<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Full Name (As it Appears on Your Passport)"/> <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="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 type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Questions Regarding Your Vacation Preferences"/> <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. If your vacation will include several cities please list them all and approx how many days for each city." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="select" required="true" label="What kind of trip would you like to take?" name="what-kind-of-trip-would-you-like-to-take" multiple="multiple" className="form-control"> <option label="Select One" value="select-one">Select One</option> <option label="Cruise" value="cruise">Cruise</option> <option label="Land" value="land">Land</option> </field> <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="radio-group" required="true" label="Do all travelers have current passports?" description="passports are required for international travel" name="do-all-travelers-have-current-passports"> <option label="Yes, with 6 months available for travel." value="yes-with-6-months-available-for-travel">Yes, with 6 months available for travel.</option> <option label="No" value="no">No</option> <option label="Applied/Renewed and waiting on delivery." value="appliedrenewed-and-waiting-on-delivery">Applied/Renewed and waiting on delivery.</option> </field> <field type="radio-group" required="true" label="Are you currently working with another travel advisor/agent for this vacation?" name="are-you-currently-working-with-another-travel-advisoragent-for-this-vacation"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Are you celebrating anything?" description="Birthday Honeymoon Anniversary Girls Trip etc." name="are-you-celebrating-anything" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Are your dates flexible?" inline="true" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="How many adult travelers?" name="number-of-travelers" value="1" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Will there be anyone over 55 years traveling?" inline="true" name="will-there-be-anyone-over-55-years-traveling"> <option label="Yes" value="Yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="How many children travelers?" description="Under 18 years of age" name="number-1523378007739" value="0" subtype="text" className="form-control"/> <field type="text" required="true" label="What are the ages of the minor travelers? If none, please type N/A" name="what-are-the-ages-of-all-travelers" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your total BUDGET per adult traveler for this trip?" description="This just gives us a general per person starting point and can always be changed later." name="budget"> <option label="$1,000 to $2,500" value="1000-to-2500">$1,000 to $2,500</option> <option label="$2,500 to $4,500" value="2500-to-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-to-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> </field> <field type="radio-group" label="Does this BUDGET include airfare?" name="does-this-budget-include-airfare"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="date" required="true" label="What date will you be ready to put down a deposit?" description="What date will you be making your first payment to secure your trip?" name="what-date-will-you-be-ready-to-put-down-a-deposit" className="form-control"/> <field type="header" subtype="h1" label="AIR TRAVEL"/> <field type="text" label="What is your departure city and state?" description="What city will you be flying out of?" name="text-1523378298953" subtype="text" className="form-control"/> <field type="text" label="Airline Preference" placeholder="Frequent Flyer Rewards Program" name="airline-preference" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Accessibility Requirements"/> <field type="textarea" required="true" label="Do you have any accessibility requirements that we need to be aware of?" description="ex. wheelchair assistive devices portable oxygen" name="is-there-anything-else-that-you-want-me-to-know" className="form-control"/> <field type="header" subtype="h1" label="HOTEL AND RESORT VACATION"/> <field type="radio-group" required="true" label="What best describes your hotel preference?" inline="true" name="hotel-preference" other="true"> <option label="Select One" value="select-one">Select One</option> <option label="Economy" value="economy">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury or Boutique" value="luxury-or-boutique">Luxury or Boutique</option> <option label="Resort/All-Inclusive" value="resortallinclusive">Resort/All-Inclusive</option> <option label="Vacation Homes/Rentals" value="vacation-homesrentals">Vacation Homes/Rentals</option> <option label="Unique Concept" value="unique-concept">Unique Concept</option> </field> <field type="checkbox-group" label="Features" description="Check all that apply" inline="true" name="checkbox-group-1523380534070" other="true"> <option label="Select All That Apply" value="select-all-that-apply">Select All That Apply</option> <option