Share your information with Patrice A. Cosely

Patrice A. Cosely

MJG Travel Agency, LLC

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		<field type="paragraph" subtype="p" label="Thank you for choosing MJG Travel, LLC to plan your next getaway! To help us process your request, please provide the necessary details. We’ll strive to get back to you with a personalized quote within three business days. If you have any questions in the meantime, feel free to reach out to us at mjgtravelagency@gmail.com."/>&#13;
		<field type="header" subtype="h1" label="CLIENT INQUIRY FORM"/>&#13;
		<field type="text" required="true" label="Preferred first name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Would you like to join our mailing list?" inline="true" name="would-you-like-to-join-our-mailing-list">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you deposit ready?" description="Deposits range from $50 to $750 per person." inline="true" name="are-you-deposit-ready">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you asking about a specific travel deal&amp;nbsp; posted on Facebook?" inline="true" name="are-you-asking-about-a-specific-travel-deal-posted-on-facebook">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768322051146" rule="eyJ3aGVuRmllbGQiOiJhcmUteW91LWFza2luZy1hYm91dC1hLXNwZWNpZmljLXRyYXZlbC1kZWFsLXBvc3RlZC1vbi1mYWNlYm9vayIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiaWYteWVzLXByb3ZpZGUtdGhlLXBvc3RpbmctZGF0ZS1hbmQtZGVzdGluYXRpb24iXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJpZi15ZXMtcHJvdmlkZS10aGUtcG9zdGluZy1kYXRlLWFuZC1kZXN0aW5hdGlvbiIsImxhYmVsIjoiSWYgeWVzLCBwbGVhc2UgaW5jbHVkZSB0aGUgcG9zdGluZyBkYXRlLCBkZXN0aW5hdGlvbiwgYW5kIHNwZWNpZnkgd2hldGhlciBpdCB3YXMgc2hhcmVkIG9uIHlvdXIgYnVzaW5lc3Mgb3IgcGVyc29uYWwgRmFjZWJvb2sgcGFnZSJ9XX0="/>&#13;
		<field type="text" label="If yes, please include the posting date, destination, and specify whether it was shared on your business or personal Facebook page" name="if-yes-provide-the-posting-date-and-destination" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="header" subtype="h1" label="TRAVELER&#39;S INFORMATION&amp;nbsp;"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of travelers (adults and children)" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you traveling with children?" inline="true" name="are-you-traveling-with-children">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768322104772" rule="eyJ3aGVuRmllbGQiOiJhcmUteW91LXRyYXZlbGluZy13aXRoLWNoaWxkcmVuIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJpZi15ZXMtcHJvdmlkZS10aGUtYWdlcy1hdC10aW1lLW9mLXRyYXZlbCJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6ImlmLXllcy1wcm92aWRlLXRoZS1hZ2VzLWF0LXRpbWUtb2YtdHJhdmVsIiwibGFiZWwiOiJJZiB5ZXMsIHByb3ZpZGUgdGhlIGFnZXMgYXQgdGltZSBvZiB0cmF2ZWwifV19"/>&#13;
		<field type="text" label="If yes, provide the ages at time of travel" name="if-yes-provide-the-ages-at-time-of-travel" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="radio-group" required="true" label="Will this be an international trip?" name="will-this-be-an-international-trip">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1769662402755" rule="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"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1769662635693" rule="eyJ3aGVuRmllbGQiOiJ3aWxsLXRoaXMtYmUtYW4taW50ZXJuYXRpb25hbC10cmlwIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Im5vIiwidGhlbkFjdGlvbiI6InNob3ciLCJ0aGVuRmllbGRzIjpbInJhZGlvLWdyb3VwLTE3MzQyMjE1MzMyNTEiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJyYWRpby1ncm91cC0xNzM0MjIxNTMzMjUxIiwibGFiZWwiOiJGb3IgZG9tZXN0aWMgZmxpZ2h0cywgaWYgeW91IGRvIG5vdCBoYXZlIGEgdmFsaWQgcGFzc3BvcnQsIGFyZSB5b3UgUmVhbCBJRC1jb21wbGlhbnQgYXMgcmVxdWlyZWQgZm9yIGFpciB0cmF2ZWwgYmVnaW5uaW5nIE1heSA3LCAyMDI1PyJ9XX0="/>&#13;
		<field type="radio-group" label="For international flights, do all travelers have valid passports that meet the requirement of being valid for at least six months beyond the return date?" inline="true" name="radio-group-1734221533964" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="For domestic flights, if you do not have a valid passport, are you Real ID-compliant as required for air travel beginning May 7, 2025?" inline="true" name="radio-group-1734221533251" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No, but I have a valid passport" value="no-but-i-have-a-valid-passport">No, but I have a valid passport</option>&#13;
			<option label="No, I do not have a Real ID or valid passport" value="no-i-do-not-have-a-real-id-or-valid-passport">No, I do not have a Real ID or valid passport</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="BUDGET INFORMATION"/>&#13;
		<field type="radio-group" required="true" label="Estimated Budget (per person)" description="This just gives me a general starting point and can always be changed later." inline="true" name="budget">&#13;
