<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Get Started Planning"/> <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="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="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="select" required="true" label="Preferred Communication Style" name="preferred-communication-style" className="form-control"> <option label="Email" value="email">Email</option> <option label="Phone Call" value="phone-call">Phone Call</option> <option label="Text Message" value="text-message">Text Message</option> </field> <field type="text" required="true" label="Where do you want to travel?" name="where-do-you-want-to-travel" subtype="text" className="form-control"/> <field type="text" required="true" label="When do you want to travel? Tell us your dates and length of travel." description="We need specific dates but let us know if this is flexible." placeholder="EX: Our travel dates are July 20-27 but we are flexible by 2 days on each end. We want to be gone at least 6 nights but no more than 10." name="when-do-you-want-to-travel" subtype="text" className="form-control"/> <field type="text" required="true" label="List the members of your traveling party and their relation to you" description="EX: 4 couples- friends from college; grandparents (60s) with their kids and grandkids (4 adults 4 children age 5-10) 8 college girlfriends in their 30s, etc." name="tell-me-about-your-traveling-party-who-is-coming-ages-special-celebrations-any-special-requestsneeds-dietary-mobility-allergies-etc" subtype="text" className="form-control"/> <field type="text" required="true" label="Are you celebrating anything on this trip?" name="list-any-dietary-or-other-special-needs-of-anyone-in-the-traveling-party" subtype="text" className="form-control"/> <field type="text" required="true" label="What is the most stressful part of planning travel for you?" name="what-is-the-most-stressful-part-of-planning-travel-for-you" subtype="text" className="form-control"/> <field type="select" required="true" label="What are you willing to invest for your ideal travel experience (accommodations and activities- air/meals not included)" name="what-are-you-willing-to-invest-for-your-ideal-travel-experience-accommodations-and-activities-airmeals-not-included" className="form-control"> <option label="$5000-$7499" value="50007499">$5000-$7499</option> <option label="$7500-$9999" value="75009999">$7500-$9999</option> <option label="$10,000-$14,999" value="1000014999">$10,000-$14,999</option> <option label="$15,000-$19,999" value="1500019999">$15,000-$19,999</option> <option label="$20,000+" value="20000">$20,000+</option> <option label="Whatever it takes to get the experience we want" value="whatever-it-takes-to-get-the-experience-we-want">Whatever it takes to get the experience we want</option> </field> <field type="radio-group" required="true" label="Are you comfortable booking your own airfare? (I am happy to consult on options but do not book airfare)" name="are-you-comfortable-booking-your-own-airfare-i-am-happy-to-consult-on-options-but-do-not-book-airfare"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="From what airport will you depart?" name="from-what-airport-will-you-depart" subtype="text" className="form-control"/> <field type="text" label="List any allergies or accessibility needs" name="list-any-allergies-or-accessibility-needs" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="What is your travel style?" name="what-does-your-ideal-trip-include" other="true"> <option label="Rest and Relaxation" value="rest-and-relaxation">Rest and Relaxation</option> <option label="Activity- keep me on the move" value="activity-keep-me-on-the-move">Activity- keep me on the move</option> <option label="Family Activities" value="family-activities">Family Activities</option> <option label="Mix of R&R and discovering a new place" value="mix-of-rr-and-discovering-a-new-place">Mix of R&R and discovering a new place</option> <option label="Off-the-beaten-path- Get me away from the crowds" value="offthebeatenpath-get-me-away-from-the-crowds">Off-the-beaten-path- Get me away from the crowds</option> <option label="Instagramable- I want all the perfect photos" value="instagramable-i-want-all-the-perfect-photos">Instagramable- I want all the perfect photos</option> <option label="Local Culture- I want to interact with locals" value="local-culture-i-want-to-interact-with-locals">Local Culture- I want to interact with locals</option> </field> <field type="text" required="true" label="Why do you want to work with a travel advisor for this trip?" description="I don't have time to plan there are too many choices I want everything taken care of for me, etc" name="why-do-you-want-to-work-with-a-travel-advisor-for-this-trip" subtype="text" className="form-control"/> <field type="text" label="Is there anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="text" label="What is your social media of choice? (Share how we can find and connect with you)" name="what-is-your-social-media-of-choice" subtype="text" className="form-control"/> <field type="textarea" required="true" label="When you get home after your trip, in one sentence how would you like to describe the trip to your friends and family" description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="textarea" label="Tell me any other helpful information" description="Motion sickness Fear of heights Fear of water, etc." name="is-there-anything-else-you-would-like-me-to-know-" className="form-control"/> <field type="checkbox-group" required="true" label="Would you like to be added to our monthly e-newsletter" name="would-you-like-to-be-added-to-our-monthly-enewsletter"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="We charge a non-refundable travel planning fee, starting at $400. This fee covers the time involved in researching, preparing and executing a customized travel experience for you. This form collects your name, email address, physical address, and phone number information so that we may communicate with you and begin planning." name="we-charge-a-nonrefundable-travel-planning-fee-starting-at-250-this-fee-covers-the-time-involved-in-researching-preparing-and-executing-a-customized-travel-experience-for-you-this-form-collects-your-name-email-address-physical-address-and-phone-number-information-so-that-we-may-communicate-with-you-and-begin-planning"> <option label="I understand and agree" value="i-understand-and-agree">I understand and agree</option> </field> <field type="checkbox-group" required="true" label="PGT accepts all bookings solely as the booking agent for the travel Suppliers on your itinerary. Separate Supplier terms and conditions will apply to your reservation and purchase of travel-related goods and services that you select, and you understand and agree that by booking travel through PGT, you are also agreeing to the booking terms of each Supplier partner you have selected for your itinerary. You agree that you will abide by the terms and conditions of purchase imposed by any Supplier that you have selected as a service provider on an itinerary you have approved." name="priceless-gem-travel-llc-acts-solely-as-a-booking-agent-for-disclosed-principal-suppliers-and-is-not-the-source-or-provider-of-any-travel-service-each-supplier-is-an-independent-entity-with-its-own-management-and-is-not-subject-to-the-control-of-priceless-gem-travel-for-this-reason-you-will-typically-see-all-pricing-as-bundled-rates-and-not-broken-out-by-component-our-partners-do-not-provide-component-pricing-to-protect-their-contracts-therefore-priceless-gem-travel-is-not-able-to-provide-disclose-component-pricing-do-you-agree-and-understand-that-you-will-receive-all-pricing-as-a-package-rate"> <option label="I understand and I agree" value="i-understand-and-i-agree">I understand and I agree</option> </field> </fields> </form-template> </body> </html>
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