<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="INQUIRY - LUXURY SMALL SHIP EUROPEAN OCEAN CRUISE"/> <field type="header" subtype="h2" 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="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" required="true" label="Please list all additional travelers with their full names and birthdays as they appear on their passports." name="please-list-all-additional-travelers-with-their-full-names-and-birthdays-as-they-appear-on-their-passports" className="form-control"/> <field type="text" label="Would you like to add anyone to our communications? Please list their name(s) and email(s) below." name="would-you-like-to-add-anyone-to-our-communications-please-list-their-names-and-emails-below" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="About Your Trip"/> <field type="date" required="true" label="What's the earliest you can depart?" name="whats-the-earliest-you-can-depart" className="form-control"/> <field type="date" required="true" label="What's the latest you can return?" name="whats-the-latest-you-can-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" required="true" label="How many nights would you like the cruise to be (this can be a range)?" name="how-many-nights-would-you-like-the-cruise-to-be-this-can-be-a-range" subtype="text" className="form-control"/> <field type="text" required="true" label="Are you interested in a Pre-Stay or Post-Stay (list how many days either before or after you would like to arrive to cruise- or if you’d to visit other locations prior to embarking&nbsp; on your cruise)" name="are-you-interested-in-a-prestay-or-poststay-list-how-many-days-either-before-or-after-you-would-like-to-arrive-to-cruise-or-if-youd-to-visit-other-locations-prior-to-embarking-on-your-cruise" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Would you like to include airfare?&nbsp;" description="*We only book business class and above" name="would-you-like-to-include-airfare"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="If you would like to include airfare, which airport would you be departing from?" name="if-you-would-like-to-include-airfare-which-airport-would-you-be-departing-from" subtype="text" className="form-control"/> <field type="text" label="Are you celebrating anything special?" name="are-you-celebrating-anything-special" subtype="text" 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="textarea" label="If you have cruised before, please list any of your past passenger/loyalty cruise numbers:" name="if-you-have-cruised-before-please-list-any-of-your-past-passengerloyalty-cruise-numbers" rows="2" className="form-control"/> <field type="textarea" label="Please list below if you have a cruise line preferences:" name="please-list-below-if-you-have-a-cruise-line-preferences" rows="3" className="form-control"/> <field type="textarea" label="Please list below if there are any cruise lines you would like to avoid:" name="please-list-below-if-there-are-any-cruise-lines-you-would-like-to-avoid" rows="3" className="form-control"/> <field type="checkbox-group" required="true" label="Please select the area(s) that you are most interested In visiting:" name="please-select-the-areas-that-you-are-most-interested-in-visiting"> <option label="Mediterranean (to include locations such as Spain, France, and Italy)" value="mediterranean-to-include-locations-such-as-spain-france-and-italy">Mediterranean (to include locations such as Spain, France, and Italy)</option> <option label="Mediterranean (to include locations such as Italy, Greece and Croatia)" value="mediterranean-to-include-locations-such-as-italy-greece-and-croatia">Mediterranean (to include locations such as Italy, Greece and Croatia)</option> <option label="Greek Islands Only" value="greek-islands-only">Greek Islands Only</option> <option label="Scandinavia/Baltic (to include locations such as Demark, Norway, and Sweden)" value="scandinaviabaltic-to-include-locations-such-as-demark-norway-and-sweden">Scandinavia/Baltic (to include locations such as Demark, Norway, and Sweden)</option> <option label="British Isles (to include Ireland/Scotland)" value="british-isles-to-include-irelandscotland">British Isles (to include Ireland/Scotland)</option> <option label="Iceland" value="iceland">Iceland</option> <option label="Portugal/Azores" value="portugalazores">Portugal/Azores</option> <option label="Atlantic Crossing" value="atlantic-crossing">Atlantic Crossing</option> <option label="Specialized Itinerary not listed above" value="specialized-itinerary-not-listed-above">Specialized Itinerary not listed above</option> </field> <field type="radio-group" required="true" label="What is your minimum budget starting with 2 people in a cabin that you are comfortable with for the CRUISE ONLY?" name="what-is-your-minimum-budget-starting-with-2-people-in-a-cabin-that-you-are-comfortable-with-for-the-cruise-only" other="true"> <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="$25,000+" value="25000">$25,000+</option> <option label="$15,000-$25,000" value="1500025000">$15,000-$25,000</option> <option label="$10,000-$15,000" value="1000015000">$10,000-$15,000</option> </field> <field type="textarea" label="Is there anything else I should know about your price range?" name="is-there-anything-else-i-should-know-about-your-price-range" className="form-control"/> <field type="header" subtype="h1" label="Your Preferences&nbsp;"/> <field type="radio-group" required="true" label="Which option would you prefer while pricing out options?" name="which-option-would-you-prefer-while-pricing-out-options" other="true"> <option label="All-Inclusive Pricing at time of booking (to included things like pre paid gratuities, all tours, unlimited drinks)" value="allinclusive-pricing-at-time-of-booking-to-included-things-like-pre-paid-gratuities-all-tours-unlimited-drinks">All-Inclusive Pricing at time of booking (to included things like pre paid gratuities, all tours, unlimited drinks)</option> <option label="I would rather pay less initially and include