<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Client Information"/> <field type="text" required="true" label="First name" 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="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="textarea" required="true" label="Please list all additional travelers with their full names and birthdays as they appear on their passports." name="please-list-all-additional-travelers-with-their-full-names-and-birthdays-as-they-appear-on-their-passports" className="form-control"/> <field type="text" label="Would you like to add anyone to our communications? Please list their name(s) and email(s) below." name="would-you-like-to-add-anyone-to-our-communications-please-list-their-names-and-emails-below" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="About Your Trip"/> <field type="date" required="true" label="What's the earliest you can depart?" name="whats-the-earliest-you-can-depart" className="form-control"/> <field type="date" required="true" label="What's the latest you can return?" name="whats-the-latest-you-can-return" className="form-control"/> <field type="radio-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="How many nights would you like the cruise to be (this can be a range)?" name="how-many-nights-would-you-like-the-cruise-to-be-this-can-be-a-range" other="true"> <option label="3-4 nights" value="34-nights">3-4 nights</option> <option label="7 nights" value="7-nights">7 nights</option> <option label="10 nights" value="10-nights">10 nights</option> <option label="10+ nights" value="10-nights">10+ nights</option> </field> <field type="text" label="Are you celebrating anything special?" name="are-you-celebrating-anything-special" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Is this your first cruise?" name="is-this-your-first-cruise"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="I'm a cruise pro!" value="im-a-cruise-pro">I'm a cruise pro!</option> </field> <field type="text" label="Which cruise(s) line have you sailed with before?" name="which-cruises-line-have-you-sailed-with-before" subtype="text" className="form-control"/> <field type="textarea" label="If you have cruised before, please list any of your past passenger/loyalty cruise numbers:" name="if-you-have-cruised-before-please-list-any-of-your-past-passengerloyalty-cruise-numbers" rows="2" className="form-control"/> <field type="textarea" label="Please list below if you have a cruise line preferences:" name="please-list-below-if-you-have-a-cruise-line-preferences" rows="3" className="form-control"/> <field type="textarea" label="Please list below if there are any cruise lines you would like to avoid:" name="please-list-below-if-there-are-any-cruise-lines-you-would-like-to-avoid" rows="3" className="form-control"/> <field type="checkbox-group" required="true" label="Please select the area(s) that you are most interested In visiting:" name="please-select-the-areas-that-you-are-most-interested-in-visiting" other="true"> <option label="Eastern Caribbean" value="eastern-caribbean">Eastern Caribbean</option> <option label="South Caribbean" value="south-caribbean">South Caribbean</option> <option label="Western Caribbean" value="western-caribbean">Western Caribbean</option> <option label="Bahamas" value="bahamas">Bahamas</option> <option label="Bermuda" value="bermuda">Bermuda</option> <option label="Transatlantic " value="transatlantic-">Transatlantic </option> <option label="West Coast " value="west-coast-">West Coast </option> <option label="New England/Canada" value="new-englandcanada">New England/Canada</option> <option label="Alaska" value="alaska">Alaska</option> <option label="Panama Canal" value="panama-canal">Panama Canal</option> <option label="Hawaii" value="hawaii">Hawaii</option> </field> <field type="checkbox-group" label="If cruising to Alaska, I would like:" name="if-cruising-to-alaska-i-would-like"> <option label="Cruise Only" value="cruise-only">Cruise Only</option> <option label="Cruise & Land Tour " value="cruise-land-tour-">Cruise & Land Tour </option> </field> <field type="text" required="true" label="Which ports can you depart from?" name="which-ports-can-you-depart-from" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Are you okay with flying to your initial port of call?" name="are-you-okay-with-flying-to-your-initial-port-of-call"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="What is your minimum budget starting with 2 people in a cabin that you are comfortable with for the CRUISE ONLY?" name="what-is-your-minimum-budget-starting-with-2-people-in-a-cabin-that-you-are-comfortable-with-for-the-cruise-only" other="true"> <option label="$3,000-$5,000" value="30005000">$3,000-$5,000</option> <option label="$5,000-$7,000" value="50007000">$5,000-$7,000</option> <option label="$7,000-$10,000" value="700010000">$7,000-$10,000</option> <option label="$10,000-$15,000" value="1000015000">$10,000-$15,000</option> <option label="$15,000+" value="15000">$15,000+</option> </field> <field type="header" subtype="h1" label="Your Preferences&nbsp;"/> <field type="checkbox-group" required="true" label="Are you interested in:" description="Check all that apply" name="are-you-interested-in" other="true"> <option label="Large ship ocean cruise (Royal Caribbean, Disney, Celebrity, etc.)" value="large-ship-ocean-cruise-royal-caribbean-disney-celebrity-etc">Large ship ocean cruise (Royal Caribbean, Disney, Celebrity, etc.)</option> <option label="Luxury small ship ocean cruise (Silversea, Seabourn, Regent, etc.)" value="luxury-small-ship-ocean-cruise-silversea-seabourn-regent-etc">Luxury small ship ocean cruise (Silversea, Seabourn, Regent, etc.)