<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Airfare - Head of Household"/> <field type="header" subtype="h1" label="Passport Information"/> <field type="text" required="true" 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" 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 (nickname)" name="preferred-name" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of birth" name="birthday" className="form-control"/> <field type="radio-group" required="true" label="Gender" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> <option label="X" value="other">X</option> </field> <field type="text" label="Passport number (this may be required for some bookings by the supplier/airline)" name="passport-number" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of issue" name="passport-date-of-issue" className="form-control"/> <field type="date" required="true" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="text" required="true" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/> <field type="text" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/> <field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="For non-US passport holders, do you have a valid Green Card" name="for-nonus-passport-holders-do-you-have-a-valid-green-card"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="N/A" value="na">N/A</option> </field> <field type="date" label="Green Card Expiration Date" name="green-card-expiration-date" className="form-control"/> <field type="paragraph" subtype="p" label="On June 1, 2019, as part of IATA Resolution 830d, the International Air Transport Association (IATA) began to require that all travel advisors and travel agencies enter passenger contact information when booking air tickets in order to help contact the passenger “in an operational disruption” and so that airlines are “able to advise passengers of irregular flight operations and disruptions.” "/> <field type="paragraph" subtype="p" label="For this reason, the information you provide on this form will be stored on a PCI-compliant website. Be assured that the information will never be sold or shared with anyone for any other purpose than to book your travel arrangements."/> <field type="checkbox-group" required="true" label="By checking off this box, I am confirming that I have read and understand IATA's new regulations regarding disclosing my contact information to the airline/s" name="by-checking-off-this-box-i-am-confirming-that-i-have-read-and-understand-iatas-new-regulations-regarding-disclosing-my-contact-information-to-the-airlines"> <option label="I allow for Perfectly Planned Journeys to collect my contact information and pass it on to the airline/s." value="i-allow-for-perfectly-planned-journeys-to-collect-my-contact-information-and-pass-it-on-to-the-airlines">I allow for Perfectly Planned Journeys to collect my contact information and pass it on to the airline/s.</option> <option label="I decline to provide my contact information, and understand that this will prevent the airline/s from contacting me with pertinent information." value="i-decline-to-provide-my-contact-information-and-understand-that-this-will-prevent-the-airlines-from-contacting-me-with-pertinent-information">I decline to provide my contact information, and understand that this will prevent the airline/s from contacting me with pertinent information.</option> </field> <field type="header" subtype="h1" label="Contact Information"/> <field type="text" required="true" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Address"/> <field type="text" required="true" 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" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Request"/> <field type="radio-group" required="true" label="What type of ticket will you need?" name="what-type-of-ticket-will-you-need"> <option label="One Way" value="one-way">One Way</option> <option label="Round Trip" value="round-trip">Round Trip</option> <option label="Multi Destination" value="multi-destination">Multi Destination</option> </field> <field type="text" required="true" label="How many people will you be traveling with?&nbsp; (including those not in your household)" name="how-many-people-will-you-be-traveling-with" subtype="text" className="form-control"/> <field type="text" required="true" label="How many adults from your household in addition to you are traveling?" name="how-many-of-the-travelers-live-in-your-household-in-addition-to-you" subtype="text" className="form-control"/> <field type="text" required="true" label="How many children (age 2 - 11 years old) from your household will be traveling?" name="how-many-children-age-2-11-years-old-from-your-household-will-be-traveling" subtype="text" className="form-control"/> <field type="text" required="true" label="How many infants from your household will be traveling?" name="how-many-infants-from-your-household-will-be-traveling" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of Departure" name="preferred-date-of-departure" className="form-control"/> <field type="text" required="true" label="Is your departure date&nbsp; flexible?&nbsp; Please give alternate dates." name="please-specify-below-if-your-dates-are-flexible" subtype="text" className="form-control"/> <field type="paragraph" subtype="p" label="Time Zone Note: When you fly east across multiple time zones, your arrival time moves forward on the clock. For example, when departing the United States for Europe, you lose several hours due to the time difference. This means that although you leave the U.S. on one calendar day, you typically arrive in Europe the following day.