Luxe World Travels

Luxe World Travels, LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="date" label="Today's Date" name="todays-date" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Group's Name (i.e. Jameson's Wedding)" name="groups-name-ie-jamesons-wedding" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Type of Travel Package" name="type-of-travel-package">&#13;
			<option label="Land only Package" value="Hotel, Airport Transfer, Excursions, etc">Land only Package</option>&#13;
			<option label="Full Vacation Package" value="Land Package + Flight">Full Vacation Package</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Total number of Suitemates" name="total-number-of-suitemates">&#13;
			<option label="Single Occupancy" value="single-occupancy">Single Occupancy</option>&#13;
			<option label="Double Occupancy" value="double-occupancy">Double Occupancy</option>&#13;
			<option label="Triple Occupancy" value="triple-occupancy">Triple Occupancy</option>&#13;
		</field>&#13;
		<field type="text" label="Suitemate's Name (Double Occupancy)" name="suitemates-name-double-occupancy" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Suitemate's DOB (Double Occupancy)" name="suitemates-dob-double-occupancy" className="form-control"/>&#13;
		<field type="text" label="Suitemate's Name (Triple Occupancy)" name="suitemates-name-triple-occupancy" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Suitemate's DOB (Triple Occupancy)" name="suitemates-dob-triple-occupancy" className="form-control"/>&#13;
		<field type="text" label="Desired Room Category &amp;amp; Bedding (i.e. Deluxe Jr. Suite, King Bed)" name="desired-room-category-bedding-ie-deluxe-jr-suite-king-bed" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you currently have a passport that will still be active 3 months after the trip concludes?" name="do-you-currently-have-a-passport-that-will-still-be-active-3-months-after-the-trip-concludes">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you desire trip protection?" name="do-you-desire-trip-protection">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" 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"/>&#13;
		<field type="textarea" label="Additional Notes for your trip" description="AAA  Military  Special Accommodations needed?" name="additional-notes-for-your-trip" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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By signing below, I authorize Luxe World Travels, LLC to charge the credit card provided herein.

Booking Terms and Conditions:

Required deposits/payments must be up to date at all times to maintain individual or group bookings. Bookings that do not have the required deposit/payment will be automatically cancelled. For groups, the Supplier reserves the right to recall all or part of a groups unsold space.

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