<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Cruise Vacation Request"/> <field type="paragraph" subtype="p" label="I appreciate your interest in working with me to plan your cruise vacation. Please complete the below information so I can find the best cruise for you.&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp;&nbsp;"/> <field type="header" subtype="h1" label="Your Contact information"/> <field type="paragraph" subtype="p" label="Please Note: The name and date of birth on your identification must exactly match the information listed on your booking for this trip."/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <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="Preferred name" name="preferred-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="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" 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="header" subtype="h2" label="Important Dates"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;"/> <field type="header" subtype="h1" label="Let's talk about your trip!&nbsp;"/> <field type="text" required="true" label="Where would you like to cruise?&nbsp;" name="where-would-you-like-to-cruise-" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="PLEASE NOTE: Some countries may refuse entry to individuals with criminal records, such as DUIs. It's your responsibility to research and comply with the entry laws of your destination and to determine if you or anyone in your group has a criminal record. That Vacation Lady does not inquire about an individual’s criminal record in the interest of respecting our Clients’ privacy.&nbsp;" name="please-note-some-countries-may-refuse-entry-to-individuals-with-criminal-records-such-as-duis-its-your-responsibility-to-research-and-comply-with-the-entry-laws-of-your-destination-and-to-determine-if-you-or-anyone-in-your-group-has-a-criminal-record-that-vacation-lady-does-not-inquire-about-an-individuals-criminal-record-in-the-interest-of-respecting-our-clients-privacy-"> <option label="I understand" value="i-understand">I understand</option> </field> <field type="date" required="true" label="When would you like to depart?&nbsp;" name="when-would-you-like-to-depart-" className="form-control"/> <field type="date" required="true" label="When would you like to return?&nbsp;" name="when-would-you-like-to-return-" className="form-control"/> <field type="radio-group" label="Are your dates flexible?&nbsp;" name="are-your-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 trip budget? Please indicate a dollar amount as this helps me provide quotes that meet your financial preferences.&nbsp;" placeholder="$5000" name="what-is-your-trip-budget-please-indicate-a-dollar-amount-as-this-helps-me-provide-quotes-that-meet-your-financial-preferences-" subtype="text" className="form-control"/> <field type="text" required="true" label="How many people will be traveling?&nbsp;" name="how-many-people-will-be-traveling-" subtype="text" className="form-control"/> <field type="text" label="Please provide the ages of any travelers who will be under 18 at the time of travel.&nbsp;" name="please-provide-the-ages-of-any-travelers-who-will-be-under-18-at-the-time-of-travel-" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do all travelers have a valid passort? Passports should be valid at least 6 months past your return date.&nbsp;" name="do-all-travelers-have-a-valid-passort-passports-should-be-valid-at-least-6-months-past-your-return-date-"> <option label="Yes" value="yes">Yes</option> <option label="No but in the process of applying/renewing" value="no-but-in-the-process-of-applyingrenewing">No but in the process of applying/renewing</option> <option label="No" value="no">No</option> </field> <field type="text" label="How many cabins would you like to book?&nbsp;" name="how-many-cabins-would-you-like-to-book-" subtype="text" className="form-control"/> <field type="textarea" label="For multiple cabin requests please list the guest make up of each cabin.&nbsp;" placeholder="Cabin 1- 2 Adults Cabin 2- 2 Adults 2 kids 3 & 5" name="for-multiple-cabin-requests-please-list-the-guest-make-up-of-each-cabin-" className="form-control"/> <field type="checkbox-group" label="Which cruise lines have you sailed on before?&nbsp;" description="Check all that apply" inline="true" name="if-you-answered-no-please-indicate-the-cruise-lines-you-have-sailed-on-before-" other="true"> <option label="Disney" value="disney">Disney</option> <option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option> <option label="Norwegian" value="norwegian">Norwegian</option> <option label="Carnival" value="carnival">Carnival</option> <option label="MSC" value="msc">MSC</option> <option label="AmaWaterways" value="amawaterways">AmaWaterways</option> <option label="Viking" value="viking">Viking</option> <option label="None- this is our first cruise" value="none-this-is-our-first-cruise">None- this is our first cruise</option> </field> <field type="checkbox-group" label="Do you have a preferred cruise line for this trip?