things once onboard (gratuities, specialty drinks, upgraded tour options) ((beer and wine will be served at meals and each stop will include a complimentary tour, however additional tour options/experiences are available for an upcharge))" value="i-would-rather-pay-less-initially-and-include-things-once-onboard-gratuities-specialty-drinks-upgraded-tour-options-beer-and-wine-will-be-served-at-meals-and-each-stop-will-include-a-complimentary-tour-however-additional-tour-optionsexperiences-are-available-for-an-upcharge">I would rather pay less initially and include things once onboard (gratuities, specialty drinks, upgraded tour options) ((beer and wine will be served at meals and each stop will include a complimentary tour, however additional tour options/experiences are available for an upcharge))</option> </field> <field type="checkbox-group" required="true" label="Are you interested in:" description="Check all that apply" name="are-you-interested-in" other="true"> <option label="Luxury small-ship ocean cruise (Silversea, Seabourn, Regent, etc.)" value="luxury-smallship-ocean-cruise-silversea-seabourn-regent-etc">Luxury small-ship ocean cruise (Silversea, Seabourn, Regent, etc.)</option> <option label="Yacht charter (Ritz-Carlton, Explora, SeaDream, etc.,)" value="yacht-charter-ritzcarlton-explora-seadream-etc">Yacht charter (Ritz-Carlton, Explora, SeaDream, etc.,)</option> <option label="Expedition cruise (Lindblad, Hurtigruten, etc.)" value="expedition-cruise-lindblad-hurtigruten-etc">Expedition cruise (Lindblad, Hurtigruten, etc.)</option> </field> <field type="checkbox-group" required="true" label="What type of cabin are you interested in?" description="You can choose multiple options if you'd like to compare pricing. Please note depending on the size of the cruise ship there might be sub categories within the ones listed below (ex - interior garden view - faces inside of ship)" name="what-type-of-cabin-are-you-interested-in" other="true"> <option label="Suite" value="suite">Suite</option> <option label="Veranda/Balcony" value="verandabalcony">Veranda/Balcony</option> <option label="Ocean View/Window" value="ocean-viewwindow">Ocean View/Window</option> <option label="Interior View/No Window" value="interior-viewno-window">Interior View/No Window</option> <option label="Connecting Cabins Required" value="connecting-cabins-required">Connecting Cabins Required</option> <option label="Open To Additional Options Depending On Ship Layout" value="open-to-additional-options-depending-on-ship-layout">Open To Additional Options Depending On Ship Layout</option> </field> <field type="textarea" required="true" label="Cabin location preferences. Ex - mid-ship, aft or forward" name="cabin-location-preferences-ex-midship-aft-or-forward" className="form-control"/> <field type="checkbox-group" label="Are any of these important? *These only apply to ocean cruises." inline="true" name="are-any-of-these-important-these-only-apply-to-ocean-cruises" other="true"> <option label="Casino" value="casino">Casino</option> <option label="Babysitting" value="babysitting">Babysitting</option> <option label="Kids/Teen club" value="kidsteen-club">Kids/Teen club</option> <option label="Sports court" value="sports-court">Sports court</option> <option label="Lots of specialty dining venues" value="lots-of-specialty-dining-venues">Lots of specialty dining venues</option> <option label="Rock wall" value="rock-wall">Rock wall</option> <option label="Zipline" value="zipline">Zipline</option> <option label="Flow Rider" value="flow-rider">Flow Rider</option> <option label="Water slide" value="water-slide">Water slide</option> <option label="Go-carts" value="gocarts">Go-carts</option> <option label="Adults-only pool" value="adultsonly-pool">Adults-only pool</option> <option label="Outdoor movies" value="outdoor-movies">Outdoor movies</option> <option label="Spa" value="spa">Spa</option> <option label="Nightly shows" value="nightly-shows">Nightly shows</option> </field> <field type="checkbox-group" required="true" label="Dining Time Preferences" name="are-you-looking-forward-to" other="true"> <option label="Early (5:30 pm - 6:00 pm start time)" value="early-530-pm-600-pm-start-time">Early (5:30 pm - 6:00 pm start time)</option> <option label="Late (8:00 pm start time)" value="late-800-pm-start-time">Late (8:00 pm start time)</option> <option label="My time dining (dining at my own leisure if applicable)" value="my-time-dining-dining-at-my-own-leisure-if-applicable">My time dining (dining at my own leisure if applicable)</option> </field> <field type="header" subtype="h1" label="Additional Information"/> <field type="radio-group" required="true" label="Is anyone in your party pregnant or planning to become pregnant before the cruise?" description="This is so we can advise as each cruise line has their own policy regarding cruising while pregnant. This information is private." name="is-anyone-in-your-party-pregnant-or-planning-to-become-pregnant-before-the-cruise"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="Is everyone in your party a US citizen?" description="If not we need to know we can advise you properly." name="is-everyone-in-your-party-a-us-citizen"> <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="text" required="true" label="What state do you reside in?" name="what-state-do-you-reside-in" subtype="text" className="form-control"/> <field type="textarea" label="What else would you like me to know? (dietary or medical requirements, special requests, etc)" name="what-else-would-you-like-me-to-know-dietary-or-medical-requirements-special-requests-etc" className="form-control"/> <field type="header" subtype="h1" label="Final Notes To Further Customize Your Travel&nbsp;"/> <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="Anything else you'd like me to know about your trip?" name="anything-else-youd-like-me-to-know-about-your-trip" rows="3" className="form-control"/> </fields> </form-template> </body> </html>
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