<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Please Fill Out The Details Below"/> <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="Phone number" name="phone-number" 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="Where Would You Like To Go?" description="If you're not sure just give me a few destinations you're considering." name="destination" subtype="text" className="form-control"/> <field type="text" label="What Is It About This Destination That Interests You?" name="what-is-it-about-this-destination-that-interests-you" subtype="text" className="form-control"/> <field type="radio-group" 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 need help with research & planning" value="i-have-some-ideas-but-need-help-with-research-planning">I have some ideas, but need help with research & planning</option> <option label="I know what I want, but need help finalizing details" value="i-know-what-i-want-but-need-help-finalizing-details">I know what I want, but need help finalizing details</option> <option label="Other" value="other">Other</option> </field> <field type="date" 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" 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="checkbox-group" 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" label="Is This Trip For A Special Occasion?(Birthday, Anniversary, Honeymoon, Engagement, Babymoon, etc.)" name="is-this-trip-for-a-special-occasionbirthday-anniversary-etc" subtype="text" className="form-control"/> <field type="text" required="true" label="How Many Travelers Will Be In Your Party?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" label="How Many Rooms?&nbsp; Will They Be Split?" name="how-many-rooms-will-they-be-split" subtype="text" className="form-control"/> <field type="text" label="If Your Travel Dates Are Flexible, Can You Give A Range Of Dates Or Further Information You Would Like Me To Know." name="if-your-travel-dates-are-flexible-can-you-give-a-range-of-dates-or-further-information-you-would-like-me-to-know" subtype="text" className="form-control"/> <field type="text" required="true" label="What Is Your Departure City?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="Do You Or Any Members In Your Travel Party Have Any Dietary Restrictions Or Allergies? If Yes, Please List What You Would Like Me To Be Aware Of." name="do-you-or-any-members-in-your-travel-party-have-any-dietary-restrictions-or-allergies-if-yes-please-list-what-you-would-like-me-to-be-aware-of" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="TRAVEL PREFERENCES"/> <field type="text" required="true" label="Will Airline Tickets Need To Be Included In Your Vacation Package (vs using miles or cc points)" name="will-airline-tickets-need-to-be-included-in-your-vacation-package-vs-using-miles" subtype="text" className="form-control"/> <field type="text" label="Please List Your Preferred Airline(s) -If applicable . Sometimes There Are Additional Discounts At The Time Of Booking For Those With A Delta Skymiles #.&nbsp; Always inquire if you can use miles to book as it can vary by each trip." name="please-list-your-preferred-airlines-if-applicable-sometimes-there-are-additional-discounts-at-the-time-of-booking-for-those-with-a-delta-skymiles-" 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="radio-group" label="Do You Have Preference For Seating?" 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> <option label="Economy" value="economy">Economy</option> <option label="Comfort +/Premium" value="comfort-premium">Comfort +/Premium</option> <option label="Business Class/First" value="business-classfirst">Business Class/First</option> </field> <field type="radio-group" required="true" label="What Type Of Accommodations Do You Prefer?" 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="All-Inclusive " value="allinclusive-">All-Inclusive </option> <option label="Resort or Hotel Stay (meals/drinks not included)" value="resort-or-hotel-stay-mealsdrinks-not-included">Resort or Hotel Stay (meals/drinks not included)</option> <option label="Private Apartment" value="private-apartment">Private Apartment</option> <option label="Private Villa" value="private-villa">Private Villa</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="Are You A Pool Person Or A Beach Person?" name="are-you-a-pool-person-or-a-beach-person"> <option label="Beach" value="beach">Beach</option> <option label="Pool " value="pool-">Pool </option> <option label="I balance my time in between both " value="i-balance-my-time-in-between-both-">I balance my time in between both </option> <option label="It doesn't matter for this getaway" value="it-doesnt-matter-for-this-getaway">It doesn't matter for this getaway</option> </field> <field type="radio-group" required="true" label="What Type Of Getaway