</option> <option label="Yacht charter (Ritz-Carlton, Explora, SeaDream, etc.,)" value="yacht-charter-ritzcarlton-explora-seadream-etc">Yacht charter (Ritz-Carlton, Explora, SeaDream, etc.,)</option> <option label="Expedition cruise (Lindblad, Hurtigruten, etc.)" value="expedition-cruise-lindblad-hurtigruten-etc">Expedition cruise (Lindblad, Hurtigruten, etc.)</option> </field> <field type="checkbox-group" required="true" label="What type of cabin are you interested in?" description="You can choose multiple options if you'd like to compare pricing. Please note depending on the size of the cruise ship there might be sub categories within the ones listed below (ex - interior garden view - faces inside of ship)" name="what-type-of-cabin-are-you-interested-in" other="true"> <option label="Suite" value="suite">Suite</option> <option label="Veranda/Balcony" value="verandabalcony">Veranda/Balcony</option> <option label="Ocean View/Window" value="ocean-viewwindow">Ocean View/Window</option> <option label="Interior/No Window" value="interiorno-window">Interior/No Window</option> <option label="Connecting Cabins Required" value="connecting-cabins-required">Connecting Cabins Required</option> <option label="Open To Additional Options Depending On Ship Layout" value="open-to-additional-options-depending-on-ship-layout">Open To Additional Options Depending On Ship Layout</option> </field> <field type="textarea" required="true" label="Cabin location preferences. Ex - mid-ship, aft or forward" name="the-number-of-cabins-and-location-preferences-do-they-need-to-connect-or-is-sidebyside-or-just-nearby-okay" rows="4" className="form-control"/> <field type="checkbox-group" label="Are any of these important? *These only apply to ocean cruises." inline="true" name="are-any-of-these-important-these-only-apply-to-ocean-cruises" other="true"> <option label="Casino" value="casino">Casino</option> <option label="Babysitting" value="babysitting">Babysitting</option> <option label="Kids/Teen club" value="kidsteen-club">Kids/Teen club</option> <option label="Sports court" value="sports-court">Sports court</option> <option label="Lots of specialty dining venues" value="lots-of-specialty-dining-venues">Lots of specialty dining venues</option> <option label="Rock wall" value="rock-wall">Rock wall</option> <option label="Zipline" value="zipline">Zipline</option> <option label="Flow Rider" value="flow-rider">Flow Rider</option> <option label="Water slide" value="water-slide">Water slide</option> <option label="Go-carts" value="gocarts">Go-carts</option> <option label="Adults-only pool" value="adultsonly-pool">Adults-only pool</option> <option label="Outdoor movies" value="outdoor-movies">Outdoor movies</option> <option label="Spa" value="spa">Spa</option> <option label="Nightly shows" value="nightly-shows">Nightly shows</option> </field> <field type="checkbox-group" required="true" label="Dining Time Preferences" description="Choose as many as you like" name="are-you-looking-forward-to"> <option label="Early (5:30 pm - 6:00 pm start time)" value="early-530-pm-600-pm-start-time">Early (5:30 pm - 6:00 pm start time)</option> <option label="Late (8:00 pm start time)" value="late-800-pm-start-time">Late (8:00 pm start time)</option> <option label="My time dining (dining at my own leisure if applicable)" value="my-time-dining-dining-at-my-own-leisure-if-applicable">My time dining (dining at my own leisure if applicable)</option> </field> <field type="header" subtype="h1" label="Additional Information"/> <field type="radio-group" required="true" label="Is anyone in your party pregnant or planning to become pregnant before the cruise?" description="This is so we can advise as each cruise line has their own policy regarding cruising while pregnant. This information is private." name="is-anyone-in-your-party-pregnant-or-planning-to-become-pregnant-before-the-cruise"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="Is everyone in your party a US citizen?" description="If not we need to know we can advise you properly." name="is-everyone-in-your-party-a-us-citizen"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" label="Promotions you qualify for (if available):" name="promotions-you-qualify-for-if-available" other="true"> <option label="Senior (55 or older)" value="senior-55-or-older">Senior (55 or older)</option> <option label="Military" value="military">Military</option> <option label="Fire/EMT/Law Enforcement" value="fireemtlaw-enforcement">Fire/EMT/Law Enforcement</option> <option label="Teacher" value="teacher">Teacher</option> </field> <field type="text" required="true" label="What state do you reside in?" name="what-state-do-you-reside-in" subtype="text" className="form-control"/> <field type="textarea" label="What else would you like me to know? (dietary or medical requirements, special requests, etc)" name="what-else-would-you-like-me-to-know-dietary-or-medical-requirements-special-requests-etc" className="form-control"/> <field type="textarea" label="Anything else you'd like me to know about your trip?" name="anything-else-youd-like-me-to-know-about-your-trip" rows="3" className="form-control"/> <field type="paragraph" subtype="p" label="By submitting this client inquiry form, you consent to have reviewed the Terms &amp; Conditions of working with The Hello Agency. Please visit https://thehelloagency.com/terms-of-service to review. I also understand that I may be required to pay a non-refundable Professional Planning Fee. This will be paid directly to The Hello Agency and discussed before you schedule a planning call. Initial Planning Calls are complimentary."/> </fields> </form-template> </body> </html>
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