<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Thank you for choosing Bucket List Travel Society for your travel and tour services! We are luxury travel consultants and your satisfaction is our top priority! To ensure your travel experience is tailored to your preferences, we invite you to share the specifics of your travel requirements.&nbsp;"/> <field type="text" required="true" label="Email Address" name="email" subtype="text" className="form-control"/> <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="date" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/> <field type="text" required="true" label="Where would you like to go?" description="If you're not sure just give us 3 destinations you're considering." placeholder="ex: Las Vegas" name="destination" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your departure city/airport code?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="date" required="true" label="When would you like to depart?" description="This just gives us a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/> <field type="date" required="true" label="When would you like to return?" description="This just gives us a general idea of when you like to return; it can be changed later." name="ending-at" 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="select" required="true" label="Package Type" name="package-type" className="form-control"> <option label="Hotel Only" value="hotel-only">Hotel Only</option> <option label="Hotel and Airfare" value="hotel-and-airfare">Hotel and Airfare</option> <option label="Hotel, Airfare & Car Rental" value="hotel-airfare-car-rental">Hotel, Airfare & Car Rental</option> <option label="Hotel and Car Rental" value="hotel-and-car-rental">Hotel and Car Rental</option> <option label="Rental Home/Apartment/Condo" value="rental-homeapartmentcondo">Rental Home/Apartment/Condo</option> <option label="Luxury Villa" value="luxury-villa">Luxury Villa</option> <option label="Train" value="train">Train</option> </field> <field type="select" required="true" label="Please share your preferences you may have. (select all that apply)" name="please-share-your-preferences-you-may-have-select-all-that-apply" multiple="multiple" className="form-control"> <option label="All Inclusive" value="all-inclusive" selected="selected">All Inclusive</option> <option label="Adult Only" value="adult-only">Adult Only</option> <option label="Family Friendly" value="family-friendly">Family Friendly</option> <option label="Breakfast Included" value="breakfast-included">Breakfast Included</option> <option label="European Plan (meals not included)" value="european-plan-meals-not-included">European Plan (meals not included)</option> </field> <field type="select" required="true" label="Please let us know of any special amenities. (select all that apply)" name="please-let-us-know-of-any-special-amenities-select-all-that-apply" className="form-control"> <option label="Butler Service" value="butler-service" selected="selected">Butler Service</option> <option label="Club Level" value="club-level">Club Level</option> <option label="Connecting/Adjoining Rooms" value="connectingadjoining-rooms">Connecting/Adjoining Rooms</option> </field> <field type="text" label="Loyalty Programs" placeholder="ex: Hilton Honors AAdvantage # Delta points etc." name="loyalty-programs" subtype="text" className="form-control"/> <field type="text" required="true" label="How many rooms are you requesting?" name="how-many-rooms" subtype="text" className="form-control"/> <field type="text" label="What type of bed situation do you prefer?" description="King Queen Double etc." placeholder="King Queen Double etc." name="what-type-of-bed-situation-do-you-prefer" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers per room?" name="how-many-travelers-per-room" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Please inform us of any room preferences you would like considered." name="hotel-preference" other="true"> <option label="Standard Room" value="standard-room">Standard Room</option> <option label="Swim Up " value="swim-up-">Swim Up </option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Ocean Front" value="ocean-front">Ocean Front</option> <option label="Pool View" value="pool-view">Pool View</option> <option label="Garden View" value="garden-view">Garden View</option> <option label="City View" value="city-view">City View</option> <option label="Suite - Honeymoon" value="suite-honeymoon">Suite - Honeymoon</option> <option label="Suite - Presidential" value="suite-presidential">Suite - Presidential</option> </field> <field type="text" required="true" label="How many travelers are 18 years and older?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="How many children? If there are children, please add their ages.&nbsp;" description="Please place N/A if there are no children traveling." placeholder="Example: 3 children 4 7 11" name="text-1683242819843" subtype="text" className="form-control"/> <field type="radio-group" label="If you have any children that are less than 2 years old traveling with you, do you request any lap seats?" name="if-you-have-any-children-that-are-less-than-2-years-old-traveling-with-you-do-you-request-any-lap-seats"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="N/A" value="na">N/A</option> </field> <field type="radio-group" required="true" label="What is your budget for each traveler? Disclaimer: Prices are subject to change until the booking has been completed." description="This just gives us a general starting point and can always be changed later." name="budget"> <option label="$1,000" value="1000">$1,000</option> <option label="$1,000 to $1,500" value="1000-to-1500">$1,000 to $1,500</option> <option label="$1,500 to $2,000" value="1500-to-2000">$1,500 to $2,000</option> <option label="$2,000 to $2,500" value="2000-to-2500">$2,000 to $2,500</option> <option label="$2,500 - $3,000" value="2500-3000">$2,500 - $3,000</option> <option label="$3,000 +" value="3000-">$3,000 +</option> </field> <field type="radio-group" required="true" label="If we find exactly what you are look for, withing budget, are you ready to secure the booking with a payment?" name="are-you-ready-to-book"> <option label="Yes! I am deposit ready" value="yes-i-am-deposit-ready">Yes! I am deposit ready</option> <option label="Within the next 2 weeks" value="within-the-next-2-weeks">Within the next 2 weeks</option> <option label="Within the next month" value="within-the-next-month">Within the next month</option> <option label="Just looking at my options" value="just-looking-at-my-options">Just looking at my options</option> <option label="Pay in full today" value="pay-in-full-today">Pay in full today</option> </field> <field type="text" required="true" label="Do you request a payment plan?" name="do-you-need-a-payment-plan" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="If requesting a rental car, what is your