Are You Hoping To Experience?" name="what-type-of-getaway-are-you-hoping-to-experience"> <option label="Family Friendly" value="family-friendly">Family Friendly</option> <option label="Food & Wine" value="food-wine">Food & Wine</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 Culture" value="local-culture">Local Culture</option> <option label="Romance" value="romance">Romance</option> <option label="Rest & Relaxation " value="rest-relaxation-">Rest & Relaxation </option> <option label="Multigenerational" value="multigenerational">Multigenerational</option> <option label="Adventure " value="adventure-">Adventure </option> <option label="Scuba " value="scuba-">Scuba </option> <option label="Golf " value="golf-">Golf </option> </field> <field type="radio-group" label="Bedding Preference" name="bed-preference"> <option label="King" value="king">King</option> <option label="2 Double/Queen" value="2-doublequeen">2 Double/Queen</option> <option label="Twin Beds" value="twin-beds">Twin Beds</option> </field> <field type="text" label="How Many Children In Your Travel Party And Their Ages At The Time Of Travel.&nbsp;" name="how-many-children-and-their-ages-at-the-time-of-travel" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Please Include ALL Travelers Full Names As Seen On ID's/Passports and&nbsp;Birthdates For Accurate Quotes" name="please-include-all-travelers-passport-names-and-dates-of-birth-for-accurate-quotes" className="form-control"/> <field type="radio-group" required="true" label="What Is Your Desired Budget For All Travelers" description="This provides a general starting point and can always be changed later." name="budget"> <option label="$5,000-$7,500" value="50007500">$5,000-$7,500</option> <option label="$7,600-$9,500" value="76009500">$7,600-$9,500</option> <option label="$9,600-$12,500" value="960012500">$9,600-$12,500</option> <option label="$12,600-15,500" value="1260015500">$12,600-15,500</option> <option label="$15,600-$20,000" value="1560020000">$15,600-$20,000</option> <option label="$20,100-$25,000" value="2010025000">$20,100-$25,000</option> <option label="$25,600-$30,000" value="2560030000">$25,600-$30,000</option> <option label="$30,100+" value="30100">$30,100+</option> </field> <field type="radio-group" required="true" label="If Budget Is Fixed, What Aspects Of The Vacation Are You Willing To Compromise To Fit The Budget?" name="if-budget-is-fixed-what-aspects-of-the-vacation-are-you-willing-to-compromise-to-fit-the-budget"> <option label="I am open to increasing my budget if it provides the experience I am seeking" value="i-am-open-to-increasing-my-budget-if-it-provides-the-experience-i-am-seeking">I am open to increasing my budget if it provides the experience I am seeking</option> <option label="I am willing to compromise the length of stay" value="i-am-willing-to-compromise-the-length-of-stay">I am willing to compromise the length of stay</option> <option label="I am willing to compromise the view from my room" value="i-am-willing-to-compromise-the-view-from-my-room">I am willing to compromise the view from my room</option> <option label="I am willing to compromise to a more modest resort" value="i-am-willing-to-compromise-to-a-more-modest-resort">I am willing to compromise to a more modest resort</option> <option label="I am willing to compromise room occupancy and accept 3-4 people sharing a room" value="i-am-willing-to-compromise-room-occupancy-and-accept-34-people-sharing-a-room">I am willing to compromise room occupancy and accept 3-4 people sharing a room</option> <option label="Other " value="other-">Other </option> </field> <field type="text" label="If This Is A Group, Please Indicate The Desired Per Person Budget Here." name="if-this-is-a-group-please-indicate-the-desired-per-budget-here" subtype="text" className="form-control"/> <field type="textarea" label="What Hotels/Resorts Have You Loved Staying At Previously And What Did You Enjoy About Them?" name="where-have-you-traveled-in-the-past-what-is-your-favorite-vacation-and-why" className="form-control"/> <field type="text" label="What Is Your Least Favorite Destination Or Place You Have Traveled To/Stayed At?" name="what-is-your-least-favorite-place-you-have-traveled-tostayed-at" subtype="text" className="form-control"/> <field type="checkbox-group" label="Do You Have A Preference For Activities You Are Interested In?" description="Check ALL That Apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Historical sites" value="historical-sites">Historical sites</option> <option label="Foodie experiences" value="foodie-experiences">Foodie experiences</option> <option label="Private tours" value="private-tours">Private tours</option> <option label="Group tours" value="group-tours">Group tours</option> <option label="Adventure