<html> <body> <form-template> <fields> <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 type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="date" label="Ideal 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"/> <field type="date" label="Ideal 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"/> <field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> </field> <field type="checkbox-group" label="Who are you traveling with?&nbsp;" name="who-are-you-traveling-with-"> <option label="Myself" value="myself">Myself</option> <option label="My Family" value="my-family">My Family</option> <option label="My Partner" value="my-partner">My Partner</option> <option label="My Friends" value="my-friends">My Friends</option> <option label="Company" value="company">Company</option> <option label="Mixture" value="mixture">Mixture</option> </field> <field type="textarea" label="Please list all traveler full names and birthdates" name="please-list-all-traveler-full-names-and-birthdates" className="form-control"/> <field type="checkbox-group" label="Which of the following services do you typically need assistance with?" name="which-of-the-following-services-do-you-typically-need-assistance-with"> <option label="Flights" value="flights">Flights</option> <option label="Accommodation" value="accommodation">Accommodation</option> <option label="Private Guides " value="private-guides-">Private Guides </option> <option label="Special Experiences" value="special-experiences">Special Experiences</option> <option label="Itinerary and Logistics Consulting" value="itinerary-and-logistics-consulting">Itinerary and Logistics Consulting</option> <option label="Destination Consulting" value="destination-consulting">Destination Consulting</option> <option label="Yacht Charters" value="yacht-charters">Yacht Charters</option> <option label="Private Jet Charters" value="private-jet-charters">Private Jet Charters</option> <option label="Travel Insurance " value="travel-insurance-">Travel Insurance </option> </field> <field type="checkbox-group" label="What is your trip budget without airfare?" name="what-is-your-trip-budget-without-airfare"> <option label="$10,000 - $20,000" value="10000-20000">$10,000 - $20,000</option> <option label="$20,000 - $30,000" value="20000-30000">$20,000 - $30,000</option> <option label="$30,000 - $40,000" value="30000-40000">$30,000 - $40,000</option> <option label="$40,000 - $50,000" value="40000-50000">$40,000 - $50,000</option> <option label="$50,000 - $60,000" value="50000-60000">$50,000 - $60,000</option> <option label="$60,000 - $70,000" value="60000-70000">$60,000 - $70,000</option> <option label="> $70,000" value="-70000">> $70,000</option> </field> <field type="text" label="What is your reason for travel? Are you celebrating anything?" placeholder="Honeymoon anniversary summer vacation spring break etc" name="what-is-the-reason-for-your-trip" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="Do you have any destinations in mind? Or are you open to suggestions?&nbsp;" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: France Cape Town London" name="destination" subtype="text" className="form-control"/> <field type="text" label="Are there any destinations that you would consider undesirable?&nbsp;" name="are-there-any-destinations-that-you-would-consider-undesirable-" subtype="text" className="form-control"/> <field type="text" label="What is your favorite hotel you've stayed in / most fond travel memory you have? Why?&nbsp;" name="what-is-your-favorite-hotel-youve-stayed-in-most-fond-travel-memory-you-have-why-" subtype="text" className="form-control"/> <field type="textarea" label="Describe your vision for this trip:" placeholder="In a general sense how do you see the trip going? Are there any bucket list items you're excited about checking off? Have you visited the destination before / done any research? What are you most excited about experiencing? Do you have any questions or concerns related to this trip / destination?" name="describe-your-vision-for-this-trip" rows="2" className="form-control"/> <field type="checkbox-group" label="What kind of vibe are you looking for on this trip?