Share your information with Lee Anne Emig

Lee Anne Emig

The Vaca Shop

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		<field type="header" subtype="h2" label="Virgin Voyages Sailing - Quick Quote"/>&#13;
		<field type="paragraph" subtype="p" label="Ahoy Sailor! Whether you&#39;re ready to book or just exploring your options, complete this short form and I will respond with a custom quote. If you have questions about a sailing or the form, reach out to me directly at leeanne@thevacashop.com.&amp;nbsp; Don&#39;t see what you want? As a certified Virgin Voyages First Mate, I can assist you with other cabin/suite options, itineraries, pricing and promotions.&amp;nbsp; &amp;nbsp;QUICK TIP: If you don&#39;t hear from me within 24 hours, please check your spam folder. If you can&#39;t find a reply, text me at (618) 407-7517.&amp;nbsp; Much thanks!&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="PASSPORTS ARE REQUIRED to Travel: Passport must be valid for at least 6 months beyond your travel dates to enter many international destinations.&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;"/>&#13;
		<field type="radio-group" label="Are you interested in FlexPay options?" name="radio-group-1781997588889">&#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 have a preferred Departure Date" name="radio-group-1785861904626">&#13;
			<option label="Yes - please list below" value="yes-please-list-below">Yes - please list below</option>&#13;
			<option label="Undecided" value="undecided">Undecided</option>&#13;
		</field>&#13;
		<field type="date" label="Preferred Departure Date" name="date-1785860749743" className="form-control"/>&#13;
		<field type="radio-group" label="Have you decided on which Sailing itinerary you&#39;re interested in?" name="radio-group-1785861983960">&#13;
			<option label="Yes - please list below" value="yes-please-list-below">Yes - please list below</option>&#13;
			<option label="Undecided" value="undecided">Undecided</option>&#13;
		</field>&#13;
		<field type="text" label="Which Virgin Voyages Sailing are you interested In?" name="text-1785860831572" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you have a preferred departure port?" name="radio-group-1785862105563">&#13;
			<option label="Yes - please list below" value="yes-please-list-below">Yes - please list below</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Preferred Departure Port - what port will you embark from?" name="text-1785860879080" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What type of Cabin do you prefer?" name="radio-group-1785861259333">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Sea View" value="sea-view">Sea View</option>&#13;
			<option label="Sea Terrace" value="sea-terrace">Sea Terrace</option>&#13;
			<option label="Rock Star Suite" value="rock-star-suite">Rock Star Suite</option>&#13;
			<option label="Undecided" value="undecided">Undecided</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Has anyone in your cabin cruised with Virgin Voyages before?" name="radio-group-1781994194632">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Does anyone in your cabin require an accessible cabin?" name="radio-group-1781994283982">&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Hearing or Vision Impairment" value="hearing-or-vision-impairment">Hearing or Vision Impairment</option>&#13;
			<option label="Limited Mobility" value="limited-mobility">Limited Mobility</option>&#13;
			<option label="Wheelchair or Scooter" value="wheelchair-or-scooter">Wheelchair or Scooter</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Lead Guest Contact Details"/>&#13;
		<field type="text" required="true" label="Legal First name of the Lead Guest" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Legal Last name of Lead Guest" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email of Lead Guest" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number of Lead Guest" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Still Have a Question? I&#39;m here to assist you! Just reach out by EMAIL at leeanne@thevacashop.com or TEXT me at (618) 407-7517. Have a fabulous day!"/>&#13;
	</fields>&#13;
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