Share your information with
Keisha Roberts
Top Tier Travel
<html> <body> <form-template> <fields> <field type="header" subtype="h1" label=" "/> <field type="paragraph" subtype="p" label="Thank you so much for allowing us to plan your vacation. Please be sure to share as much detail about your trip as possible. This will allow us to provide an accurate quote. Keep in mind, prices/quotes are subject to change without a deposit being made for the actual trip.&nbsp;&nbsp;"/> <field type="header" subtype="h2" label="Full legal name(As it is on Passport and Gov't ID)"/> <field type="text" label="Prefix(Mr,Ms,.Mrs?)" name="prefix" 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 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="date" label="Lead passengers date of birth." name="birthday" className="form-control"/> <field type="header" subtype="h2" label="Passport Info"/> <field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/> <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="radio-group" label="Sex" 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="Place of birth" name="place-of-birth" subtype="text" className="form-control"/> <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="header" subtype="h1" label="Vacation Service &nbsp;options."/> <field type="radio-group" label="Vacation options" name="vacation-options"> <option label="Cruises- NO FLIGHTS(Flight is being booked separately)" value="cruises-no-flightsflight-is-being-booked-separately">Cruises- NO FLIGHTS(Flight is being booked separately)</option> <option label=" All inclusive- Caribbean,Mexico,Costa Rica Etc- NO FLIGHTS- (resort & airport transportation)" value="-all-inclusive-caribbeanmexicocosta-rica-etc-no-flights-resort-airport-transportation"> All inclusive- Caribbean,Mexico,Costa Rica Etc- NO FLIGHTS- (resort & airport transportation)</option> <option label=" All inclusive- Caribbean,Mexico,Costa Rica Etc- FLIGHTS Included- (resort, roundtrip airfare & airport transportation)" value="-all-inclusive-caribbeanmexicocosta-rica-etc-flights-included-resort-roundtrip-airfare-airport-transportation"> All inclusive- Caribbean,Mexico,Costa Rica Etc- FLIGHTS Included- (resort, roundtrip airfare & airport transportation)</option> </field> <field type="textarea" label="Indicate Destination, resort or cruise line you have in mind." description="Resort in Jamaica Mexico Bahamas etc. Cruise: Western Caribbean etc" placeholder="Resort in Jamaica Mexico Bahamas etc. Cruise: Western Caribbean etc" name="other-roommates-names-as-on-passport-and-dob" rows="0" className="form-control"/> <field type="text" label="Number of adults passengers&nbsp; ? (18 and up)" name="is-your-billing-address-and-mailing-address-the-same-if-not-please-list-your-mailing-address-for-important-travel-documents-to-be-mailed" subtype="text" className="form-control"/> <field type="text" required="true" label="Number of children?&nbsp; (17 and under)" name="are-you-sticking-with-the-original-dates-that-were-quoted-if-not-what-are-the-new-dates-you-and-i-discussed" subtype="text" className="form-control"/> <field type="paragraph" subtype="p" label="If you need more than 10 rooms please advise before submitting this form"/> <field type="text" required="true" label="How many rooms or cruise cabins will you need?" name="how-many-rooms-or-cruise-cabins-will-you-need" subtype="text" className="form-control"/> <field type="text" required="true" label="How many people in each room?" placeholder="Example: 3 Rooms: 2 people each. Or Room 1 &amp; 2: 2 people. Room 3: 3 people" name="text-1750946549381" subtype="text" className="form-control"/> <field type="checkbox-group" label="If Cruise: Preferred type of Cabin" description="Ex: Inside(No windows) Oceanview(lower deck on ship) Balcony (Step out a view)" name="emergency-contact-person-contact-number"> <option label="Inside Cabin" value="inside-cabin">Inside Cabin</option> <option label="Oceanview" value="oceanview">Oceanview</option> <option label="Suite( Higher cost)" value="suite-higher-cost">Suite( Higher cost)</option> <option label="N/A- doing a Resort" value="na-doing-a-resort">N/A- doing a Resort</option> </field> <field type="checkbox-group" label="If resort: Preferred room type if avilable" description="Ex: Garden view Ocean View Walk out Swim up" name="is-this-an-international-or-domestic-trip"> <option label="Garden view" value="garden-view">Garden view</option> <option label=" Ocean View" value="-ocean-view"> Ocean View</option> <option label="Walk out (Pending resort)" value="walk-out-pending-resort">Walk out (Pending resort)</option> <option label="Swim up (Pending resort)" value="swim-up-pending-resort">Swim up (Pending resort)</option> <option label="Suite (Pending resort & high cost)" value="suite-pending-resort-high-cost">Suite (Pending resort & high cost)</option> <option label="N/A- doing a Cruise" value="na-doing-a-cruise">N/A- doing a Cruise</option> </field> <field type="radio-group" label="Indicate your Resort or Cruise Preference&nbsp;" name="indicate-your-resort-or-cruise-preference-"> <option label="I have no preference " value="i-have-no-preference-">I have no preference </option> <option label="Family Friendly Resort or Cruise" value="family-friendly-resort-or-cruise">Family Friendly Resort or Cruise</option> <option label="ADULT ONLY Resort or Cruise" value="adult-only-resort-or-cruise">ADULT ONLY Resort or Cruise</option> </field> <field type="radio-group" label="Resort Preference" name="resort-preference" other="true"> <option label="Party Resort" value="party-resort">Party Resort</option> <option label="Brand New Resort" value="brand-new-resort">Brand New Resort</option> <option label="Luxury Resort" value="luxury-resort">Luxury Resort</option> <option label="Relaxation" value="relaxation">Relaxation</option> <option label="Adults Only" value="adults-only">Adults Only</option> <option label="Family Resort" value="family-resort">Family Resort</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="paragraph" subtype="p" label="****PLEASE UNDERSTAND BEDDING IS NOT GUARANTEED UNLESS YOU CHOOSE A SPECIFIC PROPERTY THAT ALLOWS YOU TO PRESELECT THE BEDDING OPTION.&nbsp; THE BEDDING IS DETERMINED BY THE HOTEL/RESORT AT CHECK IN.&nbsp; A REQUEST WILL BE PUT IN AT THE TIME OF BOOKING IF BEDDING IS NOT SPECIFIED****"/> <field type="radio-group" label="Bed Type Preference" inline="true" name="bed-type-preference"> <option label="King size bed (one bed)" value="king-size-bed-one-bed">King size bed (one bed)</option> <option label="2 beds in the room/cabin" value="2-beds-in-the-roomcabin">2 beds in the room/cabin</option> </field> <field type="paragraph" subtype="p" label="Pending the resort the bed type will vary.&nbsp; Some resorts bedding is not guaranteed.&nbsp;"/> <field type="header" subtype="h1" label="Travel Dates"/> <field type="date" label="Date of Departure" description="EX: 3/13/2014" name="date-of-departure" className="form-control"/> <field type="date" label="Date of Return" description="EX: 3/13/2014" name="date-of-return" className="form-control"/> <field type="checkbox-group" label="If a cruise: How long of cruise do you desire?" inline="true" name="if-a-cruise-how-long-of-cruise-do-you-desire"> <option label="2-5 Days" value="25-days">2-5 Days</option> <option label="6-9 Day" value="69-day">6-9 Day</option> <option label="10+ Days" value="10-days">10+ Days</option> </field> <field type="text" label="What airport you would you like to depart from? (ONLY for All inclusive with 1-3 rooms)" name="departure-airport-na-if-not-needed" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is the budget per person? (Please be realistic about your budget)" inline="true" name="what-is-the-budget-per-person-keep-in-mind-what-you-want-included-in-your-trip"> <option label="$950-$1200 Per Person" value="9501200-per-person">$950-$1200 Per Person</option> <option label="$1201-$1400 Per Person" value="12011400-per-person">$1201-$1400 Per Person</option> <option label="$1401-$1600 Per Person" value="14011600-per-person">$1401-$1600 Per Person</option> <option label="$1601-$1800 Per Person" value="16011800-per-person">$1601-$1800 Per Person</option> <option label="$1801-$2000 Per Person" value="18012000-per-person">$1801-$2000 Per Person</option> <option label="$2001-$2500 Per Person" value="20012500-per-person">$2001-$2500 Per Person</option> <option label="$2501+ Per Person" value="2501-per-person">$2501+ Per Person</option> <option label="$5000+ Per Person" value="5000-per-person">$5000+ Per Person</option> <option label="I don't know" value="i-dont-know">I don't know</option> </field> <field type="radio-group" required="true" label="When will you be ready to make a deposit?" name="when-will-you-be-ready-to-make-a-deposit"> <option label="7 days or less" value="7-days-or-less">7 days or less</option> <option label="7-14 days" value="714-days">7-14 days</option> <option label="2 weeks or more" value="2-weeks-or-more">2 weeks or more</option> <option label="I'm ready now" value="im-ready-now">I'm ready now</option> </field> <field type="radio-group" label="Would you like to apply for Uplift/ Flex pay travel financing with POSSIBLY $0 down. (uplift will pay for your whole trip now, and you make additional payments with uplift over time). Please keep in mind you can also use 3rd party payers (Klarna, Affirm, AfterPay, Zip, Etc.) Please let me know if you need assistance" inline="true" name="would-you-like-to-apply-for-uplift-flex-pay-travel-financing-with-0-down-uplift-will-pay-for-your-whole-trip-now-and-you-make-additional-payments-with-uplift-over-timeinstead-of-movacay"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Is this trip a special occasion? (bday ,anniversary etc.)" name="is-this-trip-a-special-occasion-bday-anniversary-etc" subtype="text" className="form-control"/> <field type="clientLoyaltyPrograms" label="Loyalty Programs: If you have it available, for the type of trip you desire" 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"/> <field type="checkbox-group" label="I understand my inquiry will be processed in 3-5 business days?" description="Business days are Mon-Fri not including the weekend. This is the standard booking time frame if&nbsp; you didn't request expedited service." name="i-understand-my-inquiry-will-be-processed-in-35-business-days"> <option label="Yes, I do" value="yes-i-do">Yes, I do</option> </field> <field type="text" required="true" label="How did you hear about Top Tier Travel?