&nbsp; This is esp. important if you are going on a cruise or scheduled tour etc.&nbsp; Because of potential delays, it is always recommended to schedule arrival at least one day before your cruise / tour starts."/> <field type="text" required="true" label="Preferred Departure Airport&nbsp;&nbsp;" name="preferred-departure-airport-" subtype="text" className="form-control"/> <field type="text" label="Is there an alternate airport you would be willing to depart from if the price or flight schedule is significantly better?&nbsp; Please list airport/s." name="alternate-airports" subtype="text" className="form-control"/> <field type="text" required="true" label="Flying to:&nbsp; (please specify all destinations &amp; dates)" name="flying-to-please-specify-all-destinations-dates" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of Return&nbsp;" name="preferred-date-of-return-the-date-you-leave-the-destination" className="form-control"/> <field type="checkbox-group" required="true" label="Is this the date you would like to leave the destination or arrive at your home airport (if different)?" name="is-this-the-date-you-would-like-to-leave-the-destination-or-arrive-at-your-home-airport-if-different"> <option label="Leave the destination" value="leave-the-destination">Leave the destination</option> <option label="Arrive at my home airport" value="arrive-at-my-home-airport">Arrive at my home airport</option> <option label="I am flexible" value="i-am-flexible">I am flexible</option> </field> <field type="header" subtype="h1" label="Important Fare &amp; Booking Policy"/> <field type="paragraph" subtype="p" label="Please do not book multiple tickets for the same traveler on the same travel date or routing in an effort to compare or hold pricing. Airlines monitor duplicate reservations, and when they detect more than one booking for the same passenger, they may cancel both without warning and without refund.&nbsp;"/> <field type="paragraph" subtype="p" label="In addition, please do not book connections you do not intend to take (for example, reserving an itinerary with a layover solely to obtain a lower fare but planning to skip the second flight). Airlines consider this a violation of their ticketing rules, and it can result in cancellation of onward travel, loss of remaining flight segments, forfeited miles, and possible fare penalties."/> <field type="paragraph" subtype="p" label="Our goal is to protect your trip integrity and prevent any disruptions, cancellations, or financial loss due to airline fare rules."/> <field type="checkbox-group" required="true" label="I understand and agree to the Fare &amp; Booking Policy" name="i-understand-and-agree-to-the-fare-booking-policy"> <option label="Yes" value="yes">Yes</option> </field> <field type="header" subtype="h1" label="Travel Preferences"/> <field type="paragraph" subtype="p" label="We will do our best to accommodate your preferences but please understand that this is not always possible.&nbsp; &nbsp; &nbsp; Basic Economy tickets do not allow seat selection.&nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="Seat Selection Policy: Please note that when airlines charge an additional fee for seat selection, we are unable to assist with choosing or securing seats. You are welcome to select and purchase preferred seats directly through the airline once your ticket has been issued."/> <field type="radio-group" label="Seat preference" description="Please note that we are not always able to get your first choice of seats and the airline may switch your seat after it has been assigned" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Least Expensive" value="least-expensive">Least Expensive</option> </field> <field type="radio-group" required="true" label="Fare Type" name="fare-type"> <option label="First Class" value="first-class">First Class</option> <option label="Business" value="business">Business</option> <option label="Premium Economy" value="premium-economy">Premium Economy</option> <option label="Economy Plus" value="economy-plus">Economy Plus</option> <option label="Economy" value="economy">Economy</option> <option label="Basic Economy" value="basic-economy">Basic Economy</option> <option label="Checked Luggage" value="checked-luggage">Checked Luggage</option> <option label="Carbon Offset (optional)" value="carbon-offset-optional">Carbon Offset (optional)</option> </field> <field type="checkbox-group" label="Do you expect to check luggage?" name="do-you-expect-to-check-luggage"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Not Sure" value="not-sure">Not Sure</option> </field> <field type="header" subtype="h1" label="Special Requests"/> <field type="paragraph" subtype="p" label="Please indicate any specific travel preferences, such as selecting the best available fare class within your budget, or selecting Business Class for only part of your journey. This ensures that we can tailor your arrangements according to your comfort and priorities."/> <field type="textarea" label="Special Travel Preferences" name="special-travel-preferences" className="form-control"/> <field type="text" label="Max amount you are willing to pay?&nbsp; You may wonder why I would ask this.