label="All Inclusive" value="all-inclusive">All Inclusive</option> <option label="Adults Only" value="adults-only">Adults Only</option> <option label="Family Friendly" value="family-friendly">Family Friendly</option> <option label="Concierge Level" value="concierge-level">Concierge Level</option> <option label="Suite/Jr. Suite" value="suitejr-suite">Suite/Jr. Suite</option> <option label="On the Beach" value="on-the-beach">On the Beach</option> <option label="Near City Center" value="near-city-center">Near City Center</option> <option label="Kids Club" value="kids-club">Kids Club</option> <option label="Near Air/Cruise Port" value="near-aircruise-port">Near Air/Cruise Port</option> <option label="Luxury Resort" value="luxury-resort">Luxury Resort</option> <option label="Activities On-Site" value="activities-onsite">Activities On-Site</option> <option label="Restaurant On-Site" value="restaurant-onsite">Restaurant On-Site</option> <option label="Microwave in room" value="microwave-in-room">Microwave in room</option> <option label="Refrigerator in room" value="refrigerator-in-room">Refrigerator in room</option> <option label="Kitchenette" value="kitchenette">Kitchenette</option> <option label="Handicap Accessible" value="handicap-accessible">Handicap Accessible</option> <option label="First Floor" value="first-floor">First Floor</option> </field> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." inline="true" name="vibe-preference" other="true"> <option label="Select All That Apply" value="select-all-that-apply">Select All That Apply</option> <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 Cultural Experiences" value="local-cultural-experiences">Local Cultural Experiences</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="Wellness" value="wellness">Wellness</option> </field> <field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" inline="true" name="activity-preferences" other="true"> <option label="Select All That Apply" value="select-all-that-apply">Select All That Apply</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure Activities" value="adventure-activities">Adventure Activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and Theater" value="arts-and-theater">Arts and Theater</option> <option label="Shopping" value="shopping">Shopping</option> <option label="Food & Wine Tasting" value="food-wine-tasting">Food & Wine Tasting</option> <option label="Beach and Watersports" value="beach-and-watersports">Beach and Watersports</option> <option label="Yoga" value="yoga">Yoga</option> <option label="Fitness" value="fitness">Fitness</option> <option label="Wellness" value="wellness">Wellness</option> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <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="h1" label="CRUISE TRAVEL (Complete this section only if you are planning a cruise.)"/> <field type="text" label="Cruiseline Preferences" placeholder="Frequent Cruiser Rewards Program" name="cruiseline-preferences" subtype="text" className="form-control"/> <field type="text" label="Cruise Itinerary" placeholder="ex: Bahamas Western Caribbean Cuba etc." name="cruise-itinerary" subtype="text" className="form-control"/> <field type="text" label="Which cruise port would you like to leave from?" name="which-cruise-port-would-you-like-to-leave-from" subtype="text" className="form-control"/> <field type="text" label="How many nights would you like to cruise?" name="number-1544997665193" value="0" subtype="text" className="form-control"/> <field type="radio-group" label="Pre and Post Nights" description="Will you be staying in a hotel the day before and after the cruise?" inline="true" name="pre-and-post-nights"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="How many cabins do you need?" name="number-1528897438207" value="0" subtype="text" className="form-control"/> <field type="radio-group" label="Cabin Class" inline="true" name="cabin-class"> <option label="Inside Cabin" value="inside-cabin">Inside Cabin</option> <option label="Ocenview Cabin" value="ocenview-cabin">Ocenview Cabin</option> <option label="Balcony Cabin" value="balcony-cabin">Balcony Cabin</option> <option label="Suite" value="suite">Suite</option> <option label="All Options for Group" value="all-options-for-group">All Options for Group</option> </field> <field type="radio-group" label="Beverage Plan" inline="true" name="radio-group-1523379276544"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Beverage Plan Type" inline="true" name="radio-group-1524537022960"> <option label="Alchohol" value="alchohol">Alchohol</option> <option label="Soda/Juice" value="sodajuice">Soda/Juice</option> </field> <field type="header" subtype="h1" label="Military Status"/> <field type="select" required="true" label="Select" name="select-1544985997649" className="form-control"> <option label="Select One" value="select-one">Select One</option> <option label="Active" value="active">Active</option> <option label="Retired" value="retired">Retired</option> <option label="N/A" value="na">N/A</option> </field> </fields> </form-template> </body> </html>
Submit Form
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