&nbsp;" inline="true" name="do-you-have-a-preferred-cruise-line-for-this-trip-" other="true"> <option label="Disney" value="disney">Disney</option> <option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option> <option label="Norwegian" value="norwegian">Norwegian</option> <option label="Carnival" value="carnival">Carnival</option> <option label="MSC" value="msc">MSC</option> <option label="AMAWaterways" value="amawaterways">AMAWaterways</option> <option label="Viking" value="viking">Viking</option> </field> <field type="radio-group" required="true" label="Which cabin type would you like to book?&nbsp;" description="Not all cabin types are available on all ships" name="which-cabin-type-would-you-like-to-book-"> <option label="Inside/Interior (no window or balcony)" value="insideinterior-no-window-or-balcony">Inside/Interior (no window or balcony)</option> <option label="Oceanview (window/porthole only)" value="oceanview-windowporthole-only">Oceanview (window/porthole only)</option> <option label="Balcony/Verandah" value="balconyverandah">Balcony/Verandah</option> </field> <field type="radio-group" required="true" label="Where would you like your cabin located?&nbsp;" name="where-would-you-like-your-cabin-located-"> <option label="Front of the ship (aka Bow/Forward)" value="front-of-the-ship-aka-bowforward">Front of the ship (aka Bow/Forward)</option> <option label="Mid-Ship" value="midship">Mid-Ship</option> <option label="Rear of the ship (aka Aft/Stern)" value="rear-of-the-ship-aka-aftstern">Rear of the ship (aka Aft/Stern)</option> <option label="Best value for my cabin type." value="best-value-for-my-cabin-type">Best value for my cabin type.</option> </field> <field type="radio-group" label="If booking multiple cabins please select one" name="if-booking-multiple-cabins-please-select-one"> <option label="Cabins must be connecting" value="cabins-must-be-connecting">Cabins must be connecting</option> <option label="Cabins should be as close as possible on the same deck but do not have to connect" value="cabins-should-be-as-close-as-possible-on-the-same-deck-but-do-not-have-to-connect">Cabins should be as close as possible on the same deck but do not have to connect</option> <option label="We just want to be on the same ship" value="we-just-want-to-be-on-the-same-ship">We just want to be on the same ship</option> </field> <field type="radio-group" label="Dining Time Preference- Please note dining times vary by cruise line. Times are subject to availability.&nbsp;" name="dining-time-preference"> <option label="Early" value="early">Early</option> <option label="Late" value="late">Late</option> <option label="My Time (not available on all lines)" value="my-time-not-available-on-all-lines">My Time (not available on all lines)</option> <option label="No Preference" value="no-preference">No Preference</option> </field> <field type="text" label="Do you have any accommodation needs/requests?" description="Visual Auditory Mobility issues/wheelchair use cribs etc." name="meal-preference" subtype="text" className="form-control"/> <field type="radio-group" label="Are you celebrating a special occasion?&nbsp;" name="are-you-celebrating-a-special-occasion-" other="true"> <option label="Birthday" value="birthday">Birthday</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Reunion" value="reunion">Reunion</option> <option label="Wedding/Honeymoon" value="weddinghoneymoon">Wedding/Honeymoon</option> </field> <field type="clientLoyaltyPrograms" label="Please add any cruise line loyalty programs you belong to, including your member number.&nbsp;" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/> <field type="textarea" label="Please tell me about any must haves or deal breakers.&nbsp;" name="please-tell-me-about-any-must-haves-or-deal-breakers" className="form-control"/> <field type="textarea" label="How did you hear about That Vacation Lady?&nbsp;" name="how-did-you-hear-about-that-vacation-lady-" className="form-control"/> <field type="textarea" label="Anything else you would like me to know?&nbsp;" name="anything-else-you-would-like-me-to-know-" className="form-control"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="Thank you for completing the above information. My office hours are M - Th 9 am - 5 pm, Fri 9 am - 4 pm, Sat by appointment only. Please allow me 1 business day from the date you submit this form to review your information and contact you with our next steps. If you have not received a response within 1 business day please check your promotions and/or spam/junk mail folders as some email providers will route my emails there. I'm looking forward to working with you!&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="That Vacation Lady, LLC is an independent agent of Outside Agents/Cruises and Tours Unlimited. Florida Seller of Travel Ref. No. ST15578 – CST 2090937-50 – Washington UBID No. 603189022"/> </fields> </form-template> </body> </html>
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