<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Contact Information"/> <field type="text" required="true" label="First name ( As it appears on travel documents)" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name ( As it appears on travel documents)" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name ( As it appears on travel documents)" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of birth" name="birthday" className="form-control"/> <field type="radio-group" required="true" label="Gender" 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="radio-group" required="true" label="Possible Discount Traveler Qualifiers" name="possible-discount-traveler-qualifiers" other="true"> <option label="Military (may require proof)" value="military-may-require-proof">Military (may require proof)</option> <option label="Senior.....55+" value="senior55">Senior.....55+</option> <option label="Interline" value="interline">Interline</option> <option label="N/A" value="na">N/A</option> </field> <field type="clientLoyaltyPrograms" label="Loyalty/Reward Programs&nbsp; (Select from the drop down list)" 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="header" subtype="h1" label="GROUP INFORMATION"/> <field type="text" required="true" label="GROUP NAME" name="text-1714752648964" subtype="text" className="form-control"/> <field type="text" label="GROUP BOOKING NUMBER (if known)" name="text-1714752719675" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Travel Preferences"/> <field type="radio-group" label="Airline Seat Preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Opposite aisle" value="opposite aisle">Opposite aisle</option> </field> <field type="radio-group" label="Hotel or Cabin Bed preference" name="bed-preference"> <option label="1bed" value="1bed">1bed</option> <option label="2 beds " value="2-beds">2 beds </option> </field> <field type="radio-group" required="true" label="Number of people in the room/cabin?" name="number-of-people-in-the-roomcabin" other="true"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> </field> <field type="textarea" required="true" label="Full names (as it appears on travel documents) AND dates of births of additional travelers in your cabin/room" name="textarea-1714753170960" className="form-control"/> <field type="radio-group" label="Cruise Cabin Preference" name="cruise-cabin-preference" other="true"> <option label="Interior" value="interior">Interior</option> <option label="Oceanview" value="oceanview">Oceanview</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Suite" value="suite">Suite</option> </field> <field type="radio-group" label="Cruise Cabin Location Preference (If available)" name="cruise-cabin-location-preference"> <option label="FRONT (FORWARD) " value="front-forward-">FRONT (FORWARD) </option> <option label="MIDDLE (MID)" value="middle-mid">MIDDLE (MID)</option> <option label="BACK (AFT)" value="back-aft">BACK (AFT)</option> <option label="NO PREFERENCE/BEST PRICE" value="no-preferencebest-price">NO PREFERENCE/BEST PRICE</option> </field> <field type="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Want Travel Insurance?" name="want-travel-insurance"> <option label="Yes" value="yes">Yes</option> <option label="NO" value="no">NO</option> <option label="Not Sure" value="not-sure">Not Sure</option> </field> <field type="checkbox-group" required="true" label="What documents will&nbsp; you travel with? (select all that apply)" toggle="true" name="what-documents-will-you-travel-with-check-all-that-apply" other="true"> <option label="Drivers License" value="drivers-license">Drivers License</option> <option label="Passport" value="passport">Passport</option> <option label="Birth Certificate" value="birth-certificate">Birth Certificate</option> </field> </fields> </form-template> </body> </html>
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