&nbsp;" description="What platform or person" placeholder="Facebook Tik Tok Friends name. etc" name="how-did-you-hear-about-movacay-" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Additional information you would like me to know." placeholder="Medical Issues/Allergies/Dietary Restrictions" name="additional-information-you-would-like-me-to-know" className="form-control"/> <field type="select" required="true" label="Do you have more than 3 medications that you will be taking with you?" placeholder="Do you have more than 3 medications that you will be taking with you?" name="do-you-have-more-than-3-medications-that-you-will-be-taking-with-you" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="*Once&nbsp; quote is established and sent, the lead passenger has 7 business days to move forward with deposit or advise of other decisions. No communication will result in the quote being closed."/> <field type="header" subtype="h1" label="TRAVEL PROTECTION:"/> <field type="radio-group" required="true" label="&nbsp;By signing below, I understand that declining travel insurance could result in the loss of my travel cost and/or require more money to correct the situation. I also acknowledge that without insurance, there may be no way to recoup any losses, costs or expenses incurred.I also understand there may be a cost associated.&nbsp;" name="-by-signing-below-i-understand-that-declining-travel-insurance-could-result-in-the-loss-of-my-travel-cost-andor-require-more-money-to-correct-the-situation-i-also-acknowledge-that-without-insurance-there-may-be-no-way-to-recoup-any-losses-costs-or-expenses-incurredi-also-understand-there-may-be-a-cost-associated-"> <option label="I ACCEPT travel protection, add it to my quote." value="i-accept-travel-protection-add-it-to-my-quote">I ACCEPT travel protection, add it to my quote.</option> <option label="I DECLINE travel protection. I understand this could result in loss of ALL travel costs. " value="i-decline-travel-protection-i-understand-this-could-result-in-loss-of-all-travel-costs-">I DECLINE travel protection. I understand this could result in loss of ALL travel costs. </option> <option label="I DECLINE travel protection at the time of booking but I will add it no later than 60 days from the time I make a deposit." value="i-decline-travel-protection-at-the-time-of-booking-but-i-will-add-it-no-later-than-60-days-from-the-time-i-make-a-deposit">I DECLINE travel protection at the time of booking but I will add it no later than 60 days from the time I make a deposit.</option> </field> <field type="paragraph" subtype="p" label="CANCELLATION POLICY: Please understand that TOP TIER TRAVEL has a cancellation policy outside of the supplier. If you have to cancel your trip after booking there is a cancellation charge depending on when you cancel. The details will depend on the timeframe but will be put in writing and sent to you when you book your vacation/trip.&nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="Travel Planning Fee Acknowledgement:&nbsp; A non-refundable planning fee may apply depending on the complexity of your trip.&nbsp; This covers research, customized planning, and exclusive deal sourcing.&nbsp; You will be advised of this fee prior to proceeding with the planning of your vacation."/> <field type="textarea" label="Text Area" name="textarea-1752548334085" value="I consent to having your business collect details via this form.I acknowledge that I have read this registration form completely and the information I provided is accurate. I understand that my deposit is non-refunable and other cancellation penalties will apply depending on the cancel date. Prices are subject to change and will change until deposit is paid. I understand that if my roomate (s) cancel my rate will change. I understand that all monies must be paid by the final payment date. If my balance is left unpaid my room/cabin will be canceled immediately and this will forfeit any monies paid for my trip.I confirm that once my travel arrangements are confirmed I agree for Top Tier Travel (Keisha Roberts) to process charges with my debit/credit card for charges deposits or payments pertaining to my travel arrangements which will be presented with an invoice or receipt.Insurance Waiver I understand that if I decline travel insurance I am responsible for any penalties and out of pocket expenses incurred. I will also make my own provisions in the event of an emergency while I am traveling." className="form-control"/> <field type="select" label="Select" placeholder="Please choose "Yes" if you agree and understand the statements above. Please choose no if you want to cancel and not proceed." name="select-1752548352341" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Do you agree with the statements above?" name="radio-group-1768840158718"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="paragraph" subtype="p" label="Paragraph"/> </fields> </form-template> </body> </html>
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