<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Your Contact Information"/> <field type="paragraph" subtype="p" label="Please enter your personal information exactly as it appears on your passport.&nbsp; At the booking stage, I will ask for a photo of the picture page of your passport. I cannot book your flights without a copy of the photo page on your passport.&nbsp;"/> <field type="text" 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" name="preferred-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" label="Citizenship" name="citizenship" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Your Travel Plans"/> <field type="text" required="true" label="Please list your departure airport(s)&nbsp; (The airport you are leaving from.)" name="please-list-your-departure-airports-" subtype="text" className="form-control"/> <field type="date" required="true" label="When do you want to leave home for your trip?" name="when-do-you-want-to-leave-home-for-your-trip" className="form-control"/> <field type="text" required="true" label="Please list your destination airport. (The airport you are flying to!)" name="please-list-your-destination-airports" subtype="text" className="form-control"/> <field type="date" required="true" label="What day do you want to fly home from your trip?" name="what-day-do-you-want-to-fly-home" className="form-control"/> <field type="checkbox-group" required="true" label="What class would you like me to quote for?" name="what-class-would-you-like-me-to-quote-for"> <option label="International First Class" value="international-first-class">International First Class</option> <option label="International Business Class" value="international-business-class">International Business Class</option> <option label="International Premium Economy. " value="international-premium-economy-">International Premium Economy. </option> </field> <field type="radio-group" label="How many people are traveling?" name="how-many-people-are-traveling" other="true"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> </field> <field type="header" subtype="h1" label="Your Travel Preferences"/> <field type="radio-group" label="Seat preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> </field> <field type="text" label="Airline meal preference" name="meal-preference" 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="textarea" label="Please let me know if there's anything important I should know about your flights.&nbsp;" name="please-let-me-know-if-theres-anything-important-i-should-know-about-your-flights-" className="form-control"/> <field type="date" label="When does your passport expire?" name="when-does-your-passport-expire" className="form-control"/> <field type="checkbox-group" label="Please select any other services you might be interested in." name="please-select-any-other-services-you-might-be-interested-in"> <option label="VIP Meet & Greet on Departure (Estimate $600 for two travelers.)" value="vip-meet-greet-on-departure-estimate-600-for-two-travelers">VIP Meet & Greet on Departure (Estimate $600 for two travelers.)</option> <option label="VIP Meet & Greet on Arrival (Estimate $600 for two travelers.)" value="vip-meet-greet-on-arrival-estimate-600-for-two-travelers">VIP Meet & Greet on Arrival (Estimate $600 for two travelers.)</option> <option label="Private airport transfers (Fees vary based on location but generally start at $200.)" value="private-airport-transfers-fees-vary-based-on-location-but-generally-start-at-200">Private airport transfers (Fees vary based on location but generally start at $200.)</option> </field> <field type="checkbox-group" label="I understand that I will need to upload my passport and the passports of any family members to Antidote Travel before my plane ticket can be booked.&nbsp;" name="i-understand-that-i-will-need-to-upload-my-passport-to-antidote-travel-before-my-plane-ticket-can-be-booked-"> <option label="Yes" value="yes">Yes</option> </field> <field type="checkbox-group" label="I understand that Antidote Travel *may* charge $100 per ticket to book roundtrip international flights.&nbsp;" name="i-understand-that-antidote-travel-may-charge-100-per-ticket-to-book-roundtrip-international-flights-"> <option label="Yes" value="yes">Yes</option> </field> </fields> </form-template> </body> </html>
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