Embedded forms must require the client's name and email. We have added/required these fields for you.
<html> <body> <form-template> <fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field> <field type="header" subtype="h2" label="A Few Additional Details..."/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="text" label="Dates of Travel?" description="How many nights." name="dates-of-travel" subtype="text" className="form-control"/> <field type="text" label="What are your preferred departure cities?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="How many travelers? (Children please list age at time of travel)" description="3 Adult 2 Children 12/15" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" label="If a small group, what are the room breakdowns?&nbsp; (Room 1-1A2K(1 adult 2 kids)" description="Room 1- 2A2K Room 2- 1A1K etc." name="if-a-small-group-what-are-the-room-breakdowns-room-11a2k1-adult-2-kids" subtype="text" className="form-control"/> <field type="radio-group" label="What is your budget for this trip ?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$2,500" value="2500">$2,500</option> <option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> <option label="Whatever it takes to make it happen" value="whatever-it-takes-to-make-it-happen">Whatever it takes to make it happen</option> </field> <field type="radio-group" label="Preferred Time between Flights?" name="preferred-time-between-flights"> <option label="Less than 2 Hours" value="less-than-2-hours">Less than 2 Hours</option> <option label="2+ Hours" value="2-hours">2+ Hours</option> </field> <field type="radio-group" label="Airline Preference" description="Value (cheap rate pay for carry-ons checked luggage and seats) Premium(amenities vary by provider)" name="airline-preference"> <option label="Value Airline" value="value-airline">Value Airline</option> <option label="Premium Airline" value="premium-airline">Premium Airline</option> </field> <field type="radio-group" label="What best describes your Hotel/Resort preference?" name="hotel-preference" other="true"> <option label="Necessities" value="necessities">Necessities</option> <option label="Convenient" value="convenient">Convenient</option> <option label="Comfort" value="comfort">Comfort</option> <option label="Lavish" value="lavish">Lavish</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for in your Hotel/Resort?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</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="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-and-wine">Food and wine</option> </field> <field type="radio-group" label="Do you want Excursions Included?" description="Activities during your trip." name="do-you-want-excursions-included"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> <option label="Fishing" value="fishing">Fishing</option> <option label="NONE" value="none">NONE</option> </field> <field type="checkbox-group" required="true" label="Travel items needed" description="What are you wanting specific assistance with for your trip" name="travel-items-needed"> <option label="Hotel/Resort (Domestic)" value="hotelresort-domestic">Hotel/Resort (Domestic)</option> <option label="All-Inclusive Resort (International)" value="allinclusive-resort-international">All-Inclusive Resort (International)</option> <option label="Rentals" value="rentals">Rentals</option> <option label="Flights" value="flights">Flights</option> <option label="Cruise" value="cruise">Cruise</option> <option label="Transportation" value="transportation">Transportation</option> <option label="Excursions" value="excursions">Excursions</option> <option label="EVERYTHING" value="everything">EVERYTHING</option> </field> <field type="select" required="true" label="Best Way to Communicate with you?" name="best-way-to-communicate-with-you" className="form-control"> <option label="Phone Call" value="phone-call">Phone Call</option> <option label="Text Message" value="text-message">Text Message</option> <option label="Email" value="email">Email</option> <option label="Messenger Chat" value="messenger-chat">Messenger Chat</option> </field> <field type="text" label="If phone call/text msg please input phone number below. If messenger please give your name as it appears on Facebook." name="if-phone-calltext-msg-please-input-phone-number-below-if-messenger-please-give-your-name-as-it-appears-on-facebook" subtype="text" className="form-control"/> <field type="select" required="true" label="Time To make decision?" name="time-to-make-decision" className="form-control"> <option label="ASAP" value="asap">ASAP</option> <option label="1-2 Weeks" value="12-weeks">1-2 Weeks</option> <option label="This Month" value="this-month">This Month</option> <option label="Over a Month Out" value="over-a-month-out">Over a Month Out</option> </field> <field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travel budget and/or travel preferences?" name="notes" className="form-control"/> <field type="text" label="How did you hear of us?" name="how-did-you-hear-of-us" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Travel Partner Packages" description="Select your level of service. Are you only looking for flights Questions on travel arrangements/passports/visas Planning and may opt to book on your own or complete VIP Travel Management (concierge services before during and post travel)" name="travel-partner-packages"> <option label="Flight Planning ONLY $25 (domestic)/ $100 (Multi-Leg International)" value="flight-planning-only-25-domestic-100-multileg-international">Flight Planning ONLY $25 (domestic)/ $100 (Multi-Leg International)</option> <option label="Travel Consultation ONLY $30 (1- 30 min consultation)" value="travel-consultation-only-30-1-30-min-consultation">Travel Consultation ONLY $30 (1- 30 min consultation)</option> <option label="Basic Travel Package $50 (1- Location/3 options and 2-Plan Revisions)" value="basic-travel-package-50-1-location3-options-and-2plan-revisions">Basic Travel Package $50 (1- Location/3 options and 2-Plan Revisions)</option> <option label="VIP Travel Management Package $150 (1-Location/ 3 Options, 2- Travel Plan Revisions, 1-Planning Call, 1 Pre-Trip call, and During Travel Concierge)" value="vip-travel-management-package-150-1location-3-options-2-travel-plan-revisions-1planning-call-1-pretrip-call-and-during-travel-concierge">VIP Travel Management Package $150 (1-Location/ 3 Options, 2- Travel Plan Revisions, 1-Planning Call, 1 Pre-Trip call, and During Travel Concierge)</option> <option label="Returning Client $25" value="returning-client-25">Returning Client $25</option> <option label="Jen Miller Referral" value="jen-miller-referral">Jen Miller Referral</option> </field> </fields> </form-template> </body> </html>
Submt
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
Type
Draw
×
By signing, I understand that this is a legally binding contract.