<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="All Inclusive Vacations Form"/> <field type="paragraph" subtype="p" label="All-inclusive resorts are typically located in the Caribbean, however, there are some in other places around the world. Some of the most popular destinations for All-Inclusive Resorts include Mexico, Jamaica, and Dominican Republic. All inclusive vacations typically include the resort, food and beverages."/> <field type="header" subtype="h2" label="Full name"/> <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="Birthday" name="birthday" className="form-control"/> <field type="radio-group" label="Gender" name="gender"> <option label="M" value="m">M</option> <option label="F" value="f">F</option> <option label="X" value="x">X</option> </field> <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"/> <field type="textarea" label="Additional Travelers: Legal Names &amp; Ages *If kids are traveling. please indicate here the ages and how many kids will be traveling.&nbsp;&nbsp;" description="If travel is booked with GXT Travel each additional traveler will need to fill out their own profile form" name="additional-travelers-legal-names-ages-if-travel-is-booked-with-gxt-travel-each-additional-traveler-will-need-to-fill-out-their-own-profile-form" 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" label="Line 2" name="address-line-2" 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="text" required="true" label="Country" description="Quotes are only provided to US residents" name="address-country" 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" description="Please provide a valid email address." name="email" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Preferred method of contact" inline="true" name="preferred-method-of-contact"> <option label="Email" value="email">Email</option> <option label="Phone" value="phone">Phone</option> <option label="Text" value="text">Text</option> </field> <field type="text" required="true" label="Destination?" description="If not sure please give at least 3 destinations you would consider." name="destination" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Trip Details"/> <field type="checkbox-group" required="true" label="Which destination would you like to visit?" name="which-destination-would-you-like-to-visit" other="true"> <option label="Mexico - Cancun / Rivera Maya / Tulum" value="mexico-cancun-rivera-maya-tulum">Mexico - Cancun / Rivera Maya / Tulum</option> <option label="Mexico - Los Cabos" value="mexico-los-cabos">Mexico - Los Cabos</option> <option label="Mexico - Puerto Vallarta / Riviera Nayarit" value="mexico-puerto-vallarta-riviera-nayarit">Mexico - Puerto Vallarta / Riviera Nayarit</option> <option label="Mexico - Other" value="mexico-other">Mexico - Other</option> <option label="Jamaica (Montego Bay/Negril/Ocho Rios)" value="jamaica-montego-baynegrilocho-rios">Jamaica (Montego Bay/Negril/Ocho Rios)</option> <option label="Dominican Republic" value="dominican-republic">Dominican Republic</option> <option label="Costa Rica" value="costa-rica">Costa Rica</option> <option label="Saint Lucia" value="saint-lucia">Saint Lucia</option> <option label="Aruba" value="aruba">Aruba</option> <option label="Caribbean - Other" value="caribbean-other">Caribbean - Other</option> </field> <field type="textarea" required="true" label="Please describe Other vacation type" name="please-describe-other-vacation-type" className="form-control"/> <field type="date" required="true" label="When would you like to depart?" description="Just give general dates if not sure. You can change it at a later time." name="when-would-you-like-to-depart" className="form-control"/> <field type="date" required="true" label="When would you like to return?" description="Just give general dates if not sure. You can change it at a later time." name="when-would-you-like-to-return" className="form-control"/> <field type="radio-group" required="true" label="Are your dates flexible?" inline="true" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="Please list alternate dates, if flexible." name="please-list-alternate-dates-if-flexible" className="form-control"/> <field type="checkbox-group" required="true" label="I would like my quote to include:" inline="true" name="i-would-like-my-quote-to-include" other="true"> <option label="Airfare" value="airfare">Airfare</option> <option label="Transfers (to/from airport, hotel, port, etc.)" value="transfers-tofrom-airport-hotel-port-etc">Transfers (to/from airport, hotel, port, etc.)