activities" value="adventure-activities">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Museums" value="museums">Museums</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Hiking & Biking" value="hiking-biking">Hiking & Biking</option> </field> <field type="text" label="What Concerns Do You Have About Travel? Of What Are Your Pain Points When Traveling?" name="what-concerns-do-you-have-about-travel-of-what-are-your-pain-points-when-traveling" subtype="text" className="form-control"/> <field type="text" label="What Do You Most Want To Get Out Of This Trip?" name="must-dos" subtype="text" className="form-control"/> <field type="text" label="When You're Envisioning Your Vacation, What are Some Of Your "Must Have's", "Nice To Have's", and "I'd Rather Not Have" Items?&nbsp;" name="when-youre-envisioning-your-vacation-what-are-some-of-your-must-haves-nice-to-haves-and-id-rather-not-have-items-is-there-anything-else-you-would-like-me-to-know-" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Important Details&nbsp;"/> <field type="radio-group" required="true" label="Trip Protection Insurance Is Always Highly Recommended For Travel, And Cancel For Any Reason Type Insurance Is The Only Type Of Policy&nbsp; That Covers COVID-Related Cancellations.&nbsp; Live Well Travel Will Require A Waiver To Be Signed If Trip Protection Insurance Is Declined For This Trip*" name="trip-protection-insurance-is-always-highly-recommended-for-travel-and-cancel-for-any-reason-type-insurance-is-the-only-type-of-policy-that-covers-covidrelated-cancellations-live-well-travel-will-require-a-waiver-to-be-signed-if-trip-protection-insurance-is-declined-for-this-trip"> <option label="I understand and plan to accept the cancel for any reason insurance." value="i-understand-and-plan-to-accept-the-cancel-for-any-reason-insurance">I understand and plan to accept the cancel for any reason insurance.</option> <option label="I am not sure yet about purchasing trip protection insurance." value="i-am-not-sure-yet-about-purchasing-trip-protection-insurance">I am not sure yet about purchasing trip protection insurance.</option> <option label="I plan to decline trip protection insurance and sign the waiver." value="i-plan-to-decline-trip-protection-insurance-and-sign-the-waiver">I plan to decline trip protection insurance and sign the waiver.</option> </field> <field type="checkbox-group" required="true" label="LWT will provide a complimentary travel consultation to determine your travel needs. Your travel advisor will charge a professional service fee for the service, knowedge and support throughout the travel planning process. This will be a conversation that each advisor will have prior to sending your travel proposal due to the uncompensated time/effort required to research and discuss the most recent travel restrictions applicable to each individual situation.&nbsp; This travel professional fee will vary pending the complexity of your trip. Live Well Travel will also provide resources and support through your entire travel planning and discuss these details with you during the initial consultation.&nbsp;" name="after-a-complimentary-phoneemail-consultation-if-you-have-selected-a-destination-with-covid-travel-restrictions-live-well-travel-will-charge-a-covid-travel-support-fee-prior-to-sending-your-trip-quote-due-to-the-uncompensated-timeeffort-required-to-research-and-discuss-the-most-recent-travel-restrictions-applicable-to-each-individual-situation-this-support-fee-may-either-be-applied-to-your-overall-trip-or-as-a-separate-planning-fee-pending-the-complexity-of-your-trip-live-well-travel-will-also-provide-resources-and-support-through-the-complex-process-"> <option label="I understand that LWT may collect a travel professional fee and will discuss this with me at the time of consultation " value="i-understand-that-lwt-may-collect-a-travel-professional-fee-and-will-discuss-this-with-me-at-the-time-of-consultation-">I understand that LWT may collect a travel professional fee and will discuss this with me at the time of consultation </option> </field> <field type="text" label="Anything Else You Would Like Me To Know?" name="anything-else-you-would-like-me-to-know" subtype="text" className="form-control"/> <field type="text" required="true" label="How Did You Hear About Live Well Travel?" name="how-did-you-hear-about-live-well-travel" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Consent" name="consent"> <option label="I consent to having Live Well Travel to collect my details via this form" value="i-consent-to-having-live-well-travel-to-collect-my-details-via-this-form">I consent to having Live Well Travel to collect my details via this form</option> </field> </fields> </form-template> </body> </html>
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