Tracey Lillard

The Travel Bug Vacations, LLC

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		<field type="header" subtype="h2" label="Please enter your contact information"/>&#13;
		<field type="text" label="Prefix" description="Mr  Mrs  Ms, Miss" 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" 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" required="true" label="Phone Number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="What is your date of birth?" placeholder="mm/dd/yyyy" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Tell Us About Your Ideal Trip"/>&#13;
		<field type="text" required="true" label="How many adults will be traveling? (18+)" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Children? Please list DOB for each child. If no children will be traveling, enter &quot;0&quot; or &quot;N/A&quot;." name="how-many-children-are-traveling-below-the-age-of-15-years-old" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="If traveling outside of the United States, does everyone have a passport that does not expire within 6 months after your return date?" description="Some countries require your passport to have an expiration date more than 6 months after the return date.  For example  if you were going to Italy &amp; your return date is 4/1/2023  then your passport must not expire before to 10/4/2023." name="passport-expiring">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Special Accommodations: Please list any mobility issues, allergies, pregnant, dietary restrictions, etc. &lt;br&gt;We will take these into consideration when planning your trip and also share this info with the hotel, air, or cruise line ahead of your expected arrival." name="allergies" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Trip Information"/>&#13;
		<field type="select" required="true" label="What's the trip occasion?" description="Select the reason for your trip" name="reason-for-trip" className="form-control">&#13;
			<option label="" value=""/>&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Family Reunion" value="family-reunion">Family Reunion</option>&#13;
			<option label="General Vacation" value="general-vacation">General Vacation</option>&#13;
			<option label="Girl's / Guy's Only Trip" value="girls-guys-only-trip">Girl's / Guy's Only Trip</option>&#13;
			<option label="Honeymoon / Anniversary" value="honeymoon-anniversary">Honeymoon / Anniversary</option>&#13;
			<option label="Romantic Getaway" value="romantic-getaway">Romantic Getaway</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you like to go?" description="If you're not sure  just give us a couple of destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" 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="When would you like to return?" 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="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#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="familyfriendly">Family-Friendly</option>&#13;
			<option label="Adults-Only" value="adultsonly">Adults-Only</option>&#13;
			<option label="Food and Wine" value="food-and-wine">Food and Wine</option>&#13;
			<option label="LGBTQ+ Friendly" value="lgbtq-friendly">LGBTQ+ Friendly</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How Many Rooms Do You Need" name="how-many-rooms-do-you-need" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What best describes your &lt;b&gt;Accommodation&lt;/b&gt; preferences?" name="hotel-preference" other="true">&#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;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Please select the options you want to include in your trip proposal (Select all that apply)" name="please-select-the-options-you-want-to-include-in-your-trip-proposal-select-all-that-apply" other="true">&#13;
			<option label="All-inclusive Resort (There are no real AIs in the USA.)" value="allinclusive-resort-there-are-no-real-ais-in-the-usa">All-inclusive Resort (There are no real AIs in the USA.)</option>&#13;
			<option label="Hotel/Resort (not All-inclusive)" value="hotelresort-not-allinclusive">Hotel/Resort (not All-inclusive)</option>&#13;
			<option label="Vacation Rental (House, Cabin, Condo, Mansion, etc.)" value="vacation-rental-house-cabin-condo-mansion-etc">Vacation Rental (House, Cabin, Condo, Mansion, etc.)</option>&#13;
			<option label="Flights (You must pair flights with another option.)" value="flights-you-must-pair-flights-with-another-option">Flights (You must pair flights with another option.)</option>&#13;
			<option label="Amusement Park Tickets (WDW, Universal, Sea World, etc.)" value="amusement-park-tickets-wdw-universal-sea-world-etc">Amusement Park Tickets (WDW, Universal, Sea World, etc.)</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Activities" value="activities">Activities</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Will anyone need flight arrangements made for them?" description="Note: Flights will require full payment at the time of booking." name="will-anyone-need-flights-arrangements-made-for-them">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No, I'll make my own flight arrangements" value="No-flights">No, I'll make my own flight arrangements</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Flight time preferences?" name="preferred-travel-time" className="form-control">&#13;
			<option label="" value=""/>&#13;
			<option label="Anytime" value="anytime">Anytime</option>&#13;
			<option label="Morning" value="morning">Morning</option>&#13;
			<option label="Afternoon" value="afternoon">Afternoon</option>&#13;
			<option label="Evening" value="evening">Evening</option>&#13;
			<option label="Red-Eye" value="redeye">Red-Eye</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Arts and Theater" value="arts-and-theater">Arts and Theater</option>&#13;
			<option label="Adventure Activities" value="adventure-activities">Adventure Activities</option>&#13;
			<option label="Amusement Parks" value="amusement-parks">Amusement Parks</option>&#13;
			<option label="Beach and Water" value="beach-and-water">Beach and Water</option>&#13;
			<option label="Cultural Immersion Experiences (local people, food, history, etc)" value="cultural-immersion-experiences-local-people-food-history-etc">Cultural Immersion Experiences (local people, food, history, etc)</option>&#13;
			<option label="Health &amp; Wellness" value="health-wellness">Health &amp; Wellness</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Scuba / Water Activities" value="scuba-water-activities">Scuba / Water Activities</option>&#13;
			<option label="Sightseeing (local attractions, city tours)" value="sightseeing-local-attractions-city-tours">Sightseeing (local attractions, city tours)</option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see? What's most important to you when it comes to planning this trip?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Special Events &amp;amp; Instructions"/>&#13;
		<field type="radio-group" required="true" label="Would you like us to plan a special event for you and/or your guest(s) before, during, or after the trip?" description="Please let us know if we need to make special event accommodations for events such as cocktail parties  welcome dinners,  etc." name="custom-event-planning">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Do you have any special instruction or anything you would you like us to know?" description="What else would you like me to know about your budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="text" label="&lt;b&gt;Promo Code&lt;/b&gt;" description="Promo codes will be verified manually when we review your request." name="promo-code" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Referral Code or Name of the person who referred you to us" description="Enter the Referral Code or the full name of the person who referred you." name="referral-code-or-name-of-the-person-who-referred-you-to-us" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Acknowledgements"/>&#13;
		<field type="radio-group" required="true" label="I understand that there is a non-refundable Travel Itinerary Planning &amp;amp; Support Service Fee for every trip that requires The Travel Bug Vacations to set aside time to research &amp;amp; plan a customized trip or special occasion for me. &lt;i&gt;**This will be discussed in detail during our initial appointment. &lt;/i&gt;&lt;br&gt;&lt;br&gt;Please indicate that you understand by selecting Yes below. If you select No, we will not proceed with processing your request nor your initial appointment." name="i-understand-there-is-a-nonrefundable-design-fee-to-everyone-collected-prior-any-work-down-for-your-trip-this-will-be-discussed-in-detail-during-our-appointment-included-in-the-booking-request-if-you-do-not-accept-i-will-not-book-your-travel-but-youre-welcome-to-book-your-own-">&#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="I understand that travel insurance is recommended for all types of travel, not just to protect my investment but to also protect myself from unforeseen circumstances.&lt;br&gt;&lt;i&gt;Please indicate whether or not you would like to include a FREE travel insurance quote with your proposal. If you select NO, you will need to sign an INSURANCE WAIVER at the time of booking.&lt;/i&gt;" name="i-understand-travel-insurance-is-included-in-my-rate-if-i-do-not-want-travel-insurance-i-must-request-an-insurance-waiver">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
	</fields>&#13;
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