			<option label="$2,000 to $3,000" value="2000-to-3000">$2,000 to $3,000</option>&#13;
			<option label="$4,000 to $5,000" value="4000-to-5000">$4,000 to $5,000</option>&#13;
			<option label="$6,000 to $7,000" value="6000-to-7000">$6,000 to $7,000</option>&#13;
			<option label="$8,000 to $9,000" value="8000-to-9000">$8,000 to $9,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Payment Options" inline="true" name="payment-options">&#13;
			<option label="Payment in Full" value="payment-in-full">Payment in Full</option>&#13;
			<option label="Deposit with Payment Plan (if trip is more than 45 days of departure)" value="deposit-with-payment-plan-if-trip-is-more-than-45-days-of-departure">Deposit with Payment Plan (if trip is more than 45 days of departure)</option>&#13;
			<option label="Book Now, Pay Later with Upgrade (subject to credit approval)" value="book-now-pay-later-with-upgrade-subject-to-credit-approval">Book Now, Pay Later with Upgrade (subject to credit approval)</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="BOOKING INFORMATION"/>&#13;
		<field type="text" required="true" label="Destination" placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Date" 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"/>&#13;
		<field type="date" required="true" label="Return Date" 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"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" inline="true" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Departure city/state" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="TRAVEL STYLE"/>&#13;
		<field type="radio-group" required="true" label="Accommodation choice" inline="true" name="hotel-preference">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
			<option label="All-inclusive" value="allinclusive">All-inclusive</option>&#13;
			<option label="Adults only" value="adults-only">Adults only</option>&#13;
			<option label="Air BnB" value="air-bnb">Air BnB</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Room type" inline="true" name="room-type">&#13;
			<option label="Standard" value="standard">Standard</option>&#13;
			<option label="Junior suite" value="junior-suite">Junior suite</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Oceanfront" value="oceanfront">Oceanfront</option>&#13;
			<option label="Swim Out" value="swim-out">Swim Out</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Room setup" inline="true" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Trip vibes" inline="true" name="vibe-preference">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Adventure interest" inline="true" name="activity-preferences">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theatre" value="art-theatre">Arts and theatre</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Are you celebrating a special occasion?" name="text-1732918515145" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Additional information or special accommodations (adults only, handicap accessible, food allergies, etc.)" name="notes" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="TRAVEL INSURANCE"/>&#13;
		<field type="paragraph" subtype="p" label="Life is unpredictable, and unexpected situations can arise before or during your trip. MJG Travel Agency strongly recommends purchasing travel insurance to help protect your travel investment."/>&#13;
		<field type="paragraph" subtype="p" label="Travel insurance may provide coverage for events such as Trip Cancellation, Trip Interruption, Trip Delay, Missed Connections, Baggage Loss or Delay, Emergency Medical Expenses, and Emergency Medical Transportation, depending on the policy."/>&#13;
		<field type="paragraph" subtype="p" label="Please note that most travel insurance policies are reimbursement-based, meaning eligible expenses (including nonrefundable deposits or payments) may be reimbursed after documentation is submitted to the insurance provider."/>&#13;
		<field type="paragraph" subtype="p" label="Airfare policies vary by airline. In many cases, canceled flights are issued as flight credits rather than cash refunds, typically valid for up to 12 months from the original travel date."/>&#13;
		<field type="paragraph" subtype="p" label="For coverage of pre-existing medical conditions or supplier financial default, policies usually must be purchased at the time of booking or shortly after the initial deposit. Terms vary by provider."/>&#13;
		<field type="checkbox-group" required="true" label="I acknowledge that MJG Travel Agency, LLC has recommended or offered travel insurance protection. If I choose not to purchase a policy, I accept full responsibility for declining this coverage." name="i-acknowledge-that-mjg-travel-agency-llc-has-recommended-or-offered-travel-insurance-protection-if-i-choose-not-to-purchase-a-policy-i-accept-full-responsibility-for-declining-this-coverage">&#13;
