Embedded forms must require the client's name and email. We have added/required these fields for you.
<html> <body> <form-template> <fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field> <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="header" subtype="h1" label="PASSPORT INFORMATION"/> <field type="paragraph" subtype="p" label="For air &amp; cruise reservations, the passenger name(s) MUST match the passport exactly. NOTE: if you don’t have your passport number handy please just be sure that your name and birthdate match your passport exactly.&nbsp;"/> <field type="text" required="true" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/> <field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="radio-group" required="true" label="Gender as it appears on passport/gov. ID" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> </field> <field type="date" required="true" label="Date of Birth" name="birthday" className="form-control"/> <field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/> <field type="text" required="true" label="Street Address&nbsp;" description="Please include Address from where you will be departing from" name="address-line-1" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="AIR"/> <field type="textarea" required="true" label="Preferred&nbsp; Departure Airport" description="Please include Airport from where you will be departing from." name="preferred-airport" className="form-control"/> <field type="radio-group" label="Please Select Preferred Airfare Class" name="please-select-preferred-airfare-class"> <option label="Economy " value="economy">Economy </option> <option label="Business " value="business">Business </option> </field> <field type="radio-group" label="Seat preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Opposite aisle" value="opposite aisle">Opposite aisle</option> </field> <field type="header" subtype="h1" label="BOOKING DETAILS"/> <field type="radio-group" required="true" label="Cabin Selection (Additional higher cabins available upon request)" name="cabin-selection"> <option label="Category E - Fixed Windows Starting at $4,223 pp" value="category-e-fixed-windows-starting-at-4223-pp">Category E - Fixed Windows Starting at $4,223 pp</option> <option label="Category D - Fixed Windows Starting at $5,074 pp" value="category-d-fixed-windows-starting-at-5074-pp">Category D - Fixed Windows Starting at $5,074 pp</option> <option label="Category CB - French Balcony Starting at $5122 pp" value="category-cb-french-balcony-starting-at-5122-pp">Category CB - French Balcony Starting at $5122 pp</option> <option label="Category CA - French Balcony Starting at $5,522 pp" value="category-ca-french-balcony-starting-at-5522-pp">Category CA - French Balcony Starting at $5,522 pp</option> <option label="Category BB - French Balcony & Outside Balcony Starting at $6,122 pp" value="category-bb-french-balcony-outside-balcony-starting-at-6122-pp">Category BB - French Balcony & Outside Balcony Starting at $6,122 pp</option> <option label="Higher Categories - Upon Request" value="higher-categories-upon-request">Higher Categories - Upon Request</option> <option label="Request for Single Occupancy Rates" value="request-for-single-occupancy-rates">Request for Single Occupancy Rates</option> <option label="Unsure, I would like to set up a phone consultation." value="unsure-i-would-like-to-set-up-a-phone-consultation">Unsure, I would like to set up a phone consultation.</option> </field> <field type="radio-group" required="true" label="Occupancy" name="occupancy"> <option label="Single Occupancy " value="single-occupancy-">Single Occupancy </option> <option label="Double Occupancy" value="double-occupancy">Double Occupancy</option> </field> <field type="radio-group" label="Beds" name="beds"> <option label="One Bed" value="one-bed">One Bed</option> <option label="Two Beds" value="two-beds">Two Beds</option> </field> <field type="text" label="If selecting Double Occupancy, who will you share with?" name="if-selecting-double-occupancy-who-will-you-share-with" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Pre / Post Extensions" name="pre-post-extensions"> <option label="Pre-Cruise PARIS ( 3 days) $1380 per person" value="precruise-paris-3-days-1380-per-person">Pre-Cruise PARIS ( 3 days) $1380 per person</option> <option label="Post Cruise BARCELONA ( 3 days) $1170 per person" value="post-cruise-barcelona-3-days-1170-per-person">Post Cruise BARCELONA ( 3 days) $1170 per person</option> <option label="No Pre / Post Extension" value="no-pre-post-extension">No Pre / Post Extension</option> <option label="I'd like to discuss alternative options for pre / post travel" value="id-like-to-discuss-alternative-options-for-pre-post-travel">I'd like to discuss alternative options for pre / post travel</option> </field> <field type="textarea" label="Additional Requests or Notes" name="additional-requests-or-notes" className="form-control"/> </fields> </form-template> </body> </html>
SUBMIT PROFILE
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Hyatt (World of Hyatt)
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British Airways (Executive Club)
Alaska Airlines (Mileage Plan)
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National (Emerald Club)
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Hawaiian Airlines (HawaiianMiles)
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Best Western Rewards
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Norwegian Cruise Line (Latitudes)
Aeromexico (Club Premier)
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KLM BlueBiz (Corporate)
RZD (Bonus)
Elite Hotels of Sweden
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Hotelbooker.org
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Czech Airlines (OK Plus Corporate)
Uzbekistan Airways (UzAirPlus)
TAAG Angola Airlines (Umbi Umbi Club)
Yelloh! Village (Yelloh! Plus)
Future Inns (Rewards Club)
Nordavia (Golden Mile)
Air Arabia (Airewards)
Royal Brunei Airlines (Royal Skies)
Leonardo Hotels (AdvantageCLUB)
Air Moldova Club
Air Cote D'Ivoire (sMiles)
Air Macau (Privileges)
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Sandals Select Guest (SSG)
Mandarin Oriental Fan
Relais and Chateaux 5C
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Silversea Venetian
Oceania Cruise Lines
Regent Cruise Line
Seabourn Cruise Line
Lindblad Expeditions
SeaDream Yacht Club
Cunard
Virgin Voyages Sailing Club
AmaWaterways