<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="INQUIRY - AFRICA"/> <field type="header" subtype="h1" 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="date" required="true" label="Your Date of Birth" name="your-date-of-birth" 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" label="Would you like to add anyone to our communications? Please list their name(s) and email(s) below.&nbsp;" name="would-you-like-to-add-anyone-to-our-communications-please-list-their-names-and-emails-below-" className="form-control"/> <field type="header" subtype="h1" label="ABOUT YOUR TRIP"/> <field type="textarea" required="true" label="What is the purpose for this vacation? Can you explain a little bit about what you're looking for?&nbsp;" name="what-is-the-purpose-for-this-vacation-can-you-explain-a-little-bit-about-what-youre-look-for-" className="form-control"/> <field type="textarea" required="true" label="Who all will be traveling with you? Please list all full names (including middle) AND birthdates, as listed on passport." name="who-all-will-be-traveling-with-you-please-list-all-full-names-including-middle-and-birthdates-as-listed-on-passport" className="form-control"/> <field type="date" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/> <field type="date" required="true" label="When would you like to return?" name="when-would-you-like-to-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="text" label="If flexible, please share a date range. *If sharing a range of dates, please list exact date ranges vs. general availability.&nbsp;" name="if-flexible-please-share-a-date-range" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your intended length of the trip?&nbsp;" name="what-is-your-intended-length-of-the-trip-" subtype="text" className="form-control"/> <field type="textarea" label="Have you been to Africa and or a Safari before? If so, what destinations and lodges did you visit?&nbsp;" name="have-you-been-to-africa-and-or-a-safari-before-if-so-what-destinations-and-lodges-did-you-visit-" className="form-control"/> <field type="checkbox-group" required="true" label="Which countries are you interested in visiting?&nbsp;" name="which-countries-are-you-interested-in-visiting-" other="true"> <option label="Botswana" value="botswana">Botswana</option> <option label="Namibia" value="namibia">Namibia</option> <option label="Kenya" value="kenya">Kenya</option> <option label="Rwanda" value="rwanda">Rwanda</option> <option label="Uganda" value="uganda">Uganda</option> <option label="Egypt " value="egypt-">Egypt </option> <option label="Malawi" value="malawi">Malawi</option> <option label="Mozambique" value="mozambique">Mozambique</option> <option label="Seychelles" value="seychelles">Seychelles</option> </field> <field type="text" label="Are there any destinations that you want to avoid?" name="are-there-any-destinations-that-you-want-to-avoid" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="What is your estimated investment per traveler (excluding flights and optional travel insurance)?" description="(on average Africa itineraries start at 10k per person)" name="what-is-your-estimated-investment-for-all-travelers-including-accommodations-and-activities-like-tours-and-transportation-excluding-flights-meals-and-optional-travel-insurance"> <option label="Whatever it takes to create the experience I am looking for" value="whatever-it-takes-to-create-the-experience-i-am-looking-for">Whatever it takes to create the experience I am looking for</option> <option label="$20,000+" value="20000">$20,000+</option> <option label="$15,000-$20,000" value="1500020000">$15,000-$20,000</option> <option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option> </field> <field type="checkbox-group" required="true" label="Which of the following is important to you (check all that apply)?" name="which-of-the-following-is-important-to-you-check-all-that-apply" other="true"> <option label="Authentic/Local Accommodations" value="authenticlocal-accommodations">Authentic/Local Accommodations</option> <option label="Luxury Resorts/Camps " value="luxury-resortscamps-">Luxury Resorts/Camps </option> <option label="AC/Charging Power in Room Required" value="accharging-power-in-room-required">AC/Charging Power in Room Required</option> <option label="Handicap Accessible " value="handicap-accessible-">Handicap Accessible </option> </field> <field type="checkbox-group" required="true" label="Please list all that are of interest during this trip?