<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Tell me about you and your trip...the more you tell me now, the more I can help you! Once you submit this form, scroll back up on the page to see my link to schedule a Zoom call.&nbsp;"/> <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" label="Where do you live?" name="where-do-you-live" subtype="text" className="form-control"/> <field type="text" required="true" label="Who&nbsp; can we thank for the referral?" name="how-did-you-hear-about-me" 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: Italy or Spain or anywhere warm in Europe" name="destination" subtype="text" className="form-control"/> <field type="text" required="true" label="What airport(s) do you plan on departing from?&nbsp;" placeholder="Miami but would consider Fort Lauderdale and Palm Beach" name="what-airports-do-you-want-to-depart-from" subtype="text" className="form-control"/> <field type="text" required="true" label="Who's going? Include names and ages please.&nbsp;" placeholder="Me (51) my Aunt Ann Marie (82) my cousin Maureen (~55) and my niece Colleen (22)" name="whos-going-with-you-include-names-and-ages-please-" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Now that you've told me who you are traveling with, tell me their hobbies and interests. And yours too! The more you tell me, the more special I can make your trip. There may be activities you would never had known about had you not told me your hobbies and interests." placeholder="Krista (me): I love food tours photography modern and contemporary art street art biking anything Michelin-starred. Ann Marie: Loves history more than anything. Maureen: Loves shopping history. Colleen: Will do anything her mom and grandmother do but loves ballet/dance/musicals." name="now-that-youve-told-me-who-you-are-traveling-with-tell-me-their-hobbies-and-interests-and-yours-too-the-more-you-tell-me-the-more-special-and-interesting-i-can-make-your-trip" className="form-control"/> <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="radio-group" required="true" label="Are your dates flexible?" inline="true" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="Have you already booked your flights?" inline="true" name="have-you-already-booked-your-flights"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="What is your total budget for all travelers? Consider accommodation, experiences/excursions, and trains/transfers, not flights. Bear in mind the USD is low against most other currencies right now.&nbsp;" description="This just gives me a general starting point!" name="budget"> <option label="$75,000+" value="75000">$75,000+</option> <option label="$50,000 to $75,000" value="50000-to-75000">$50,000 to $75,000</option> <option label="$35,000 to $50,000" value="35000-to-50000">$35,000 to $50,000</option> <option label="$20,000 to $35,000" value="20000-to-35000">$20,000 to $35,000</option> <option label="$15,000 to $20,000 (Recommended minimum spring/summer spend for one week in Europe for three or four people with accomodation, excursions, and trains/transfers.)" value="15000-to-20000-recommended-minimum-springsummer-spend-for-one-week-in-europe-for-three-or-four-people-with-accomodation-excursions-and-trainstransfers">$15,000 to $20,000 (Recommended minimum spring/summer spend for one week in Europe for three or four people with accomodation, excursions, and trains/transfers.)</option> <option label="$10,000 to $15,000 (Recommended minimum spring/summer spend for one week in Europe for two people with accomodation, excursions, and trains/transfers.)" value="10000-to-15000-recommended-minimum-springsummer-spend-for-one-week-in-europe-for-two-people-with-accomodation-excursions-and-trainstransfers">$10,000 to $15,000 (Recommended minimum spring/summer spend for one week in Europe for two people with accomodation, excursions, and trains/transfers.)</option> <option label="$7,500 to $10,000" value="7500-to-10000">$7,500 to $10,000</option> <option label="$5,000 to $7,500" value="5000-to-7500">$5,000 to $7,500</option> </field> <field type="textarea" label="Tell me everything you absolutely must do or see. The more you tell me, the more amazing I can make your trip." placeholder="Colosseum Naples pizza tour Amalfi coast boat ride" name="tell-me-everything-you-absolutely-must-do-or-see-the-more-you-tell-me-the-more-amazing-i-can-make-your-trip" className="form-control"/> <field type="checkbox-group" label="What type of excursions and experiences are you most interested in during your vacation? Check all that apply. Bear in mind that sometimes a private tour for four people is similar in price to four spots on a small group tour.&nbsp;" description="Imagine a private guide for The Louvre in Paris an evening with a top sake sommelier in Tokyo or a golf cart ride around Rome." name="what-type-of-touring-are-you-most-interested-in-check-all-that-apply"> <option label="Private excursions/experiences with private drivers /guides. Estimate $350 to $600 per hour and a minimum four hour tour." value="private-excursionsexperiences-with-private-drivers-guides-estimate-350-to-600-per-hour-and-a-minimum-four-hour-tour">Private excursions/experiences with private drivers /guides. Estimate $350 to $600 per hour and a minimum four hour tour.</option> <option label="Small group excursions/experiences (Usually < 24 people.)" value="small-group-excursionsexperiences-usually-24-people">Small group excursions/experiences (Usually < 24 people.)</option> <option label="Group excursions/experiences (Usually > 24 people)" value="group-excursionsexperiences-usually-24-people">Group excursions/experiences (Usually > 24 people)</option> <option label="No excursions/experiences (You'll explore on your own or just sit on a beach.)" value="no-excursionsexperiences-youll-explore-on-your-own-or-just-sit-on-a-beach">No excursions/experiences (You'll explore on your own or just sit on a beach.)