Share your information with
Daria Dimitroff
Journeys of a Lifetime
<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="CRUISE DESIGN FORM"/> <field type="header" subtype="h1" label="Name"/> <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" label="I prefer to be addressed as" name="preferred-name" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Address &amp; Contact Information"/> <field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" required="true" label="Mobile phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Home phone number" name="home-phone-number" subtype="text" className="form-control"/> <field type="text" label="Do you have a preferred phone number?" name="do-you-have-a-preferred-phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Trip Information"/> <field type="textarea" required="true" label="Who will be traveling on this trip. Please provide their ages and relationship to you." name="number-of-travelers-and-their-ages" 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" required="true" label="Where would you like to go? It can be a description like "tropical" or if there's are certain destinations or ports you want to visit, please share them here." placeholder="ex: Tahiti" name="preferred-destinations" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="The purpose of this cruise vacation is:" description="check all that apply" name="the-purpose-of-this-cruise-vacation-is" other="true"> <option label="Visiting specific destinations or countries" value="visiting-specific-destinations-or-countries">Visiting specific destinations or countries</option> <option label="Making memories with family and/or friends" value="making-memories-with-family-andor-friends">Making memories with family and/or friends</option> <option label="Romance" value="romance">Romance</option> <option label="Relax & recharge (spa?)" value="relax-recharge-spa">Relax & recharge (spa?)</option> <option label="Celebrating a special occasion" value="celebrating-a-special-occasion">Celebrating a special occasion</option> <option label="Just for fun" value="just-for-fun">Just for fun</option> </field> <field type="checkbox-group" label="What type of activities are you interested in?" name="activity-preferences" other="true"> <option label="History and culture" value="history-and-culture">History and culture</option> <option label="Museums & galleries" value="museums-galleries">Museums & galleries</option> <option label="Food & wine " value="food-wine-">Food & wine </option> <option label="Theatre" value="theatre">Theatre</option> <option label="Spa" value="spa">Spa</option> <option label="Shopping" value="shopping">Shopping</option> <option label="Beach & water" value="beach-water">Beach & water</option> <option label="Scuba or snorkeling" value="scuba-or-snorkeling">Scuba or snorkeling</option> <option label="Adventure" value="adventure">Adventure</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Golf" value="golf">Golf</option> </field> <field type="textarea" label="Is there anything you must see or do?" name="is-there-anything-you-must-see-or-do" className="form-control"/> <field type="textarea" label="What are your interests and hobbies and those of your travel companions?" name="what-are-your-interests-and-hobbies-and-those-of-your-travel-companions" className="form-control"/> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="check all that apply" name="vibe-preference" other="true"> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Multi-generational" value="multi-generational">Multi-generational</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Romantic" value="romantic">Romantic</option> <option label="Party" value="party">Party</option> <option label="LGBTQ+" value="lgbtq">LGBTQ+</option> </field> <field type="textarea" label="Is there anything you want to avoid on this trip?" name="is-there-anything-you-want-to-avoid-on-this-trip" className="form-control"/> <field type="text" label="From which ports can you depart?" description="If you don't know that's ok. We can discuss this." name="ports-you-can-depart-from" subtype="text" className="form-control"/> <field type="text" label="Which cruise lines have you sailed with before?" name="cruise-lines-youve-sailed-before" subtype="text" className="form-control"/> <field type="text" label="Which ones are on your wishlist?" name="which-ones-are-on-your-wishlist" subtype="text" className="form-control"/> <field type="text" label="Would you call yourself a foodie? What type of food excites you?" name="would-you-call-yourself-a-foodie-what-type-of-food-excites-you" subtype="text" className="form-control"/> <field type="radio-group" label="Are you looking forward to:" description="Choose as many as you like" name="are-you-looking-forward-to" other="true"> <option label="The buffet" value="the-buffet">The buffet</option> <option label="The main dining room" value="the-main-dining-room">The main dining room</option> <option label="Specialty restaurants" value="specialty-restaurants">Specialty restaurants</option> <option label="Dining on shore" value="dining-on-shore">Dining on shore</option> <option label="Table service" value="table-service">Table service</option> <option label="Tea service" value="tea-service">Tea service</option> </field> <field type="checkbox-group" label="Which of these are important on the ship?" description="Check all that apply." name="are-any-of-these-important" other="true"> <option label="Butler" value="butler">Butler</option> <option label="Spa" value="spa">Spa</option> <option label="Gym" value="gym">Gym</option> <option label="Pool" value="pool">Pool</option> <option label="Jacuzzi" value="jacuzzi">Jacuzzi</option> <option label="Fitness classes" value="fitness-classes">Fitness classes</option> <option label="Bikes" value="bikes">Bikes</option> <option label="Room Service" value="room-service">Room Service</option> <option label="Laundry service" value="laundry-service">Laundry service</option> <option label="Babysitting" value="babysitting">Babysitting</option> <option label="Kids/Teen Club" value="kidsteen-club">Kids/Teen Club</option> <option label="Adults-only pool" value="adultsonly-pool">Adults-only pool</option> <option label="Nightly entertainment" value="nightly-entertainment">Nightly entertainment</option> <option label="Casino" value="casino">Casino</option> </field> <field type="checkbox-group" required="true" label="What type of stateroom are you interested in?