Share your information with Tracey Peckford

Tracey Peckford

Go Travel

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    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field>&#13;
		<field type="header" subtype="h1" label="Traveller Information"/>&#13;
		<field type="paragraph" subtype="p" label="A passport is required for international travel for all travellers regardless of their age."/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="It is important that the name on your reservation be exactly as it is stated on your passport. You may be denied boarding or have your hotel/resort reservation cancelled if these details are incorrect."/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="If your passport is expired or will expire less than 6 months before your date of return to Canada,&amp;nbsp; please contact me as most destinations require this guideline for travel."/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="text" required="true" label="Full name as it appears on passport (please separate first name and middle with a slash)" description="Example: TRACEY/ANNE/PECKFORD" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number (Optional)" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country of issue (Optional)" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of issue (Optional)" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender as it appears on passport" inline="true" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Birthdate: DAY/MONTH/YEAR" description="DAY/MONTH/YEAR" name="preferred-pronouns" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Province" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Postal Code" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Additional Travel Information"/>&#13;
		<field type="radio-group" label="Seat preference" inline="true" name="seat-preference" other="true">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle (2 Aisles if 2 people)" value="opposite-aisle-2-aisles-if-2-people">Opposite aisle (2 Aisles if 2 people)</option>&#13;
			<option label="Bulk Head" value="bulk-head- front and no seats in front of you">Bulk Head</option>&#13;
			<option label="authorized to charge card for exit row if available" value="authorized-to-charge-card-for-exit-row-if-available">authorized to charge card for exit row if available</option>&#13;
		</field>&#13;
		<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"/>&#13;
		<field type="text" label="Canadian Travel Number" name="canadian-travel-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="NEXUS/GLOBAL ENTRY" description="Nine-digit number usually begins with 10  13  14  15  16  50  70  80  95  98  or 99 and can be found on the back of your NEXUS  SENTRI  or Global Entry card in the upper-left corner or by logging on to the Trusted Traveler Programs website." name="nexusglobal-entry" subtype="text" className="form-control"/>&#13;
		<field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Accuracy of Traveller Information" name="accuracy-of-traveller-information">&#13;
			<option label="By checking this box I confirm that the traveller information I have provided for myself or on behalf of the traveller is EXACTLY as it appears on their passport. I acknowledge and accept  that there may be a fee charged by any airline, hotel, cruise line,  tour operator, or other travel related suppliers if information is incorrect. I acknowledge and accept that I am responsible to pay any  fees charged by the  airlines, hotels, cruise lines,  tour operators, or other travel related suppliers  to make any corrections." value="by-checking-this-box-i-confirm-that-the-traveller-information-i-have-provided-for-myself-or-on-behalf-of-the-traveller-is-exactly-as-it-appears-on-their-passport-i-acknowledge-and-accept-that-there-may-be-a-fee-charged-by-any-airline-hotel-cruise-line-tour-operator-or-other-travel-related-suppliers-if-information-is-incorrect-i-acknowledge-and-accept-that-i-am-responsible-to-pay-any-fees-charged-by-the-airlines-hotels-cruise-lines-tour-operators-or-other-travel-related-suppliers-to-make-any-corrections">By checking this box I confirm that the traveller information I have provided for myself or on behalf of the traveller is EXACTLY as it appears on their passport. I acknowledge and accept  that there may be a fee charged by any airline, hotel, cruise line,  tour operator, or other travel related suppliers if information is incorrect. I acknowledge and accept that I am responsible to pay any  fees charged by the  airlines, hotels, cruise lines,  tour operators, or other travel related suppliers  to make any corrections.</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="If you are travelling with a leisure group/wedding etc, please let me know so I can ensure you are placed accordingly. If travelling with a friend, please mention their name." description="Name of who are travelling with  and which group" name="if-you-are-travelling-with-a-leisure-groupwedding-etc-please-let-me-know-so-i-can-ensure-you-are-placed-accordingly-" rows="2" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>