<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="CLIENT INFORMATION&nbsp;"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <field type="text" required="true" label="First name" name="first-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="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field required="true" type="text" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="ABOUT YOUR TRIP:"/> <field type="text" required="true" 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="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"/> <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"/> <field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Maybe " value="maybe">Maybe </option> </field> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your preferred airport of departure/city of origin?" description="Where do you prefer to leave from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="Are you celebrating a special occasion on this trip? If yes, what is the occasion?" name="are-you-celebrating-an-occasion-on-this-trip-if-yes-what-is-the-occasion" subtype="text" className="form-control"/> <field type="text" required="true" label="At what phase of planning are you in?*&nbsp;" description="We are just starting to brainstorm and are open to suggestions. We have dates but we need everything else. Flights are all booked - now help us fill in the blanks!" name="at-what-phase-of-planning-are-you-in-" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for all travelers?" name="what-is-your-budget-for-all-travelers"> <option label="$3,000 to $5,500" value="3000-to-5500">$3,000 to $5,500</option> <option label="$5,500 to $7,500" value="5500-to-7500">$5,500 to $7,500</option> <option label="$7,500 to $10,000 " value="7500-to-10000">$7,500 to $10,000 </option> <option label="$10,000 to $15,000" value="10000-to-15000">$10,000 to $15,000</option> <option label="$15,000 to 20,000" value="15000-to-20000">$15,000 to 20,000</option> <option label="20,000 to 25,000" value="20000-to-25000">20,000 to 25,000</option> <option label="25,000 to 30,000" value="25000-to-30000">25,000 to 30,000</option> <option label="30,000+" value="30000">30,000+</option> </field> <field type="checkbox-group" label="Will you be booking any portion of your trip with points??" name="will-you-be-booking-any-portion-of-your-trip-with-points"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="What components would you like included in your proposal?" name="what-components-would-you-like-included-in-your-proposal"> <option label="Flights " value="flights-">Flights </option> <option label="Accommodations" value="accommodations">Accommodations</option> <option label="Transportation (transfer, rental car, train, etc.)" value="transportation-transfer-rental-car-train-etc">Transportation (transfer, rental car, train, etc.)</option> <option label="Excursions & Activities" value="excursions-activities">Excursions & Activities</option> <option label="Insurance" value="insurance">Insurance</option> </field> <field type="radio-group" required="true" label="What best describes your accommodation style?" name="what-best-describes-your-accommodation-style"> <option label="Boutique & Intimate" value="boutique-intimate">Boutique & Intimate</option> <option label="Luxury & Exclusive" value="luxury-exclusive">Luxury & Exclusive</option> <option label="Both" value="both">Both</option> </field> <field type="text" label="What your "must have" amenities?" name="what-your-must-have-amenities" subtype="text" className="form-control"/> <field type="checkbox-group" label="What options best describe your travel priorities? Check all that apply." 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="Nightlife" value="nightlife">Nightlife</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-wine">Food and wine</option> <option label="Multi-Generational" value="multigenerational">Multi-Generational</option> <option label="Adventure" value="adventure">Adventure</option> </field> <field type="checkbox-group" required="true" label="Can you confirm that all travelers have a current/ unexpired passport with at least 6 months of eligibility from the end date of your trip?" name="can-you-confirm-that-all-travelers-have-a-current-unexpired-passport-with-at-least-6-months-of-eligibility-from-the-end-date-of-your-trip"> <option label="Yes, I can confirm" value="yes-i-can-confirm">Yes, I can confirm</option> <option label="No, travelers will need to update their passports prior to travel" value="no-travelers-will-need-to-update-their-passports-prior-to-travel">No, travelers will need to update their passports prior to travel</option> </field> <field type="checkbox-group" required="true" label="OPTIONAL: Some current travel restrictions include only allow travelers who are fully vaccinated (14+ days after an approved vaccine program in the destination). If you are comfortable sharing, please advise if you are open to destinations that require vaccine records to enter the country." name="optional-some-current-travel-restrictions-include-only-allow-travelers-who-are-fully-vaccinated-14-days-after-an-approved-vaccine-program-in-the-destination-if-you-are-comfortable-sharing-please-advise-if-you-are-open-to-destinations-that-require-vaccine-records-to-enter-the-country"> <option label="Yes- I am able to provide vaccination records" value="yes-i-am-able-to-provide-vaccination-records">Yes- I am able to provide vaccination records</option> <option label="No- I do not wish to travel where vaccination records are required" value="no-i-do-not-wish-to-travel-where-vaccination-records-are-required">No- I do not wish to travel where vaccination records are required</option> <option label="I am uncertain about the vaccination status of all parties traveling with me" value="i-am-uncertain-about-the-vaccination-status-of-all-parties-traveling-with-me">I am uncertain about the vaccination status of all parties traveling with me</option> <option label="I decline to answer" value="i-decline-to-answer">I decline to answer</option> </field> <field type="textarea" required="true" label="Describe your vision for your ideal vacation." name="tell-us-about-your-favorite-vacation-and-what-made-it-memorable" className="form-control"/> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="text" required="true" label="Please list all full names (including middle) and birthdates (as listed on passport) for all travelers?" name="please-list-all-full-names-including-middle-and-birthdates-as-listed-on-passport-for-all-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/> <field type="radio-group" label="Would you like to be added to our newsletter?" inline="true" name="would-you-like-to-be-added-to-our-newsletter"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</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 travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="header" subtype="h2" label="ABOUT HARNAL TRAVEL&nbsp;"/> <field type="checkbox-group" label="Harnal travel acts solely as a booking agent for disclosed principal Suppliers and is not the source or provider of any travel service. Each Supplier is an independent entity with its own management and is not subject to the control of Harnal Travel. For this reason, you will see all pricing as bundled rates and not broken out by component. Our partners do not provide component pricing to protect their contracts, therefore Harnal Travel is not able to provide /disclose component pricing. Do you agree and understand that you will receive all pricing as a "package rate."" name="harnal-travel-acts-solely-as-a-booking-agent-for-disclosed-principal-suppliers-and-is-not-the-source-or-provider-of-any-travel-service-each-supplier-is-an-independent-entity-with-its-own-management-and-is-not-subject-to-the-control-of-harnal-travel-for-this-reason-you-will-see-all-pricing-as-bundled-rates-and-not-broken-out-by-component-our-partners-do-not-provide-component-pricing-to-protect-their-contracts-therefore-harnal-travel-is-not-able-to-provide-disclose-component-pricing-do-you-agree-and-understand-that-you-will-receive-all-pricing-as-a-package-rate"> <option label="Yes, I understand" value="yes-i-understand">Yes, I understand</option> <option label="No, I decline" value="no-i-decline">No, I decline</option> </field> <field type="header" subtype="h2" label="TERMS &amp; CONDITIONS"/> <field type="checkbox-group" label="I accept the terms and conditions of Harnal Travel&nbsp;" name="i-accept-the-terms-and-conditions-of-harnal-travel-found-at-"> <option label="Yes, I agree" value="yes-i-agree">Yes, I agree</option> <option label="No, I decline" value="no-i-decline">No, I decline</option> </field> </fields> </form-template> </body> </html>
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