preference?" name="if-requesting-a-rental-car-what-is-your-preference" other="true"> <option label="Compact Car" value="compact-car">Compact Car</option> <option label="Standard Car" value="standard-car">Standard Car</option> <option label="Standard SUV" value="standard-suv">Standard SUV</option> <option label="Minivan" value="minivan">Minivan</option> <option label="Pickup Truck" value="pickup-truck">Pickup Truck</option> </field> <field type="textarea" required="true" label="What else would you like us to know?" description="What else would you like us to know about your budget and/or travel preferences?" name="notes" className="form-control"/> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" 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="Party/Night life" value="partynight-life">Party/Night life</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Food and wine" value="food-wine">Food and wine</option> <option label="Ziplining" value="ziplining">Ziplining</option> <option label="Beach and water activities" value="beach-and-water-activities">Beach and water activities</option> </field> <field type="text" required="true" label="Would you like us to plan excursions on your bucket list? Please be specific." name="must-dos" subtype="text" className="form-control"/> <field type="text" required="true" label="Reason for travel? Please be very specific." description="Let us know if you would like additional packages for your special occasion." placeholder="Work Birthday Guys Trip Girls Trip Wedding Anniversary etc." name="reason-for-travel-please-be-very-specific" subtype="text" className="form-control"/> <field type="text" label="Do you require any special accommodations?" description="Wheel chair accessible rooms etc." name="do-you-require-any-special-accommodations" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do you and all of your travelers have a current passport?" name="do-you-and-all-of-your-travelers-have-a-current-passport"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h2" label="Passport Info"/> <field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/> <field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/> <field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/> <field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/> <field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="text" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/> <field type="radio-group" label="Gender as it appears on your passport" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> <option label="X" value="other">X</option> </field> <field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/> <field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Would you like us to add travel insurance?" description="This is recommended." name="would-you-like-travel-to-add-travel-insurance"> <option label="Yes, add insurance to my package" value="yes-add-insurance-to-my-package">Yes, add insurance to my package</option> <option label="No, I agee to sign the decline waiver" value="no-i-agee-to-sign-the-decline-waiver">No, I agee to sign the decline waiver</option> </field> <field type="header" subtype="h1" label="Quote Requests: Please be advised, there is a non-refundable admin fee charged for our services. This includes the time invested with research services, trip coordination, working directly with the suppliers on your behalf for the best possible deals, and the procedures to process payment plans/travel insurance to cover any cancellations and/or incidentals before and during your vacation.&nbsp;"/> <field type="header" subtype="h1" label="This admin fee is a one-time payment of $25 for solo travelers and groups of 4 people or less. For groups of more than 4 people, there is a non-refundable admin fee of $50. You will receive a separate invoice, and this admin fee will not be applied to your travel booking costs. Only 2 revisions are offered for your quote within 7 business days of delivery."/> <field type="header" subtype="h3" label="Once your payment is received, you will receive a travel quote within 5 business days, unless you opt and pay for the rush fee. (To receive your quote within 24 hrs, there is an additional fee of $19.99). Your quote will be voided if you do not respond within 7 business days of receiving the quote, and the admin fee will be forfeited. Thank you!"/> <field type="header" subtype="h3" label="If you DO NOT agree, you will be directed to our SELF-SERVICE BOOKING PORTAL at http://thetravelceo.inteletravel.com/ to book your travel without our travel agent services.&nbsp;"/> <field type="checkbox-group" required="true" label="Please annotate your response regarding the admin fee." name="please-annotate-your-response-regarding-the-admin-fee"> <option label="I AGREE" value="i-agree">I AGREE</option> <option label="I DO NOT AGREE" value="i-do-not-agree">I DO NOT AGREE</option> </field> <field type="checkbox-group" label="How did you hear about us?" name="how-did-you-hear-about-us"> <option label="Facebook" value="facebook">Facebook</option> <option label="Instagram" value="instagram">Instagram</option> <option label="Youtube" value="youtube">Youtube</option> <option label="Google" value="google">Google</option> <option label="TikTok" value="tiktok">TikTok</option> <option label="Referral" value="referral">Referral</option> <option label="Repeat Client" value="repeat-client">Repeat Client</option> </field> <field type="radio-group" label="Before we proceed with booking your awesome getaway, would you first be interested in learning how you can start your own travel business? You would earn your own commissions and possibly save money on this trip and future trips." name="before-we-proceed-with-booking-your-awesome-getaway-would-you-first-be-interested-in-learning-how-you-can-become-a-travel-agent-you-would-earn-your-own-commissions-and-possibly-save-money-on-this-trip-and-future-trips"> <option label="Yes, please send me free information to start my travel business!" value="yes-please-send-me-free-information-to-start-my-travel-business">Yes, please send me free information to start my travel business!</option> <option label="No thank you, I am not interested." value="no-thank-you-i-am-not-interested">No thank you, I am not interested.</option> </field> <field type="header" subtype="h1" label="Thank you again for choosing&nbsp; Bucket List Travel Society for your travel &amp; tour services. We aim not only to meet, but to exceed your expectations by tailoring your experience. Your input allows us to curate a journey that reflects your unique preferences. Expect a personalized touch. We will review your requirements thoroughly. Our team may reach out for any questions or additional information. Thank you for entrusting us with your travel needs. We appreciate the opportunity to create a seamless and unforgettable experience for you."/> </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
Type
Draw
×
By signing, I understand that this is a legally binding contract.