</option> </field> <field type="text" required="true" label="What's the best hotel you've ever stayed at?" name="whats-the-best-hotel-youve-ever-stayed-at" subtype="text" className="form-control"/> <field type="text" required="true" label="What’s the maximum you’re comfortable spending per night on a hotel? We work exclusively with 4- and 5-star properties, which in Europe and Japan typically start at $600 per night (including breakfast) for one room for two people, depending on destination and season. Bear in mind that two queen beds in one room are uncommon outside the U.S., and the strong Euro and British pound make prices higher in USD.&nbsp; ($600 USD = 510 EUR, 440 GBP as of January 2026.)" name="whats-the-maximum-youre-willing-to-spend-on-a-hotel-per-night" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Hotel rooms in many parts of the world, particularly Europe, can be smaller than American&nbsp; hotel rooms and some don't come with air conditioning. How do you feel about this?" name="hotel-rooms-in-many-parts-of-the-world-can-be-smaller-than-american-hotel-rooms-and-some-dont-come-with-air-conditioning-how-do-you-feel-about-this"> <option label="I need a nicely-sized room AND air conditioning" value="i-need-a-nicelysized-room-and-air-conditioning">I need a nicely-sized room AND air conditioning</option> <option label="I don't care about room size but I care about AC" value="i-dont-care-about-room-size-but-i-care-about-ac">I don't care about room size but I care about AC</option> <option label="I care about room size but I don't care about AC" value="i-care-about-room-size-but-i-dont-care-about-ac">I care about room size but I don't care about AC</option> </field> <field type="textarea" required="true" label="Does anyone in your group have any allergies or dietary needs, other health needs, or mobility issues? Please be as specific as possible. This includes CPAP machines." placeholder="List any allergies chronic conditions or physical constraints." name="does-anyone-in-your-group-have-any-allergies-or-dietary-needs-other-health-needs-or-mobility-issues-please-be-as-specific-as-possible" className="form-control"/> <field type="radio-group" required="true" label="Red wine or white wine?" name="red-wine-or-white-wine" other="true"> <option label="Red" value="red">Red</option> <option label="White" value="white">White</option> <option label="Both" value="both">Both</option> <option label="Neither" value="neither">Neither</option> </field> <field type="radio-group" required="true" label="Do you plan on using frequent flyer miles or hotel points for any part of your trip?&nbsp;" name="do-you-plan-on-using-points-for-any-part-of-your-trip"> <option label="No" value="no">No</option> <option label="Possibly for flights" value="possibly-for-flights">Possibly for flights</option> <option label="Yes — for hotels" value="yes-for-hotels">Yes — for hotels</option> <option label="Yes — for most of the trip" value="yes-for-most-of-the-trip">Yes — for most of the trip</option> </field> <field type="radio-group" required="true" label="What's your timeline for making a decision? We recommend scheduling your consultation for a time when you think you can realistically make a decision on a proposal within two weeks. Pricing and availability is always subject to change." name="whats-your-timeline-for-making-a-decision"> <option label="I'm ready to book!" value="im-ready-to-book">I'm ready to book!</option> <option label="I need a proposal and a week or two to think about it." value="i-need-a-proposal-and-a-week-or-two-to-think-about-it">I need a proposal and a week or two to think about it.</option> <option label="I don't know. I'm just trying to figure things out." value="i-dont-know-im-just-trying-to-figure-things-out">I don't know. I'm just trying to figure things out.</option> </field> <field type="radio-group" required="true" label="Travel insurance will protect your investment and help you when the unexpected occurs. (Accidents/injuries, flight delays, cancellations, lost luggage, illness, evacuation and repatriation, etc.) Can I send you a quote for travel insurance for your trip?" name="travel-insurance-is-an-important-part-of-any-trip-and-will-protect-your-investment-would-you-like-a-quote-for-travel-insurance"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="Does everyone have passports that are valid at least for at least six months after your planned return to the US?" name="does-everyone-has-passports-that-are-valid-at-least-for-at-least-six-months-after-your-planned-return-to-the-us"> <option label="Yes, definitely" value="yes-definitely">Yes, definitely</option> <option label="No, we're working on this" value="no-were-working-on-this">No, we're working on this</option> <option label="I need to check" value="i-need-to-check">I need to check</option> </field> <field type="textarea" required="true" label="What do you expect to gain in working with a travel professional? We want to make sure we meet your needs." name="what-do-you-expect-to-gain-in-working-with-a-travel-professional-were-very-good-at-what-we-do-and-want-to-make-sure-we-meet-your-needs" className="form-control"/> <field type="checkbox-group" required="true" label="By submitting this form, you understand that if we decide to work together, Antidote Travel charges a travel design fee for trip planning and management." name="by-submitting-this-form-you-understand-that-antidote-travel-may-charge-a-travel-design-fee-for-trip-planning-and-management"> <option label="Yes" value="yes">Yes</option> </field> <field type="header" subtype="h1" label="When you submit this form, please scroll back up on the page for the link to schedule your consultation. You will also receive an email with the link to my calendar."/> </fields> </form-template> </body> </html>
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