<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="For the Memories Travel Quote Request"/> <field type="paragraph" subtype="p" label="Are you ready to start planning your vacation to create those special memories?"/> <field type="paragraph" subtype="p" label="Thank you so much for considering me to help you with your vacation! My services are complimentary when your trip is booked through me, and I will help make sure you are going into your vacation feeling confident and prepared.&nbsp;"/> <field type="paragraph" subtype="p" label="Please fill out this form with as much detail as possible. If you aren't sure about something, you can leave a detailed note at the bottom! No detail is too small.&nbsp;"/> <field type="paragraph" subtype="p" label="I look forward to working with you and learning about what your ideal vacation looks like for you and your family!&nbsp;"/> <field type="paragraph" subtype="p" label="- Brittany Pulliam"/> <field type="header" subtype="h2" label="Contact Information &amp; Travel Party"/> <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 required="true" type="text" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Preferred Method of Contact" name="preferred-method-of-contact" other="true"> <option label="Email" value="email">Email</option> <option label="Text" value="text">Text</option> <option label="Call" value="call">Call</option> </field> <field type="textarea" required="true" label="Total Number of Adults &amp; Their Names" name="travel-party-include-ages-for-children" className="form-control"/> <field type="textarea" label="Total Number of Children &amp; Their Birthday" name="textarea-1724463948787" className="form-control"/> <field type="header" subtype="h2" label="Tell Me About Your Vacation"/> <field type="checkbox-group" required="true" label="Where would you like to travel?" name="where-would-you-like-to-travel"> <option label="Walt Disney World" value="walt-disney-world">Walt Disney World</option> <option label="Universal Studios Orlando" value="universal-studios-orlando">Universal Studios Orlando</option> <option label="All Inclusive Vacation" value="all-inclusive-vacation">All Inclusive Vacation</option> <option label="Disneyland in California" value="disneyland-in-california">Disneyland in California</option> <option label="Disney Cruise" value="disney-cruise">Disney Cruise</option> <option label="Royal Caribbean Cruise (or other)" value="royal-caribbean-cruise-or-other">Royal Caribbean Cruise (or other)</option> <option label="Universal Studios Hollywood" value="universal-studios-hollywood">Universal Studios Hollywood</option> <option label="Other" value="other">Other</option> </field> <field type="date" required="true" label="When would you like to check-in?" 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" required="true" label="When would you like to check-out?" 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> </field> <field type="text" required="true" label="Will you be flying or driving?" description="It's okay if you don't know yet." name="departure-city" subtype="text" className="form-control"/> <field type="text" label="If visiting Disney or Universal, how many days would you like to visit the parks?" description="Walt Disney World has 4 different theme parks (and 2 water parks). Universal Orlando currently has 2 theme parks and 1 water park." name="if-visiting-disney-or-universal-how-many-days-would-you-like-to-visit-the-parks" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Are you interested in visiting more than 1 park per day?" name="are-you-interested-in-visiting-more-than-1-park-per-day" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="I'm not sure." value="im-not-sure">I'm not sure.</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference/vacation style?" name="hotel-preference" other="true"> <option label="Value" value="value">Value</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Deluxe/Deluxe Villa" value="deluxedeluxe-villa">Deluxe/Deluxe Villa</option> <option label="Offsite - If visiting the theme park, you would rather be off site" value="offsite-if-visiting-the-theme-park-you-would-rather-be-off-site">Offsite - If visiting the theme park, you would rather be off site</option> <option label="Unsure" value="unsure">Unsure</option> </field> <field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <option label="$1,500 to $2,500" value="1500-to-2500">$1,500 to $2,500</option> <option label="$2,500 to $4,000" value="2500-to-4000">$2,500 to $4,000</option> <option label="$4,000 to $5,000" value="4000-to-5000">$4,000 to $5,000</option> <option label="$5,000 to $6,000" value="5000-to-6000">$5,000 to $6,000</option> <option label="$6,000 to $7,000" value="6000-to-7000">$6,000 to $7,000</option> <option label="$7,000+" value="7000 plus">$7,000+</option> </field> <field type="header" subtype="h1" label="Let's check for discounts &amp; other details"/> <field type="checkbox-group" label="Are you interested in any of the following?" name="are-you-interested-in-any-of-the-following"> <option label="Airport Transportation" value="airport-transportation">Airport Transportation</option> <option label="Rental Car" value="rental-car">Rental Car</option> <option label="Stroller Rental" value="stroller-rental">Stroller Rental</option> <option label="Photo Package (memory maker)" value="photo-package-memory-maker">Photo Package (memory maker)</option> <option label="Dining Plan" value="dining-plan">Dining Plan</option> <option label="After Hours Events such as Mickey's Not So Scary Halloween Party, Mickey's Very Merry Christmas Party, or other after hours events during non-holiday season." value="after-hours-events-such-as-mickeys-not-so-scary-halloween-party-mickeys-very-merry-christmas-party-or-other-after-hours-events-during-nonholiday-season">After Hours Events such as Mickey's Not So Scary Halloween Party, Mickey's Very Merry Christmas Party, or other after hours events during non-holiday season.</option> <option label="None" value="none">None</option> </field> <field type="checkbox-group" required="true" label="Do any of these apply to you?" description="Check all that apply" name="do-any-of-these-apply-to-you"> <option label="Disney+ Subscriber" value="disney-subscriber">Disney+ Subscriber</option> <option label="Annual Passholder (Disney or Universal)" value="annual-passholder-disney-or-universal">Annual Passholder (Disney or Universal)</option> <option label="Disney Visa Card Holder" value="disney-visa-card-holder">Disney Visa Card Holder</option> <option label="Active or Retired Military" value="active-or-retired-military">Active or Retired Military</option> <option label="Florida Resident" value="florida-resident">Florida Resident</option> <option label="None" value="none">None</option> </field> <field type="checkbox-group" required="true" label="How did you hear about me?" description="Check all that apply" name="how-did-you-hear-about-me" other="true"> <option label="Facebook" value="facebook">Facebook</option> <option label="Instagram" value="instagram">Instagram</option> <option label="Google" value="google">Google</option> <option label="A friend--tell me who in "other!"" value="a-friendtell-me-who-in-other">A friend--tell me who in "other!"</option> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> </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.