Share your information with Jen Gross

Jen Gross

Jen with Magical Enchanted Vacations

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		<field type="paragraph" subtype="p" label="Thank you for your interest in booking your dream vacation with me. Please fill out the following to the best of your ability. Quote requests will be answered within 24-48 hours. If you don&#39;t receive a response, please email hello@seejentravelmev.com."/>&#13;
		<field type="header" subtype="h1" label="Sole Agent Statement"/>&#13;
		<field type="radio-group" required="true" label="I am currently working with another travel agent or seeking multiple quotes from other travel agents." name="i-am-currently-working-with-another-travel-agent-or-seeking-multiple-quotes-from-other-travel-agents">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Your Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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="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="date" required="true" label="Your Birthday" name="your-birthday" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Mailing Address" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Mailing Address 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Preferred Method of Contact" name="preferred-method-of-contact" className="form-control">&#13;
			<option label="Call" value="call">Call</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="radio-group" label="Are your dates flexible?" 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="header" subtype="h1" label="About Your Travelers"/>&#13;
		<field type="text" required="true" label="How many adult travelers 18+ including self?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many children are traveling with you?" name="how-many-children-are-traveling-with-you" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Full Names (First, Middle, Last) and birthdates of everyone traveling." description="e.g. Snow White   August 1  1984" name="names-and-ages-at-time-of-travel-birthdays-if-possible" rows="5" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="About Your Destination"/>&#13;
		<field type="checkbox-group" label="Where would you like to go?" description="Check all that apply." name="where-would-you-like-to-go" other="true">&#13;
			<option label="Walt Disney World (FL)" value="walt-disney-world-fl">Walt Disney World (FL)</option>&#13;
			<option label="Disneyland (CA)" value="disneyland-ca">Disneyland (CA)</option>&#13;
			<option label="Universal Orlando Resort (FL)" value="universal-orlando-resort-fl">Universal Orlando Resort (FL)</option>&#13;
			<option label="Universal Studios (CA)" value="universal-studios-ca">Universal Studios (CA)</option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="Disney's Aulani Resort (Hawaii)" value="disneys-aulani-resort-hawaii">Disney's Aulani Resort (Hawaii)</option>&#13;
			<option label="Other Cruise Line (ocean or river)" value="other-cruise-line-ocean-or-river">Other Cruise Line (ocean or river)</option>&#13;
			<option label="Sandals/Beaches Resorts (All Inclusive, Caribbean)" value="sandalsbeaches-resorts-all-inclusive-caribbean">Sandals/Beaches Resorts (All Inclusive, Caribbean)</option>&#13;
			<option label="I am not sure." value="i-am-not-sure">I am not sure.</option>&#13;
		</field>&#13;
		<field type="select" label="Are you celebrating anything special?" name="are-you-celebrating-anything-special" multiple="multiple" className="form-control">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Family Reunion" value="family-reunion">Family Reunion</option>&#13;
			<option label="Friend Group Trip" value="friend-group-trip">Friend Group Trip</option>&#13;
			<option label="First Visit" value="first-visit">First Visit</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you have a specific resort, ship, or hotel in mind?" name="do-you-have-a-specific-resort-or-hotel-in-mind" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you have a dollar amount you&#39;d like to not go over for your vacation?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="Under $1,500" value="under-1500">Under $1,500</option>&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Just a place to sleep and shower." value="value">Just a place to sleep and shower.</option>&#13;
			<option label="Comfortable, has some amenities, but moderate pricing." value="moderate">Comfortable, has some amenities, but moderate pricing.</option>&#13;
			<option label="Luxury or deluxe accommodations with ample amenities and services." value="luxury">Luxury or deluxe accommodations with ample amenities and services.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vacation vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
			<option label="Active/Adventure" value="activeadventure">Active/Adventure</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beaches" value="beaches">Beaches</option>&#13;
			<option label="Water sports" value="water-sports">Water sports</option>&#13;
			<option label="Theme parks" value="theme-parks">Theme parks</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities (e.g. hikes, etc.)" value="adventure-activities">Adventure activities (e.g. hikes, etc.)</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife/dancing" value="nightlifedancing">Nightlife/dancing</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Any special needs, diets, or ADA requirements?" name="any-special-needs-diets-or-ada-requirements" className="form-control"/>&#13;
		<field type="textarea" label="What&#39;s one thing that would make this trip feel magical?" description="What else would you like me to know about your travelers  preferences  ideas  or requests?" name="notes" className="form-control"/>&#13;
		<field type="checkbox-group" label="I would like to schedule a follow up phone call to discuss my quote request." name="i-would-like-to-schedule-a-follow-up-phone-call-to-discuss-my-quote-request">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="I understand that complimentary quotes are for reference only and are subject to price increases or availability. No courtesy holds will be made unless specifically requested by the client." name="i-understand-that-complimentary-quotes-are-for-reference-only-and-are-subject-to-price-increases-or-availability-no-courtesy-holds-will-be-made-unless-specifically-requested-by-the-client">&#13;
			<option label="I understand." value="i-understand">I understand.</option>&#13;
		</field>&#13;
	</fields>&#13;
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Terms & Conditions

We are Jen with Magical Enchanted Vacations and are excited to help you with your travel. The following terms & conditions (the "Agreement") describe what you can expect from us. The terms "we", "us", and "our" refer to Jen with Magical Enchanted Vacations and the term "you" refers to the individual who signs this agreement. Signing below indicates that you agree to the terms and conditions.

Please click the link to review the Terms and Conditions set forth by the agency.

Click to sign