Share your information with Alysha Klein

Alysha Klein

Klein & Associates Dream Vacations

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" 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="clientLoyaltyPrograms" label="Loyalty Programs" description="Virgin Voyages Club Account- If you need to do a status Match Select the Loyalty Program with the highest points and provide that information please." 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="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Second Traveler&#39;s Information"/>&#13;
		<field type="text" required="true" label="Second Travelers Full Name" name="text-1784671065210" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Second Travelers Preferred Name&amp;nbsp;" name="text-1784671102288" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Second Travelers Phone Number" name="text-1784671126246" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Second Travelers Email Address" name="text-1784671139612" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Second Travelers Virgin Club Account&amp;nbsp;" description="If you are status matching please provide me the suppliers name   loyalty number and level. I will complete the match" name="text-1784671184757" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Second Travelers Date of Birth" name="date-1784671235349" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Cabin Selection"/>&#13;
		<field type="checkbox-group" required="true" label="Cabin Selection&amp;nbsp;" name="checkbox-group-1784687106286">&#13;
			<option label="Sea Terrace starting at $3082.00" value="sea-terrace-starting-at-308200">Sea Terrace starting at $3082.00</option>&#13;
			<option label="Gorgeous Suite (570 Sq Feet) Starting at $10,080.00" value="gorgeous-suite-570-sq-feet-starting-at-1008000">Gorgeous Suite (570 Sq Feet) Starting at $10,080.00</option>&#13;
			<option label="Post Suite (833 Sq Feet) Starting at $12,530.00 " value="post-suite-833-sq-feet-starting-at-1253000-">Post Suite (833 Sq Feet) Starting at $12,530.00 </option>&#13;
			<option label="Fab Suite (950 Sq Feet) Starting at $13,930.00" value="fab-suite-950-sq-feet-starting-at-1393000">Fab Suite (950 Sq Feet) Starting at $13,930.00</option>&#13;
			<option label="Massive Suite (2,147 Sq Feet) Starting at $17,750.00" value="massive-suite-2147-sq-feet-starting-at-1775000">Massive Suite (2,147 Sq Feet) Starting at $17,750.00</option>&#13;
			<option label="I would like a different room category- Please reach out" value="i-would-like-a-different-room-category-please-reach-out">I would like a different room category- Please reach out</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="Travel Protection for the Sea Terrace is coming in at $230.00 Travel Protection for the Rockstar Suites starts at $718.00 Travel Protection: https://www.archinsurancesolutions.com/coverage/wts/classic/Paragraph"/>&#13;
		<field type="select" required="true" label="Would you like to purchase Travel Protection?&amp;nbsp;" name="select-1784671513066" className="form-control">&#13;
			<option label="Please include travel protection in my booking" value="please-include-travel-protection-in-my-booking">Please include travel protection in my booking</option>&#13;
			<option label="I wish to decline travel protection " value="i-wish-to-decline-travel-protection-">I wish to decline travel protection </option>&#13;
			<option label="Can we have a conversation to discuss more" value="can-we-have-a-conversation-to-discuss-more">Can we have a conversation to discuss more</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like assistance with a pre-cruise hotel?&amp;nbsp;" name="select-1784672128014" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like assistance with a post-cruise hotel?&amp;nbsp;" name="select-1784672140741" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like assistance with airfare?&amp;nbsp;" name="select-1784672149755" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like assistance with airport or cruise port transfers?&amp;nbsp;" name="select-1784672161326" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like to add an Additional Bar Tab? (Seaview Terrace rooms come with a $100 Bar Tab; Rockstar Mega Suites come with an unlimited bar tab!)" name="checkbox-group-1784686931625">&#13;
			<option label="$200 Bar tab get an additional $25 " value="200-bar-tab-get-an-additional-25-">$200 Bar tab get an additional $25 </option>&#13;
			<option label="$300 Bar tab get an additional $50 " value="300-bar-tab-get-an-additional-50-">$300 Bar tab get an additional $50 </option>&#13;
			<option label="$500 Bar tab get an additional $100" value="500-bar-tab-get-an-additional-100">$500 Bar tab get an additional $100</option>&#13;
			<option label="$750 Bar tab get an additional $175" value="750-bar-tab-get-an-additional-175">$750 Bar tab get an additional $175</option>&#13;
			<option label="$1,000 Bar tab get an additional $250 " value="1000-bar-tab-get-an-additional-250-">$1,000 Bar tab get an additional $250 </option>&#13;
			<option label="I do not want to purchase a Bar Tab at this time" value="i-do-not-want-to-purchase-a-bar-tab-at-this-time">I do not want to purchase a Bar Tab at this time</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Do you have any dietary restrictions, food allergies, accessibility needs, or other special considerations we should be aware of?" name="textarea-1784671850550" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Next Steps!&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="Once you submit this form, you’ll receive a confirmation message with a secure credit card link. If you’re ready to reserve your cabin and do not need assistance selecting a cabin type, complete the payment form, and I’ll process your deposit. Forms submitted Monday through Friday will be confirmed within 24–48 hours. Weekend submissions will be confirmed by the end of Monday&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Thank you so much for the opportunity to work together! Please reach out with questions at 954-355-0090 or aklein@dreamvacations.com&amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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