&nbsp;" name="which-best-describes-your-priorities-for-this-trip-select-multiple" other="true"> <option label="Safari/Game Drives" value="safarigame-drives">Safari/Game Drives</option> <option label="Gorilla Trekking" value="gorilla-trekking">Gorilla Trekking</option> <option label="Photography" value="photography">Photography</option> <option label="Cooking Classes" value="cooking-classes">Cooking Classes</option> <option label="Beach " value="beach-">Beach </option> <option label="History" value="history">History</option> <option label="Culture" value="culture">Culture</option> <option label="Shopping" value="shopping">Shopping</option> <option label="Hot Air Balloon " value="hot-air-balloon-">Hot Air Balloon </option> </field> <field type="checkbox-group" required="true" label="Room Type Preference:&nbsp;" name="room-bedding-preferences-check-all-that-apply" other="true"> <option label="King Preferred " value="king-preferred-">King Preferred </option> <option label="2 Queens (or 2 beds) Preferred" value="2-queens-or-2-beds-preferred">2 Queens (or 2 beds) Preferred</option> <option label="Suite (Bed and Den Space separated by a door)" value="suite-bed-and-den-space-separated-by-a-door">Suite (Bed and Den Space separated by a door)</option> <option label="Villa/Condo/House (Multiple Bedrooms and Living Space)" value="villacondohouse-multiple-bedrooms-and-living-space">Villa/Condo/House (Multiple Bedrooms and Living Space)</option> <option label="Connecting Rooms " value="connecting-rooms-">Connecting Rooms </option> <option label="Luxury Tent" value="luxury-tent">Luxury Tent</option> <option label="I Am Okay With Roughing It" value="i-am-okay-with-roughing-it">I Am Okay With Roughing It</option> </field> <field type="radio-group" label="If applicable, is it a deal breaker if rooms do not connect?&nbsp;" name="if-applicable-is-it-a-deal-breaker-if-rooms-do-not-connect-"> <option label="Yes " value="yes-">Yes </option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Is everyone a US citizen, with a passport valid for at least 6 months after your return?&nbsp;" name="is-everyone-a-us-citizen-with-a-passport-valid-for-at-least-6-months-after-your-return-" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Final Notes To Further Customize Your Travel"/> <field type="radio-group" required="true" label="Are you interested in adding our Concierge Services for detailed itinerary planning to include dining reservations, spa, and recreational bookings?*&nbsp;" name="are-you-interested-in-adding-our-concierge-services-for-detailed-itinerary-planning-to-include-dining-reservations-spa-and-recreational-bookings-"> <option label="Yes, I am interested" value="yes-i-am-interested">Yes, I am interested</option> <option label="No, I will book these myself" value="no-i-will-book-these-myself">No, I will book these myself</option> <option label="Unsure, can we talk about this more?" value="unsure-can-we-talk-about-this-more">Unsure, can we talk about this more?</option> </field> <field type="radio-group" required="true" label="I understand Professional Planning Fees are associated based on the level of services required. Please note, that we have a Fee Structure for our professional planning services. These fees vary based on the type of trip and level of service required. This will be discussed on your complimentary planning call with your agent." name="i-understand-professional-planning-fees-are-associated-based-on-the-level-of-services-required-please-note-that-we-have-a-fee-structure-for-our-professional-planning-services-these-fees-vary-based-on-the-type-of-trip-and-level-of-service-required-this-will-be-discussed-on-your-complimentary-planning-call-with-your-agent"> <option label="Yes, I understand" value="yes-i-understand">Yes, I understand</option> <option label="I'm confused, please explain further" value="im-confused-please-explain-further">I'm confused, please explain further</option> </field> <field type="textarea" label="Any other notes on your preferences or dreams for this trip to help me tailor it for you?" name="any-other-notes-on-your-preferences-or-dreams-for-this-trip-to-help-me-tailor-it-for-you" className="form-control"/> </fields> </form-template> </body> </html>
SUBMIT FORM
American Airlines (AAdvantage)
United Airlines (Mileage Plus)
Delta Air Lines (SkyMiles)
Hilton (Honors)
Marriott Bonvoy
Southwest Airlines (Rapid Rewards)
IHG Rewards Club
Hyatt (World of Hyatt)
JetBlue Airways (trueBlue)
British Airways (Executive Club)
Alaska Airlines (Mileage Plan)
Hertz Gold Plus Rewards
Virgin America (eleVAte)
Club Carlson Hotels
Avis (Preferred)
Amtrak (Guest Rewards)
National (Emerald Club)
Wyndham Rewards (Days Inn, etc.)
Hawaiian Airlines (HawaiianMiles)
Choice Hotels (Choice Privileges)
Frontier Airlines (EarlyReturns)
Best Western Rewards
Lufthansa (Miles and More)
Virgin Atlantic (Flying Club)
Air Canada Aeroplan
Enterprise Rent-A-Car
Korean Air (SkyPass)
Air France (Flying Blue)
Singapore Airlines (KrisFlyer)
Emirates (Skywards)
Spirit Airlines (Free Spirit)
Le Club Accorhotels (Accor Hotels, Novotel, etc.)