&nbsp;" description="Check all that apply." name="what-type-of-cabin-are-you-interested-in-" other="true"> <option label="Largest suite available" value="largest-suite-available">Largest suite available</option> <option label="Regular suite" value="regular-suite">Regular suite</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Window to look out of" value="window-to-look-out-of">Window to look out of</option> <option label="Tell me about some of the unique cabin options that are available" value="tell-me-about-some-of-the-unique-cabin-options-that-are-available">Tell me about some of the unique cabin options that are available</option> </field> <field type="checkbox-group" label="Are any of these important in your stateroom?" name="are-any-of-these-important-in-your-stateroom" other="true"> <option label="Robe" value="robe">Robe</option> <option label="Slippers" value="slippers">Slippers</option> <option label="Bathtub" value="bathtub">Bathtub</option> <option label="Coffee maker" value="coffee-maker">Coffee maker</option> <option label="Refrigerator" value="refrigerator">Refrigerator</option> <option label="Wet Bar" value="wet-bar">Wet Bar</option> </field> <field type="date" label="Earliest you can 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" label="Latest you can 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> <option label="Maybe" value="maybe">Maybe</option> </field> <field type="text" label="How many nights would you like the cruise to be (can be a range)?" name="how-many-nights-would-you-like-the-cruise-to-be-can-be-a-range" subtype="text" className="form-control"/> <field type="text" label="How many nights would you like the entire vacation to be?" name="text-1726671965164" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Number of cabins and location preferences. Do they need to connect, or is side-by-side or nearby ok?" name="number-of-cabins-and-location-preferences" className="form-control"/> <field type="radio-group" required="true" label="Is anyone in your party pregnant or planning to become pregnant before the cruise?&nbsp;" description="So that we can advise as each cruise line has its own pregnancy policy. All information is private." name="is-anyone-in-your-party-pregnant-or-planning-to-become-pregnant-before-the-cruise-" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" required="true" label="Does anyone in your party have mobility issues I should be aware of?" name="what-else-would-you-like-me-to-know-do-you-have-any-medical-or-dietary-needspreferences-does-anyone-in-your-party-have-mobility-issues-i-should-be-aware-of" className="form-control"/> <field type="radio-group" required="true" label="Is everyone in your party a US citizen?" description="If not we need to know so that we can advise you properly on cruise line requirements and international travel." name="is-everyone-in-your-party-a-us-citizen" other="true"> <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="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Moderate (4 star)" value="moderate-4-star">Moderate (4 star)</option> <option label="Luxury (5 star)" value="luxury-5-star">Luxury (5 star)</option> <option label="Ultra Lux (5+++ star)" value="ultra-lux-5-star">Ultra Lux (5+++ star)</option> <option label="Boutique (4 - 5 star)" value="boutique-4-5-star">Boutique (4 - 5 star)</option> </field> <field type="checkbox-group" required="true" label="What would you like my help with? (I only handle entire trips from top to bottom. I don't handle bits and pieces of trips or only certain parts of trips.)" name="what-would-you-like-my-help-with-i-only-handle-entire-trips-from-top-to-bottom-i-dont-handle-bits-and-pieces-of-trips-or-only-certain-parts-of-trips"> <option label="Identifying the right cruise line for me" value="identifying-the-right-cruise-line-for-me">Identifying the right cruise line for me</option> <option label="Finding the right itinerary" value="finding-the-right-itinerary">Finding the right itinerary</option> <option label="Accommodations" value="accommodations">Accommodations</option> <option label="Activities and/or tours" value="activities-andor-tours">Activities and/or tours</option> <option label="Flights" value="flights">Flights</option> <option label="Transportation (to and from airport and ship)" value="transportation-to-and-from-airport-and-ship">Transportation (to and from airport and ship)</option> <option label="All of the above" value="all-of-the-above">All of the above</option> </field> <field type="select" label="What budget do you not want to exceed on this trip?&nbsp;" description="I don't often handle trips for less than $10k and I don't handle low budget trips. The budget required for each trip varies a lot (depending on dates number of travelers length of trip etc.) but I will discuss this with you when we speak. Most people don't know what their budget should be so just give your best estimate." name="what-budget-do-you-not-want-to-exceed-on-this-trip-not-including-meals-i-dont-handle-trips-for-less-than-10k-and-i-dont-handle-low-budget-trips-the-budget-required-for-each-trip-varies-a-lot-depending-on-dates-number-of-travelers-length-of-trip-etc-but-i-will-discuss-this-with-you-when-we-speak-most-people-dont-know-what-their-budget-should-be-so-just-give-your-best-estimate" className="form-control"> <option label="" value=""/> <option label="$5,000 - $10,000" value="5000-10000">$5,000 - $10,000</option> <option label="$11,000 - $20,000" value="11000-20000">$11,000 - $20,000</option> <option label="$21,000 - $35,000" value="21000-35000">$21,000 - $35,000</option> <option label="$36,000 - $50,000" value="36000-50000">$36,000 - $50,000</option> <option label="$51,000 - $65,000" value="51000-65000">$51,000 - $65,000</option> <option label="$66,000 - $80,000" value="66000-80000">$66,000 - $80,000</option> <option label="$81,000 - $100,000" value="81000-100000">$81,000 - $100,000</option> <option label="over $100,000" value="over-100000">over $100,000</option> </field> <field type="text" label="Is there anything else you would like me to know?" name="is-there-anything-else-you-would-like-me-to-know" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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