<html> <body> <form-template> <fields> <field type="paragraph" subtype="p" label="Paragraph"/> <field type="header" subtype="h1" label="Trip Request Form"/> <field type="paragraph" subtype="p" label="Thank you for your request to book an amazing trip with Spectacular Travel Memories, LLC! We are excited to begin the process of creating your amazing travel experience. Please fill out this form as detailed as possible. Once received we will reach out to set up a time to discuss your needs and desire. Starting in January 2020 Research Fees will be required to move forward with our request. Individual Trips of 5 or fewer require a $125 nonrefundable deposit Per Adult person (PP) deposit and those over 6-15 will require a $300 PP Nonrefundable deposit. For over 16 passengers,, or groups we will discuss deposits based on group needs and dynamics. Please see the Terms and Conditions at the bottom."/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <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="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Spouses Name/Partner" name="spouses-namepartner" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" 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" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" 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="h1" label="Passport Information"/> <field type="text" required="true" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Gender As it Appears on Passport" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> </field> <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="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="Passport number" name="passport-number" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Dates of Travel"/> <field type="date" required="true" label="Desired Start Date&nbsp;&nbsp;" name="desired-start-date-" className="form-control"/> <field type="date" label="Desired Return Date" name="desired-return-date" className="form-control"/> <field type="select" label="Length of Trip" name="length-of-trip" className="form-control"> <option label="" value=""/> <option label="1 thu 3 days" value="1-thu-3-days">1 thu 3 days</option> <option label="5 days" value="5-days">5 days</option> <option label="7 thu 14" value="7-thu-14">7 thu 14</option> <option label="21 days" value="21-days">21 days</option> <option label="30 plus" value="30-plus">30 plus</option> </field> <field type="text" label="Are your dates Flexible if so provide flexibility" name="are-your-dates-flexible-if-so-provide-flexibility" subtype="text" className="form-control"/> <field type="text" required="true" label="How many Travelers?" name="how-many-travelers" subtype="text" className="form-control"/> <field type="textarea" label="Please provide the Names/DOB and Emails of All Other Adult Family Traveling" name="please-provide-the-names-and-emails-of-all-adults-traveling-if-this-is-a-solo-or-couple-trip-please-put-na" className="form-control"/> <field type="textarea" required="true" label="Are there any Children&nbsp; traveling? if so what are their ages at the time of travel? Please provide DOB and Full&nbsp; Names.." name="are-there-any-children-traveling-if-so-what-are-their-ages-at-the-time-of-travel-please-provide-dob-and-full-names" className="form-control"/> <field type="textarea" required="true" label="Will there be anyone over 55 Traveling?" name="will-there-be-anyone-over-55-traveling" className="form-control"/> <field type="text" label="Any Active Military or Veteran Passengers?" name="any-active-military-or-veteran-passengers" subtype="text" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="date" label="Birthday" name="birthday" className="form-control"/> <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="header" subtype="h2" label="Pre/Post Hotels"/> <field type="radio-group" required="true" label="Radio Group" name="pre-or-post-hotels"> <option label="Pre Hotel" value="pre-hotel">Pre Hotel</option> <option label="Post Hotel" value="post-hotel">Post Hotel</option> <option label="Pre & Post Hotel " value="pre-post-hotel-">Pre & Post Hotel </option> <option label="None" value="none">None</option> </field> <field type="header" subtype="h1" label="Air"/> <field type="text" required="true" label="What is your Airport Code" name="what-is-your-airport-code" subtype="text" className="form-control"/> <field type="radio-group" label="Air" name="air"> <option label="Economy" value="economy">Economy</option> <option label="Business Class" value="business-class">Business Class</option> <option label="1st Class" value="1st-class">1st Class</option> </field> <field type="radio-group" label="Seat preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Opposite aisle" value="opposite aisle">Opposite aisle</option> </field> <field type="header" subtype="h1" label="Transportation"/> <field type="checkbox-group" required="true" label="Will you need&nbsp; a Car or AirPort Transfers" name="will-you-need-a-rental-car-or-airport-transfers"> <option label="Car Rental " value="car-rental-">Car Rental </option> <option label="Airport Transfer to Hotel" value="airport-transfer-to-hotel">Airport Transfer to Hotel</option> <option label="Airport Transfer from Hotel" value="airport-transfer-from-hotel">Airport Transfer from Hotel</option> <option label="Airport Transfers to and from Airport" value="airport-transfers-to-and-from-airport">Airport Transfers to and from Airport</option> </field> <field type="header" subtype="h1" label="Hotels/Resorts/Villas"/> <field type="text" required="true" label="How Many Rooms Do you Need?" name="how-many-rooms-do-you-need" subtype="text" className="form-control"/> <field type="radio-group" label="Hotel preference" name="hotel-preference"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> <option label="Resort" value="resort">Resort</option> <option label="Villa" value="villa">Villa</option> </field> <field type="radio-group" label="Bed preference" name="bed-preference"> <option label="King" value="king">King</option> <option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option> <option label="Single" value="single">Single</option> <option label="Extra bed/Crib" value="extra-bedcrib">Extra bed/Crib</option> </field> <field type="header" subtype="h1" label="Cruises"/> <field type="radio-group" label="Have you been on a Cruise before?