<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Travel Curation Request Form"/> <field type="header" subtype="h1" label="Quotes are $15 each and come with 3 options for accommodations/Locations with 1 change included. Each additional quote after is $15. Payment can be sent via zelle to melanatedtravelbae@gmail.com or cashapp at $EbonyTempleLT. Service will not commence until payment has been submitted."/> <field type="date" required="true" label="Date of Quote Submission" name="date-of-quote-submission" 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" required="true" label="Phone number" name="phone-number" 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="Travel Destination? List all City/State and Countries applicable" description="If you're not sure just give me a few exact destinations you're considering." placeholder="ex: Limon Costa Rica" name="destination" subtype="text" className="form-control"/> <field type="select" required="true" label="What services would you like to include?&nbsp;" description="(flight hotel insurance activities transportation etc.)" name="what-services-would-you-like-to-add-on" className="form-control"> <option label="Full Service- Flight, Hotel, Transportation and Activities" value="full-service-flight-hotel-transportation-and-activities">Full Service- Flight, Hotel, Transportation and Activities</option> <option label="Flight & Hotel" value="flight-hotel">Flight & Hotel</option> <option label="Hotel & Car" value="hotel-car">Hotel & Car</option> <option label="Flight, Hotel and Activities" value="flight-hotel-and-activities">Flight, Hotel and Activities</option> <option label="Flight, Hotel & Venue " value="flight-hotel-venue-">Flight, Hotel & Venue </option> <option label="Flight only" value="flight-only">Flight only</option> <option label="Hotel only" value="hotel-only">Hotel only</option> <option label="Venue only" value="venue-only">Venue only</option> <option label="Car Rental only" value="car-rental-only">Car Rental only</option> <option label="All plus other additional special requested services" value="all-plus-other-additional-special-requested-services">All plus other additional special requested services</option> </field> <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"/> <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"/> <field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="What is your departure city? Are you open to flying out of any other airports?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers? Adults Ages? Children Ages?&nbsp;" name="number-of-travelers" subtype="text" className="form-control"/> <field type="select" required="true" label="How Bed count/type?&nbsp;" description="King Double room with pull our sofa two connecting rooms etc)" placeholder="King Room" name="how-bed-counttype" className="form-control"> <option label="King/ Single" value="king-single">King/ Single</option> <option label="Double/Queen Double/Twin" value="doublequeen-doubletwin">Double/Queen Double/Twin</option> <option label="Suite" value="suite">Suite</option> <option label="Two Rooms that Connect" value="two-rooms-that-connect">Two Rooms that Connect</option> <option label="Other" value="other">Other</option> </field> <field type="text" required="true" label="Number of people per room?" name="number-of-people-per-room" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your total trip budget for each traveler?&nbsp;" description="This just gives us a general starting point and can always be changed later. EX: $10K total budget for 4 people is $2.5k per person." name="budget"> <option label="$800 to $1,200" value="800-to-1200">$800 to $1,200</option> <option label="$1,200 to $2,000" value="1200-to-2000">$1,200 to $2,000</option> <option label="$2,000 to $3,000" value="2000-to-3000">$2,000 to $3,000</option> <option label="$3,000 to $4,000" value="3000-to-4000">$3,000 to $4,000</option> <option label="$4,000 to $5,000" value="4000-to-5000">$4,000 to $5,000</option> <option label="$6,000 to $7,000" value="6000-to-7000">$6,000 to $7,000</option> <option label="$7,000 to $8,000" value="7000-to-8000">$7,000 to $8,000</option> <option label="$8,000 to $9,000" value="8000-to-9000">$8,000 to $9,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="radio-group" required="true" label="What best describes your accommodation preference?" description="Price is per person price of hotel vacation rental cabin or resort with tax." name="hotel-preference"> <option label="Economy- under $150 per night" value="economy-under-150-per-night">Economy- under $150 per night</option> <option label="Economy Plus- $150- $200 per night" value="economy-plus-150-200-per-night">Economy Plus- $150- $200 per night</option> <option label="Moderate- $200- $250 per night" value="moderate-200-250-per-night">Moderate- $200- $250 per night</option> <option label="Luxury- between $250- $499 per night" value="luxury-between-250-499-per-night">Luxury- between $250- $499 per night</option> <option label="Upper Echelon- between $500 - $2k per night " value="upper-echelon-between-500-2k-per-night-">Upper Echelon- between $500 - $2k per night </option> <option label="VIP- between $2.5k and up" value="vip-between-25k-and-up">VIP- between $2.5k and up</option> <option label="Boutique- locally owned hotels, prices vary" value="boutique-locally-owned-hotels-prices-vary">Boutique- locally owned hotels, prices vary</option> </field> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> <option label="Adventurous & Active" value="adventurous-active">Adventurous & Active</option> </field> <field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> </field> <field type="text" required="true" label="Preferred Hotel Brand OR Pre Selected Vacation Home" name="preferred-hotel" subtype="text" className="form-control"/> <field type="text" required="true" label="Preferred Room Type ( Garden View, Bay View, Ocean View, Oceanfront, Swim out, Jacuzzi , Suite)" name="preferred-room-type-garden-bay-view-ocean-view-oceanfront-swim-out-jacuzzi-suite" subtype="text" className="form-control"/> <field type="text" required="true" label="Accommodation Amenity Requirements" description="Include EVERYTHING that you need from your accommodations. Location pool spa room service close to subway etc." name="accommodation-amenity-requirements" subtype="text" className="form-control"/> <field type="select" required="true" label="How many bags would you like to check?" name="how-many-bags-would-you-like-to-check" className="form-control"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> </field> <field type="select" required="true" label="Would you like to add on our VIP Concierge service to your vacation for $250?" description="This is an optional service to get hands on real time help 24 hours a day no matter the time of day with anything that you may need during your trip." name="would-you-like-to-add-on-our-vip-concierge-service-to-your-vacation-for-250" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Include any and all special requests or additions here,&nbsp;" description="excluding hotel and flights all special requests and accommodations should be requested here. Requesting later could result in a fee" name="must-dos" subtype="text" className="form-control"/> <field type="textarea" label="What else would you like me to know that was not included above? Must have &amp; Non Negotiables not previously mentioned" description="What else would you like me to know about your travelers budget and/or travel preferences? Allergies or Special Request?" placeholder="FAILURE TO PROVIDER FULL REQUEST COULD RESULT IN A FEE LATER." name="notes" className="form-control"/> </fields> </form-template> </body> </html>
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