Hotels.com Rewards
All Nippon Airways (ANA Mileage Club)
Cathay Pacific (Asia Miles)
Fairmont President's Club
Qantas (Frequent Flyer)
Budget (Fastbreak)
La Quinta, etc. (Returns)
Iberia Plus
Kimpton (Karma Rewards)
Asiana Airlines (Asiana Club)
Omni Hotels (Select Guest)
AviancaTaca (LifeMiles)
Alamo
Etihad Airways (Etihad Guest)
Aegean Airlines (Miles & Bonus)
KLM (Flying Blue)
MGM Resorts (M life Players Club)
Japan Airlines (JMB)
AirBerlin (Topbonus)
LATAM (LATAM Pass)
Thrifty (Blue Chip Rewards)
Royal Caribbean (Crown & Anchor Society)
Alitalia (MilleMiglia)
Qatar Airways (Qmiles)
Jet Airways (JetPrivilege)
Turkish Airlines (Miles&Smiles)
Icelandair (Saga Club)
Dollar Rent A Car (Express)
Carnival (VIFP)
Eva Air (Infinity MileageLands)
Sun Country Airlines (Ufly Rewards)
Shangri-La (Golden Circle)
Air India (Flying Returns)
Sixt Rent-a-Car
BMI (Diamond Club)
Booking.com
Loews Hotels (YouFirst Rewards)
Norwegian Air Shuttle ASA (Norwegian Reward)
Stash Hotel Rewards
Scandinavian Airlines System (EuroBonus)
Norwegian Cruise Line (Latitudes)
Aeromexico (Club Premier)
Copa Airlines ConnectMiles (Prefer)
Celebrity Cruises (Captain's Club)
Drury Hotels (Gold Key Club)
Aer Lingus (Gold Circle)
Virgin Australia (Velocity Frequent Flyer)
EL AL Israel Airlines (Matmid)
Princess Cruise Lines (Captain Circle)
China Airlines (Dynasty Flyer)
Delta (SkyBonus Corporate)
Melia (Melia Rewards)
GHA (Discovery)
Air China (PhoenixMiles)
Air Asia (BIG)
Gol Airlines (Smiles)
Malaysia Airlines (Enrich)
Air New Zealand (Airpoints)
WestJet (Frequent Guest)
Porter (VIPorter)
Agoda Rewards
Thai Airways (Royal Orchid Plus)
VOILÀ Hotel Rewards
Preferred Hotels, etc. (iPrefer)
Red Roof Inn (RediCard)
Aeroflot Bonus
China Eastern (Eastern Miles)
Holland America Line (Mariner Society)
Philippine Airlines (Mabuhay Miles)
Bangkok Airways (FlyerBonus)
Hilton Grand Vacations (Club)
South African Airways (Voyager)
China Southern (Sky Pearl)
Finnair Plus
Small Luxury Hotels (The Club)
TAP Portugal (Victoria Miles)
Avianca (Amigo)
Langham Hotels (1865 Club)
Fox Rent A Car (Rewards)
Hainan Airlines (Fortune Wings)
AmericInn (Easy Rewards)
Disney Cruise Line (Castaway Club)
Payless Car Rental (Perks Club)
Azul (TudoAzul)
Starwood Hotels (Preferred Business)
My Europcar (Privilege)
Hyatt (Vacation Club)
Aerolineas Argentinas (Plus)
Taj (InnerCircle)
British Airways (On Business, Corporate)
Leading Hotels of the World (Leaders Club)
Eurostar Frequent Traveler
Red Lion (Hello Rewards)
Air Tahiti Nui (Club Tiare)
United PerksPlus (Corporate Program)
NH Hotels (NH World)
Swissotel Circle
Millennium & Copthorne (My Millennium)
Ethiopian Airlines (ShebaMiles)
Royal Air Maroc (Safar Flyer)
Alaska Airlines (EasyBiz Corporate)
Vueling Airlines (Punto Punto)
Gulf Air (Falconflyer)
Star Alliance Company (PlusAwards)
Coast Hotels (Coast Rewards)
Royal Jordanian Airlines (Royal Plus)
HotelClub (Member Rewards)
Czech Airlines (OK Plus)
VIA Rail Canada (VIA Preference)
Trump Card (Privileges Program)
Borgata (Rewards)
Saudi Arabian Airlines (Alfursan)
Vietnam Airlines (Golden Lotus Plus)
Egypt Air Plus
Scandic Hotels (Scandic Friends)