&nbsp; &nbsp;The reason is that you may request Premium Economy, but for a&nbsp; little bit more you could have Business, and be much more comfortable.&nbsp; Esp. if it is a very long flight this may be a great option.&nbsp; &nbsp;Since I can not hold two tickets for you these seats ma be gone if I have to check with your first." name="max-amount-you-are-willing-to-pay-you-may-wonder-why-i-would-ask-this-the-reason-is-that-you-may-request-premium-economy-but-for-a-little-bit-more-you-could-have-business-and-be-much-more-comfortable-esp-if-it-is-a-very-long-flight-this-may-be-a-great-option-since-i-can-not-hold-two-tickets-for-you-these-seats-ma-be-gone-if-i-have-to-check-with-your-first" subtype="text" className="form-control"/> <field type="radio-group" label="Special Travel Requests" name="special-requests"> <option label="Need Assistance / Wheelchair etc." value="need-assistance-wheelchair-etc">Need Assistance / Wheelchair etc.</option> <option label="Traveling w/Big/Unusual Size Luggage" value="traveling-wbigunusual-size-luggage">Traveling w/Big/Unusual Size Luggage</option> <option label="Extra Luggage" value="extra-luggage">Extra Luggage</option> <option label="Animal" value="animal">Animal</option> <option label="Medication * / Special Medical Equipment" value="medication-special-medical-equipment">Medication * / Special Medical Equipment</option> <option label="No Special Assistance Required" value="no-special-assistance-required">No Special Assistance Required</option> </field> <field type="textarea" label="Please note:" name="textarea-1710611914367" value="This does not refer to common medications that will not need any special care. We are referring to medication that has unusual requirements. (needs to be kept cold at all times for instance)" className="form-control"/> <field type="header" subtype="h1" label="Trusted Traveler Program"/> <field type="checkbox-group" label="Do you have PreCheck or Global Entry?" name="do-you-have-precheck-or-global-entry"> <option label="PreCheck" value="precheck">PreCheck</option> <option label="Global Entry" value="global-entry">Global Entry</option> </field> <field type="text" label="If YES, please provide your account&nbsp; #" name="global-entry-number" subtype="text" 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="h1" label="Additional Information"/> <field type="text" label="Is there any additional&nbsp;information&nbsp; we should know?" name="additional-info-about-your-needs-and-hopes-for-your-trip-that-you-believe-is-important-for-successful-planning" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Insurance"/> <field type="radio-group" label="Would you like a quote for travel insurance?" name="would-you-like-a-quote-for-travel-insurance"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" label="Have you already booked part of your trip?" name="have-you-already-booked-part-of-your-trip"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="date" label="If yes, please provide date" name="if-yes-please-provide-date" className="form-control"/> <field type="text" label="Please provide the name of the supplier.&nbsp; For instance Royal Caribbean Cruise Line or Marriott Hotel" name="please-provide-the-name-of-the-supplier-for-instance-royal-caribbean-cruise-line-or-marriott-hotel" subtype="text" className="form-control"/> <field type="paragraph" subtype="p" label="Travel insurance must be purchased within the first 14 days after making the initial booking for your trip in order to qualify for Pre-existing Condition coverage, which is why we request this information."/> <field type="header" subtype="h1" label="Emergency Contact"/> <field type="textarea" label="Do you have an Emergency Contact not traveling with you?&nbsp; Please provide Name and Contact Information:" name="do-you-have-an-emergency-contact-not-traveling-with-you-please-provide-name-and-contact-information" className="form-control"/> <field type="header" subtype="h1" label="How did you hear about us"/> <field type="text" label="Please tell us how you heard about us." name="please-tell-us-how-you-heard-about-us" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Fraud Prevention &amp; Passport Information"/> <field type="paragraph" subtype="p" label="To protect against fraud and ensure compliance with airline and travel regulations, we may require a copy of a valid government-issued photo ID or passport for each traveler."/> <field type="header" subtype="h1" label="Passport Submission:"/> <field type="paragraph" subtype="p" label="For all international flights, a scanned copy or clear photo of each traveler’s valid passport is required to issue airline tickets. Your passport information will be stored securely and used solely for travel documentation and ticketing purposes."/> <field type="header" subtype="h1" label="Fraud Disclaimer:"/> <field type="paragraph" subtype="p" label="By providing your personal and payment information, you acknowledge that it is accurate and belongs to the traveler. Any misrepresentation, unauthorized use of payment methods, or fraudulent information may result in cancellation of travel services and forfeiture of payments."/> <field type="paragraph" subtype="p" label="This process is designed to protect both you and our agency and to ensure your travel arrangements are issued safely and correctly."/> <field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/> </fields> </form-template> </body> </html>
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