</option> <option label="Rental Car" value="rental-car">Rental Car</option> <option label="Excursions, Amusement Park Tickets, Activities" value="excursions-amusement-park-tickets-activities">Excursions, Amusement Park Tickets, Activities</option> </field> <field type="textarea" required="true" label="Please describe any accommodations needed for your trip" description="Please be as specific as possible." name="please-describe-any-accommodations-needed-for-your-trip" className="form-control"/> <field type="text" required="true" label="What is your departure Airport?" description="Where will you be flying from?" name="what-is-your-departure-airport" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your estimated TOTAL budget for per traveler?" name="what-is-your-estimated-total-budget-for-per-traveler" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="what-best-describes-your-hotel-preference" other="true"> <option label="Economy: I need a clean place to sleep" value="economy-i-need-a-clean-place-to-sleep">Economy: I need a clean place to sleep</option> <option label="Moderate: I prefer a bit more comfort and features" value="moderate-i-prefer-a-bit-more-comfort-and-features">Moderate: I prefer a bit more comfort and features</option> <option label="Luxury: I prefer larger rooms, finer linens, and high level of service" value="luxury-i-prefer-larger-rooms-finer-linens-and-high-level-of-service">Luxury: I prefer larger rooms, finer linens, and high level of service</option> <option label="Boutique: I prefer smaller more intimate local hotels" value="boutique-i-prefer-smaller-more-intimate-local-hotels">Boutique: I prefer smaller more intimate local hotels</option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="what-kind-of-vibe-are-you-looking-for" other="true"> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Adult Only" value="adult-only">Adult Only</option> <option label="Romantic" value="romantic">Romantic</option> <option label="Relaxing" value="relaxing">Relaxing</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Adventurous" value="adventurous">Adventurous</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="Are celebrating a special occasion?" inline="true" name="are-celebrating-a-special-occasion"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="N/A" value="na">N/A</option> </field> <field type="text" label="Please elaborate here if there is a special occasion being celebrated." name="please-elaborate-here-if-there-is-a-special-occasion-being-celebrated" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Passport Info"/> <field type="radio-group" required="true" label="Do you have a valid passport?" description="Please check that your passport does not expire within 6 months after your return." name="do-you-have-a-valid-passport"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/> <field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/> <field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/> <field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/> <field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="text" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/> <field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/> <field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/> <field type="textarea" required="true" label="If interested in excursions, please note that in this section." name="if-interested-in-excursions-please-note-that-in-this-section" className="form-control"/> <field type="text" label="Anything you absolutely must do or see?" name="anything-you-absolutely-must-do-or-see" subtype="text" className="form-control"/> <field type="textarea" required="true" label="What else would you like me to know?" description="Please let me know what else you would like for me to know." name="what-else-would-you-like-me-to-know" className="form-control"/> <field type="text" required="true" label="How did you hear about GXT Travel?" description="If you were referred please leave the person that referred you in this section." name="how-did-you-hear-about-gxt-travel" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Terms &amp; Conditions"/> <field type="paragraph" subtype="p" label="I authorize that I have submitted my research fee to GXT Travel as indicated on this invoice for the noted amount on today's date. This payment is for the services described on the invoice. I understand that all research fee payments made to GXT Travel are non-refundable. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, so long as the transaction corresponds to the terms indicated on this invoice. I also understand that research for my trip will not begin until I have submitted the research fee and the travel quote form. This is a non-refundable fee and does not apply to deposit and trip payment, even if you cancel your trip. It is non-refundable."/> <field type="header" subtype="h1" label="The price for the research fees is as following:"/> <field type="paragraph" subtype="p" label="The fees are due prior to research beginning. This is a flat fee structure. Established Clients: If you are a repeat client that has booked and traveled with GXT Travel, $20 off research fees.&nbsp; &nbsp;Once the form and fee are received, please allow up to 48 hours for turnaround for the quote.&nbsp;"/> <field type="header" subtype="h1" label="Fee Breakdown For Quotes:&nbsp;"/> <field type="paragraph" subtype="p" label="1-6 People: $75"/> <field type="paragraph" subtype="p" label="Groups of 7 or more : $125"/> <field type="paragraph" subtype="p" label="Flights/Hotel/Rental Cars (ala carte services): $35"/> <field type="paragraph" subtype="p" label="Airport Parking Only: $15"/> <field type="header" subtype="h1" label="Travel insurance will be added to the vacation package. If you choose to waive the insurance, a waiver is needed to be signed waiving the travel insurance."/> </fields> </form-template> </body> </html>
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