			<option label="Accept insurance" value="accept-insurance">Accept insurance</option>&#13;
			<option label="Decline insurance" value="decline-insurance">Decline insurance</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="PERSONALIZED TRAVEL QUOTES"/>&#13;
		<field type="paragraph" subtype="p" label="We are committed to crafting a getaway tailored specifically to you."/>&#13;
		<field type="paragraph" subtype="p" label="Individual Travel Quotes: requires $50 nonrefundable fee. Quotes will be delivered within three business days and include up to three customized options. If additional destinations, revisions, or expanded options are requested beyond the initial three, a $25 nonrefundable fee per additional quote will apply."/>&#13;
		<field type="paragraph" subtype="p" label="Group Travel Quotes (8 or more travelers): requires a $100 nonrefundable research fee and include up to three customized options. If additional destinations or expanded revisions are requested beyond the initial three, a $50 nonrefundable fee per additional quote will apply. Group quotes will be delivered within seven business days after receipt of the research fee."/>&#13;
		<field type="paragraph" subtype="p" label="All rates are subject to change until a deposit or full payment is received and applied."/>&#13;
		<field type="header" subtype="h1" label="BOOKING CHANGES AND CANCELLATION POLICY"/>&#13;
		<field type="paragraph" subtype="p" label="All cancellations and change requests must be submitted in writing."/>&#13;
		<field type="paragraph" subtype="p" label="A $100 administrative fee will apply to all confirmed bookings canceled after a deposit or payment has been made. This fee covers time spent on planning, coordination, supplier communication, and processing."/>&#13;
		<field type="paragraph" subtype="p" label="Name changes, travel date changes, destination changes, or any other booking modifications will incur a $50 administrative fee per incident."/>&#13;
		<field type="paragraph" subtype="p" label="Please note that supplier penalties, fare differences, or additional charges may apply in addition to the administrative fee, based on the terms and conditions of the hotel, cruise line, airline, or tour operator."/>&#13;
		<field type="paragraph" subtype="p" label="Travel insurance is strongly recommended to protect your investment."/>&#13;
		<field type="header" subtype="h1" label="SECURE YOUR SPOT TODAY"/>&#13;
		<field type="paragraph" subtype="p" label="Travel pricing can change until a deposit is received and applied to your booking. For most trips, deposits typically range from $50 to $750 per person and are used to secure your reservation and lock in your rates. If your trip is within 45 days of departure, the full balance will be due at the time of booking."/>&#13;
		<field type="header" subtype="h1" label="PROTECT YOUR RESERVATION"/>&#13;
		<field type="paragraph" subtype="p" label="To prevent fraudulent activity, some vendors may request a copy of your photo ID and the front and back of your credit card. If this applies to your booking, please submit the required information within 24 hours to avoid cancellation of your reservation."/>&#13;
		<field type="header" subtype="h1" label="TRAVEL DOCUMENTATION"/>&#13;
		<field type="paragraph" subtype="p" label="We’re committed to making your travel experience smooth and stress-free. Ensuring you have the proper documentation in place is essential."/>&#13;
		<field type="paragraph" subtype="p" label="INTERNATIONAL TRAVEL: Passports are required for international destinations and must be valid for at least six months beyond your return date."/>&#13;
		<field type="paragraph" subtype="p" label="DOMESTIC TRAVEL: Starting May 7, 2025, all travelers aged 18 and older flying within the U.S. must present a REAL ID-compliant driver’s license or identification card, a valid passport, or another TSA-approved form of ID."/>&#13;
		<field type="paragraph" subtype="p" label="CRUISES: While a passport is preferred for cruises departing and returning to U.S. ports, travelers may use a certified birth certificate along with government-issued photo identification."/>&#13;
		<field type="header" subtype="h1" label="CLIENT AGREEMENT"/>&#13;
		<field type="paragraph" subtype="p" label="By submitting this form, you acknowledge that you’re engaging the services of MJG Travel Agency, LLC to design and manage your trip and that you have read and agree to our Terms and Conditions of Booking, available at: www.mjgtravel.com."/>&#13;
	</fields>&#13;
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