&nbsp;" name="have-you-been-on-a-cruise-before-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="paragraph" subtype="p" label="If you have been on a Cruise please tell me which one/s and which you enjoyed or did not enjoy and why?"/> <field type="textarea" label="Text Area" name="textarea-1681070274486" className="form-control"/> <field type="radio-group" label="Cruise" name="cruise"> <option label="Premium Cruises" value="premium-cruises">Premium Cruises</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option> <option label="Boutique Cruises" value="boutique-cruises">Boutique Cruises</option> <option label="River Cruises" value="river-cruises">River Cruises</option> <option label="Transatlantic Cruises" value="transatlantic-cruises">Transatlantic Cruises</option> <option label="World Cruise" value="world-cruise">World Cruise</option> <option label="Private Yacts" value="private-yacts">Private Yacts</option> </field> <field type="radio-group" label="Cabin Type" name="cabin-type"> <option label="Inside Stateroom" value="inside-stateroom">Inside Stateroom</option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Veranda" value="veranda">Veranda</option> <option label="Suite" value="suite">Suite</option> </field> <field type="text" label="Meal preference" name="meal-preference" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Insurance"/> <field type="radio-group" required="true" label="It is highly recommended that you get insurance!" inline="true" name="it-is-highly-recommended-that-you-get-insurance" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="It is highly recommended that you get insurance!" inline="true" name="radio-group-1728274782639" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="file" label="Vaccine card photo" name="vaccine_card_photo" subtype="file" className="form-control"/> <field type="header" subtype="h1" label="Tours"/> <field type="paragraph" subtype="p" label="Please let me know what you have enjoyed on your past vacations, and what you would like to do or not on this vacation.&nbsp;"/> <field type="text" label="Tour Destination/s" name="tour-destinations" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Vibe preferences" name="vibe-preference" other="true"> <option label="All Inclusive" value="all-inclusive">All Inclusive</option> <option label="All Adult" value="all-adult">All Adult</option> <option label="Over Water Bungalows" value="over-water-bungalows">Over Water Bungalows</option> <option label="Groups" value="groups">Groups</option> <option label="Safaris" value="safaris">Safaris</option> <option label="Expatriate " value="expatriate-">Expatriate </option> <option label="Meaningful/Nonprofit" value="meaningfulnonprofit">Meaningful/Nonprofit</option> <option label="Religious" value="religious">Religious</option> <option label="Family" value="family">Family</option> <option label="Solo Travel" value="solo-travel">Solo Travel</option> <option label="Festivals" value="festivals">Festivals</option> <option label="Adventure" value="adventure">Adventure</option> </field> <field type="header" subtype="h1" label="Destination Weddings &amp; Honeymoons &amp;&nbsp; Special Romantic Occasions"/> <field type="checkbox-group" required="true" label="Activity preferences" name="activity-preferences" other="true"> <option label="Girls Get Away" value="girls-get-away">Girls Get Away</option> <option label="Couple Getaways" value="couple-getaways">Couple Getaways</option> <option label="Honeymoons" value="honeymoons">Honeymoons</option> <option label="Destination Weddings" value="destination-weddings">Destination Weddings</option> <option label="Bachelorette Parties" value="bachelorette-parties">Bachelorette Parties</option> <option label="Retie the Knot" value="retie-the-knot">Retie the Knot</option> <option label="Babymoon" value="babymoon">Babymoon</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Safari Honeymoon" value="safari-honeymoon">Safari Honeymoon</option> <option label="LGBTQ Destination Weddings & Honeymoons" value="lgbtq-destination-weddings-honeymoons">LGBTQ Destination Weddings & Honeymoons</option> </field> <field type="radio-group" required="true" label="What is your total Travel Budget?" description="Does not include other expenses." inline="true" name="what-is-your-budget-for-each-traveler"> <option label="$1,500 -$2,500" value="1500-2500">$1,500 -$2,500</option> <option label="$2,500 - $3,500" value="2500-3500">$2,500 - $3,500</option> <option label="$3,500-$4,500" value="35004500">$3,500-$4,500</option> <option label="$5,000-$6,500" value="50006500">$5,000-$6,500</option> <option label="$7,500-$8,500" value="75008500">$7,500-$8,500</option> <option label="$9000+" value="9000">$9000+</option> <option label="Unlimited Budget" value="unlimited-budget">Unlimited Budget</option> </field> <field type="header" subtype="h1" label="Would you like to add Excursions?"/> <field type="radio-group" required="true" label="Excursions" name="excursions" other="true"> <option label="Yes" value="yes">Yes</option> <option label="no" value="no">no</option> </field> <field type="header" subtype="h1" label="Vaccinations &amp; Covid"/> <field type="paragraph" subtype="p" label="Many countries require you to be vaccinated to enter. Those who are unvaccinated will have to follow increased procedures and may have to face quarantine and multiple tests upon arrival. Knowing your status will help me prepare you for your trip."/> <field type="radio-group" required="true" label="Are you Vaccinated ?" inline="true" name="are-you-vaccinated-" other="true"> <option label="Yes fully Vaccinated" value="yes-fully-vaccinated">Yes fully Vaccinated</option> <option label="No" value="no">No</option> <option label="" value=""/> </field> <field type="textarea" label="&nbsp;Anything else you would like us to know?" name="-anything-else-you-would-like-us-to-know" className="form-control"/> <field type="checkbox-group" label="Checkbox Group" name="checkbox-group-1728274666605"> <option label="Option 1" value="option-1" selected="selected">Option 1</option> </field> <field type="date" label="Date Field" name="date-1728274667944" className="form-control"/> <field type="header" subtype="h1" label="Header"/> </fields> </form-template> </body> </html>
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