JetBlue Airways (CompanyBlue)
Hostelworld (My World)
Jumeirah (Sirius)
E-Z Rent-A-Car (E-Z Money)
Deutsche Bahn (BahnCard)
Garuda (Frequent Flyer)
TripAdvisor
Kuwait Airways (Oasis Club)
Cosmopolitan Hotels (Identity)
Advantage Rent a Car (Instant Rewards)
Cayman Airways (Sir Turtle Rewards)
Caribbean Airlines (Caribbean Miles)
RIU Hotels & Resorts (RIU Class)
Easyjet
SriLankan (FlySmiLes)
TabletHotels (Reward Dollars)
Ace Rent a Car
Thalys (The Card)
S7 Priority
Air Baltic (Pins)
Choice Hotels (Nordic Choice Club)
Trident Hotels (Trident Privilege)
Middle East Airlines (Cedar Miles)
Emirates for Kids (Skysurfer)
Rydges (PriorityGUEST)
Oman Air (Sindbad)
Island Air (Cloud 9)
Ukraine International Airlines (Panorama Club)
Flybe (Rewards4all)
SNCF (Voyageur)
Marriott Gift Cards
Qantas (Aquire)
Pegasus Airlines (Pegasus Plus)
Air Transat
Silver Cloud (Rewards)
Brussels Airlines (LOOPs)
JAL Hotels (One Harmony)
Eurowings (Boomerang)
Azamara (Le Club Voyage)
Otel.com (FivePlus)
Meridiana Fly (Hi-Fly)
Prince Resorts Hawaii (Prince Preferred)
PIA (Awards Plus)
Air Astana (Nomad Club)
Regal Hotels (Regal Rewards)
IndiGo
Era Alaska (FlyAway Rewards)
Red Spotted Hanky (Loyalty points)
Thon Hotels (Thon Member)
Air Jamaica (Seventh Heaven)
Trenitalia (FrecciaClub)
Air Malta (Flypass)
Splendia (Club Rewards)
Dorint (Card)
UTair (Status)
Tsogo Sun (Frequent Guest)
Sino Hotel Group (IPrestige)
KLM BlueBiz (Corporate)
RZD (Bonus)
Elite Hotels of Sweden
New Otani (Club International)
Air Algérie (Air Algérie Plus)
Ryanair
The Montcalm & Shaftsbury (Premier Club)
Dan Hotels (e-dan club)
Pestana Priority Guest
Macdonald Hotels (The Club)
Air Mauritius (Kestrelflyer)
Frasers Hospitality (Fraser World)
AirBerlin (business points)
Park-N-Go (Frequent Parker Rewards)
Localiza Rent a Car
Jurys Inn (Jurys Rewards)
Air Caraibes (Preference)
Bulgaria Air (Fly More)
Air Niugini (Destinations)
TUIfly.com
Cebu Pacific (Getgo)
Premier Hotels (Premier Club)
Jet2.com (My Jet2)
Air Austral (My Capricorne)
CAT (C-Club)
Opinion Miles Club
Ural Airlines (Wings)
Air Europa (SUMA)
Monarch (Vantage Club)
Stena Line (Extra)
La Compagnie (My Compagnie)
First Hotels (First Member)
Belavia (Leader)
Azerbaijan Airlines (Azal Miles)
Wizz Air (Discount Club)
Tunisair (Fidelys)
Paradores (Amigos de Paradores)
Vistara (Vistara Club)
Montenegro Airlines (Vision Team)
Asky Airlines (ASKY Club)
Jinling Hotels (Elite)
Moby Lines (Moby Club)
Jin Jiang Group (J-Club)
AtlasGlobal (AtlasMiles)
Qubus Hotel (Q-Club)
Braathens Regional Airlines (BRA Friends )
Hotelbooker.org
Flynas (NaSmiles)
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)
Etihad (BusinessConnect)
Gloria Hotels & Resorts (Gloria Partner)
Santos Hotels (Club Santos)
Known Traveler Number (KTN)
Global Entry ID
TSA PreCheck
NEXUS ID
SENTRI ID
American Automative Association (AAA)
Sandals Select Guest (SSG)
Mandarin Oriental Fan
Relais and Chateaux 5C
Four Seasons Preferred
Dorchester Diamond
Peninsula Pen
Belmond Bellini
Silversea Venetian
Oceania Cruise Lines
Regent Cruise Line
Seabourn Cruise Line
Lindblad Expeditions
SeaDream Yacht Club
Cunard
Virgin Voyages Sailing Club
AmaWaterways