (RDI)" value="rothe-development-inc-rdi">Rothe Development, Inc. (RDI)</option> <option label="MORI Associates (MORI)" value="mori-associates-mori">MORI Associates (MORI)</option> <option label="RDI 1099 Consultant" value="rdi-1099-consultant">RDI 1099 Consultant</option> </field> <field type="select" required="true" label="Travel Coordinator" name="travel-coordinator" className="form-control"> <option label="Eileen Walsh, Primary" value="eileen-walsh-primary">Eileen Walsh, Primary</option> <option label=" Aubrey Calvin" value="-aubrey-calvin"> Aubrey Calvin</option> <option label="Melissa Watson" value="melissa-watson">Melissa Watson</option> <option label="Tamara Zaman" value="tamara-zaman">Tamara Zaman</option> <option label="Pam Emmick" value="pam-emmick">Pam Emmick</option> <option label="Paula BeMiller" value="paula-bemiller">Paula BeMiller</option> </field> <field type="checkbox-group" required="true" label="Services required:&nbsp;" name="services-required-"> <option label="Air" value="air">Air</option> <option label="Accommodations" value="accommodations">Accommodations</option> <option label="Car" value="car">Car</option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" required="true" label="Company Travel Card (Please note you will be sent a secure CC authorization form you will need to fill out before any bookings are made with your company card)" name="company-travel-card-please-note-you-will-be-sent-a-secure-cc-authorization-form-you-will-need-to-fill-out-before-any-bookings-are-made-with-your-company-card"> <option label="Yes, I have a company credit card. " value="yes-i-have-a-company-credit-card-">Yes, I have a company credit card. </option> <option label="No, I do not have a company credit card. " value="no-i-do-not-have-a-company-credit-card-">No, I do not have a company credit card. </option> </field> <field type="radio-group" required="true" label="Are you uploading a TCEF form? (If not, please answer ALL questions below)" name="are-you-uploading-a-tcef-form-if-not-please-answer-all-questions-below"> <option label="Yes" value="yes">Yes</option> <option label="No, I will be answering the questions below." value="no-i-will-be-answering-the-questions-below">No, I will be answering the questions below.</option> </field> <field type="header" subtype="h1" label="If you would like to upload your TCEF please submit this travel request form and then copy and paste the following URL into your internet address bar:&nbsp; https://forms.gle/sWhkUeBdAV2Jy81R9&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <field type="date" label="Date of departure" name="date-of-departure" className="form-control"/> <field type="text" label="Departing Location" name="departing-location" subtype="text" className="form-control"/> <field type="text" label="Departing time requests?" name="departing-time-requests" subtype="text" className="form-control"/> <field type="date" label="Date of Return?" name="date-of-return" className="form-control"/> <field type="text" label="Return time requests?" name="return-time-requests" subtype="text" className="form-control"/> <field type="text" label="Destination?" name="destination" subtype="text" className="form-control"/> <field type="text" label="Please list the names of any other Rothe/MORI travelers booking with whom you would like to coordinate travel (flight, car, hotel)." name="if-you-are-traveling-as-a-group-please-list-the-names-of-the-other-employees-joining-the-trip" subtype="text" className="form-control"/> <field type="text" label="What is the area of town or location that you would like to stay near?&nbsp;" name="what-is-the-area-of-town-or-location-that-you-would-like-to-stay-near-" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are you required to stay under per diem?" name="are-you-required-to-stay-under-per-diem"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" label="Will you be the primary driver of a rental car (Please coordinate with other travelers in your party. If no one answers yes to this question, no car rental will be made.)" name="will-you-be-the-primary-driver-of-a-rental-car-please-coordinate-with-other-travelers-in-your-party-if-no-one-answers-yes-to-this-question-no-car-rental-will-be-made"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="Purpose of Trip" name="purpose-of-trip" className="form-control"/> <field type="textarea" label="Other information needed for a successful trip" name="other-information-needed-for-a-successful-trip" className="form-control"/> <field type="textarea" label="Justification for not using Company Preferred Airline&nbsp; (Rothe Only - Southwest)" name="justification-for-not-using-company-preferred-airline-rothe-only" className="form-control"/> <field type="paragraph" subtype="p" label="By submitting this form you agree you have followed Rothe's Travel Policy and agree to The Giving Traveler's Terms and Conditions located at: www.thegivingtraveler.com/rothetandc"/> </fields> </form-template> </body> </html>
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