Share your information with MONICA R.

MONICA R.

Gloryda8z Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Gloryda8z Travel Vacations Request Form"/>&#13;
		<field type="header" subtype="h3" label="Thank you for considering Gloryda8z Travel to curate your glorious vacation and travel desires. Please fill in all the fields below for me to put together the best quote that meets all of your desires."/>&#13;
		<field type="header" subtype="h2" label="Client Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-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="date" required="true" label="DOB" name="dob" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Trip Details"/>&#13;
		<field type="radio-group" required="true" label="What type of trip are you inquiring about?" name="what-type-of-trip-are-you-inquiring-about">&#13;
			<option label="Couple" value="couple">Couple</option>&#13;
			<option label="Family" value="family">Family</option>&#13;
			<option label="Group" value="group">Group</option>&#13;
			<option label="Single" value="single">Single</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Which of the following are you looking for?" name="which-of-the-following-are-you-looking-for" other="true">&#13;
			<option label="All Inclusive Resort" value="all-inclusive-resort">All Inclusive Resort</option>&#13;
			<option label="Universal Studio Package" value="universal-studio-package">Universal Studio Package</option>&#13;
			<option label="Walt Disney Package " value="walt-disney-package-">Walt Disney Package </option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Luxury Villa Rentals" value="luxury-villa-rentals">Luxury Villa Rentals</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Jamaica" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If yes, please elaborate on the flexibility." name="if-yes-please-elaborate-on-the-flexibility" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you need airfare?" name="do-you-need-airfare">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If yes, what is your departure city and local airport?" description="Where will you be flying from?" placeholder="ex. Houston - IAH" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you need a rental car?" name="do-you-need-a-rental-car">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="radio-group" required="true" label="Do you have your passport?" name="do-you-have-your-passport">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adult travelers (18+) ?" placeholder="18yrs +" name="number-of-travelers" value="1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="If traveling with children, please list their names and DOB" description="If children are traveling with you please give an age range below." placeholder="ex. Jon Doe 01/01/2022" name="what-is-the-age-group-of-the-children" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What&#39;s the special occasion?&amp;nbsp;" description="i.e Birthday  Mission Trip  Honeymoon  Anniversary" name="whats-the-special-occasion-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" required="true" label="Room type" name="room-type" other="true">&#13;
			<option label="Standard" value="standard">Standard</option>&#13;
			<option label="Garden View" value="garden-view">Garden View</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Swim Up" value="swim-up">Swim Up</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many rooms needed?" name="how-many-rooms-needed" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many people per room?" name="how-many-people-per-room" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What activities are you interested in if any?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget for each traveler?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$550 to $1,100" value="550-to-1100">$550 to $1,100</option>&#13;
			<option label="$1,100 to $2,500" value="1100-to-2500">$1,100 to $2,500</option>&#13;
			<option label="$2,500 to $3,500" value="2500-to-3500">$2,500 to $3,500</option>&#13;
			<option label="$3,500 to $4,500" value="3500-to-4500">$3,500 to $4,500</option>&#13;
			<option label="$4,500 to $5,500" value="4500-to-5500">$4,500 to $5,500</option>&#13;
			<option label="$6,000+" value="6000">$6,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How soon are you looking to book?" name="how-soon-are-you-looking-to-book">&#13;
			<option label="ASAP I'm ready w/ my deposit" value="asap-im-ready-w-my-deposit">ASAP I'm ready w/ my deposit</option>&#13;
			<option label="Within the next 2 weeks" value="within-the-next-2-weeks">Within the next 2 weeks</option>&#13;
			<option label="Within the next 4 weeks" value="within-the-next-4-weeks">Within the next 4 weeks</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Protection Plus- Full Travel Credit"/>&#13;
		<field type="paragraph" subtype="p" label="By purchasing our Travel Protection Plus, travelers can put their minds at ease and have full confidence in their vacation purchases. If needed, travelers can cancel their trip for ANY reason. Simply call us at any time prior to departure to cancel and receive a full refund in the form of travel credit, minus the cost of the Travel Protection Plus. Other benefits include no fee for Changes made to the trip, Hurricane Travel Protection, and during travel benefits such as Baggage Protection, 24- hour Emergency Assistance, and More."/>&#13;
		<field type="header" subtype="h1" label="For your protection, Travel Insurance is strongly recommended and will be included in your quote unless you request otherwise."/>&#13;
		<field type="radio-group" required="true" label="Would you like to op out of getting Travel Insurance?" name="would-you-like-to-op-out-of-getting-travel-insurance">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know? The more you tell me, the better the options I can provide." 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="text" label="How did you hear about Gloryda8z Travel?" name="how-did-you-hear-about-gloryda8z-travel" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>