Share your information with Tiffany Elberfeld

Tiffany Elberfeld

Palms to Paris Travel

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		<field type="paragraph" subtype="p" label="Submitting information via this form does not automatically confirm a reservation. Palms to Paris Travel will review your info and communicate with you via email to share availability and pricing, help you make personalized choices, and finalize your reservation."/>&#13;
		<field type="checkbox-group" required="true" label="Which river cruise itinerary are you interested in joining?" name="which-river-cruise-itinerary-are-you-interested-in-joining" other="true">&#13;
			<option label="Magna on the Danube - Nov 2-9, 2025" value="magna-on-the-danube-nov-29-2025">Magna on the Danube - Nov 2-9, 2025</option>&#13;
			<option label="Swiss Alps and Rhine Castles - Nov 10-17, 2025" value="swiss-alps-and-rhine-castles-nov-1017-2025">Swiss Alps and Rhine Castles - Nov 10-17, 2025</option>&#13;
			<option label="I'm interested in both cruise itineraries." value="im-interested-in-both-cruise-itineraries">I'm interested in both cruise itineraries.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="PRIMARY TRAVELER: Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred Name *If different from first name." name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of Birth" name="birthday" className="form-control"/>&#13;
		<field type="text" required="true" label="Email *Preferably a personal (not work) email address." name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you currently have a valid U.S. Passport? *If so, please check the expiration date now." description="Passport must be valid for at least 6 months after the date you plan to return home from travel." name="do-you-currently-have-a-valid-us-passport" other="true">&#13;
			<option label="Yes, I have a valid passport that expires later than 6 months after travel." value="yes-i-have-a-valid-passport-that-expires-later-than-6-months-after-travel">Yes, I have a valid passport that expires later than 6 months after travel.</option>&#13;
			<option label="No, my passport is expired or will expire within 6 months after travel. I need to renew." value="no-my-passport-is-expired-or-will-expire-within-6-months-after-travel-i-need-to-renew">No, my passport is expired or will expire within 6 months after travel. I need to renew.</option>&#13;
			<option label="No, I don't have a passport yet. I need to apply." value="no-i-dont-have-a-passport-yet-i-need-to-apply">No, I don't have a passport yet. I need to apply.</option>&#13;
			<option label="I have applied and am waiting for my new or renewed passport." value="i-have-applied-and-am-waiting-for-my-new-or-renewed-passport">I have applied and am waiting for my new or renewed passport.</option>&#13;
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		<field type="checkbox-group" label="With what might you need additional help? Please check all that apply." name="please-indicate-your-preference-with-assistance-in-the-following-areas" other="true">&#13;
			<option label="Airfare" value="airfare">Airfare</option>&#13;
			<option label="Airport transfers" value="airport-transfers">Airport transfers</option>&#13;
			<option label="Pre-cruise hotel / travel plans" value="precruise-hotel-travel-plans">Pre-cruise hotel / travel plans</option>&#13;
			<option label="Independent tour / activity while at a cruise port stop" value="independent-tour-activity-while-at-a-cruise-port-stop">Independent tour / activity while at a cruise port stop</option>&#13;
			<option label="Post-cruise hotel / travel plans" value="postcruise-hotel-travel-plans">Post-cruise hotel / travel plans</option>&#13;
			<option label="Special Occasion / Celebration" value="special-occasion-celebration">Special Occasion / Celebration</option>&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do any of these apply to you? (Current or Former)" name="checkbox-group-1740726591010">&#13;
			<option label="Veteran / Retired Military" value="veteran-retired-military">Veteran / Retired Military</option>&#13;
			<option label="Active Duty Military" value="active-duty-military">Active Duty Military</option>&#13;
			<option label="Police Officer" value="police-officer">Police Officer</option>&#13;
			<option label="Firefighter" value="firefighter">Firefighter</option>&#13;
			<option label="First Responder" value="first-responder">First Responder</option>&#13;
			<option label="Teacher" value="teacher">Teacher</option>&#13;
			<option label="Nurse" value="nurse">Nurse</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How many total travelers will be in your stateroom/cabin? (including you)" name="how-many-travelers-will-be-in-your-cabin-including-you" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Additional Travelers"/>&#13;
		<field type="paragraph" subtype="p" label="If you will be rooming with one or more travel companions, please share their information below. We will need to communicate with all travelers so they can also share their full details, passport info, personal preferences, etc. and receive all trip details, reminders, and updates as needed."/>&#13;
		<field type="text" label="Traveler 2: Full Name" name="traveler-2-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveler 2: Email Address" name="traveler-2-email-address" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveler 3: Full Name" name="traveler-3-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveler 3: Email Address" name="traveler-3-email-address" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveler 4: Full Name" name="traveler-4-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveler 4: Email Address" name="traveler-4-email-address" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="How do you know your travel companion(s)?" name="checkbox-group-1744658958146" other="true">&#13;
			<option label="Spouse/Partner" value="spousepartner">Spouse/Partner</option>&#13;
			<option label="Family Member" value="family-member">Family Member</option>&#13;
			<option label="Friend" value="friend">Friend</option>&#13;
		</field>&#13;
		<field type="text" label="How did you hear about Palms to Paris Travel | Gather &amp;amp; Globe?" name="how-did-you-hear-about-minted-honeymoons" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Anything else you think we should know? (Special requests, comments, notes, etc.)" name="text-1740720112726" subtype="text" className="form-control"/>&#13;
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