<html> <body> <form-template> <fields> <field type="paragraph" subtype="p" label="Please note: Due to extraordinary demand we cannot service requests within 90 days of travel at this time. Thank you for your understanding."/> <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" 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="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="text" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" subtype="text" className="form-control"/> <field type="text" required="true" label="When would you like to return?" name="when-would-you-like-to-return" subtype="text" 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> </field> <field type="text" required="true" label="What is your departure city?&nbsp;" description="Please list any alternate airports for consideration" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" label="Is there a special occasion for this trip?&nbsp;" description="Anniversary Birthday Friend's Trip Family Time etc." name="is-there-a-special-occasion-for-this-trip-" subtype="text" className="form-control"/> <field type="text" required="true" label="Do you have a budget in mind for this trip? Please specify a range or maximum that does not include airfare. We are currently accepting new clients with travel budgets starting at $10,000 and a $1000/day minimum (based on 2 people sharing one room). Our minimum budget for families/groups requiring 2 or more rooms starts at $15,000 and $1500/day. Minimums do not include international airfare, insurance, or in-destination charges such as food and spa treatments.&nbsp;" description="Budget is Transportation Accommodations and Activities." name="do-you-have-a-budget-in-mind-for-this-trip-please-specify-a-range-or-maximum-that-does-not-include-airfare-i-am-currently-accepting-new-clients-with-travel-budgets-starting-at-4000-and-higher-before-airfare-" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Where are you in the planning process?" name="where-are-you-in-the-planning-process"> <option label="Just getting started" value="just-getting-started">Just getting started</option> <option label="I have some ideas, but I need help with research and planning" value="i-have-some-ideas-but-i-need-help-with-research-and-planning">I have some ideas, but I need help with research and planning</option> <option label="I know just what I want, but I need help with finalizing the details" value="i-know-just-what-i-want-but-i-need-help-with-finalizing-the-details">I know just what I want, but I need help with finalizing the details</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference"> <option label="5* Luxury" value="5-luxury">5* Luxury</option> <option label="4* or 5* Boutique" value="4-or-5-boutique">4* or 5* Boutique</option> <option label="4* Premium Brand Names (Hilton, Marriott, etc.)" value="4-premium-brand-names-hilton-marriott-etc">4* Premium Brand Names (Hilton, Marriott, etc.)</option> <option label="4* Business " value="4-business">4* Business </option> <option label="Private Apartment or Villa" value="private-apartment-or-villa">Private Apartment or Villa</option> </field> <field type="text" label="What hotel have you loved staying at previously?" description="Feel free to list more than one" name="what-hotel-have-you-loved-staying-at-previously" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="What kind of vacation experience are you hoping to have?" 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="Off the Beaten Path" value="off-the-beaten-path">Off the Beaten Path</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> </field> <field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and Water" value="beach-and-water">Beach and Water</option> <option label="Spa " value="spa-">Spa </option> <option label="Adventure Activities" value="adventure-activities">Adventure Activities</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and Theater" value="arts-and-theater">Arts and Theater</option> <option label="History " value="history-">History </option> <option label="Food and Wine" value="food-and-wine">Food and Wine</option> </field> <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="textarea" label="What else would you like us to know?" description="What else would you like me to know about you or your travel preferences?" name="notes" className="form-control"/> <field type="checkbox-group" required="true" label="Which Service are you most interested in?" name="which-service-are-you-most-interested-in"> <option label="Upgraded VIP Planning Service $500 (Custom Trip)" value="upgraded-vip-planning-service-500-custom-trip">Upgraded VIP Planning Service $500 (Custom Trip)</option> <option label="Concierge Package Add-On to VIP Planning Service $250 (Restaurant Reservations, etc.)" value="concierge-package-addon-to-vip-planning-service-250-restaurant-reservations-etc">Concierge Package Add-On to VIP Planning Service $250 (Restaurant Reservations, etc.)</option> <option label="Standard Planning/Booking Service $250 (Cruises and Packaged Tours)" value="standard-planningbooking-service-250-cruises-and-packaged-tours">Standard Planning/Booking Service $250 (Cruises and Packaged Tours)</option> <option label="Group Travel Planning $500+ TBD (More than 3 Rooms needed?)" value="group-travel-planning-500-tbd-more-than-3-rooms-needed">Group Travel Planning $500+ TBD (More than 3 Rooms needed?)</option> <option label="1 Hour Phone Consult $100 (Pick my brain)" value="1-hour-phone-consult-100-pick-my-brain">1 Hour Phone Consult $100 (Pick my brain)</option> </field> <field type="paragraph" subtype="p" label="Please note, we charge a non-refundable Research and Design fee, packaged at either $250, $500, or more depending upon needs, group size, etc. Please refer to our PROCESS page for detailed information. This fee covers the time involved in researching and crafting a highly customized travel experience for you. We are currently accepting new clients with travel budgets starting at $10,000 and a $1000/day minimum (based on 2 people sharing one room). Our minimum budget for families/groups requiring 2 or more rooms starts at $15,000 and $1500/day. Minimums do not include international airfare, insurance, or in-destination charges such as food and spa treatments. This form collects your name, email address, and phone number information so that we may communicate with you and provide assistance. Please check our PRIVACY POLICY to see how we protect your data. For Standard Booking Services and VIP Planning Services, you agree that Paloma White Travel is exclusively authorized to book hotels for the trip on your behalf; making any hotel bookings for the trip on your own will be cause for immediate termination of our services without refund of the Research and Design fee."/> <field type="checkbox-group" required="true" label="CONSENT" name="consent"> <option label="I consent to have Paloma White Travel collect my details via this form." value="i-consent-to-have-paloma-white-travel-collect-my-details-via-this-form">I consent to have Paloma White Travel collect my details via this form.</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