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Food and wine" value="food-and-wine">Food and wine</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Adventure " value="adventure-">Adventure </option> </field> <field type="checkbox-group" label="General Preferred Pace of Travel" name="general-preferred-pace-of-travel"> <option label="Quick: 1 - 2 nights in each destination" value="quick-1-2-nights-in-each-destination">Quick: 1 - 2 nights in each destination</option> <option label="Moderate: 3 - 4 nights in each destination " value="moderate-3-4-nights-in-each-destination-">Moderate: 3 - 4 nights in each destination </option> <option label="Slow: 5 - 7 night in each destination" value="slow-5-7-night-in-each-destination">Slow: 5 - 7 night in each destination</option> <option label="No preference / as recommended by Emerald Luxury Travel " value="no-preference-as-recommended-by-emerald-luxury-travel-">No preference / as recommended by Emerald Luxury Travel </option> </field> <field type="checkbox-group" label="How structured do you like to be on a day by day basis while travelling?" name="how-structured-do-you-like-to-be-on-a-day-by-day-basis-while-travelling" other="true"> <option label="Structured: You prefer to have the day planned out from start to finish" value="structured-you-prefer-to-have-the-day-planned-out-from-start-to-finish">Structured: You prefer to have the day planned out from start to finish</option> <option label="Moderately Structured: 50/50 split between leisure time and planned activities" value="moderately-structured-5050-split-between-leisure-time-and-planned-activities">Moderately Structured: 50/50 split between leisure time and planned activities</option> <option label="Relaxed: You prefer to keep most days free to explore at your own pace" value="relaxed-you-prefer-to-keep-most-days-free-to-explore-at-your-own-pace">Relaxed: You prefer to keep most days free to explore at your own pace</option> </field> <field type="checkbox-group" label="What best describes your hotel preference?" name="what-best-describes-your-hotel-preference"> <option label="Luxurious" value="luxurious">Luxurious</option> <option label="Boutique and intimate" value="boutique-and-intimate">Boutique and intimate</option> <option label="Grand Hotel / Resort" value="grand-hotel-resort">Grand Hotel / Resort</option> <option label="Economical / Functional" value="economical-functional">Economical / Functional</option> <option label="Villa / Private Residence" value="villa-private-residence">Villa / Private Residence</option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" label="Favorite In-Room Amenity" name="favorite-room-amenity-select-all-that-apply" other="true"> <option label="Terrace/Balcony" value="terracebalcony">Terrace/Balcony</option> <option label="Separate Bathtub/Shower" value="separate-bathtubshower">Separate Bathtub/Shower</option> <option label="Coffee/Tea Station" value="coffeetea-station">Coffee/Tea Station</option> <option label="Room Service" value="room-service">Room Service</option> <option label="Suite / Separate Seating Area" value="suite-separate-seating-area">Suite / Separate Seating Area</option> </field> <field type="textarea" label="Anything else to note?" placeholder="What research have you done? What else would you like me to know about your travelers budget and/or travel preferences? How can we make this a "wow" trip?" name="notes" rows="2" className="form-control"/> <field type="text" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/> <field type="checkbox-group" label="Would you like to be added to our email list for travel updates, promotions, and inspiration?" name="would-you-like-to-be-added-to-my-newsletter"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" label="Please note that a planning fee may apply to the creation of your personalized itinerary. During our complimentary intake call, we’ll discuss your travel goals and outline any applicable fees based on the specific details and complexities of your trip request." name="please-note-that-a-planning-fee-may-apply-to-the-creation-of-your-personalized-itinerary-during-our-complimentary-intake-call-well-discuss-your-travel-goals-and-outline-any-applicable-fees-based-on-the-specific-details-and-complexities-of-your-trip-request"> <option label="Yes, I understand and agree" value="yes-i-understand-and-agree">Yes, I understand and agree</option> </field> </fields> </form-template> </body> </html>
Submit form
American Airlines (AAdvantage)
United Airlines (Mileage Plus)
Delta Air Lines (SkyMiles)
Hilton (Honors)
Marriott Bonvoy
Southwest Airlines (Rapid Rewards)
IHG Rewards Club
Hyatt (World of Hyatt)
JetBlue Airways (trueBlue)
British Airways (Executive Club)
Alaska Airlines (Mileage Plan)
Hertz Gold Plus Rewards
Virgin America (eleVAte)
Club Carlson Hotels
Avis (Preferred)
Amtrak (Guest Rewards)
National (Emerald Club)
Wyndham Rewards (Days Inn, etc.)
Hawaiian Airlines (HawaiianMiles)
Choice Hotels (Choice Privileges)
Frontier Airlines (EarlyReturns)
Best Western Rewards
Lufthansa (Miles and More)
Virgin Atlantic (Flying Club)
Air Canada Aeroplan
Enterprise Rent-A-Car
Korean Air (SkyPass)
Air France (Flying Blue)
Singapore Airlines (KrisFlyer)
Emirates (Skywards)
Spirit Airlines (Free Spirit)
Le Club Accorhotels (Accor Hotels, Novotel, etc.)
Hotels.com Rewards
All Nippon Airways (ANA Mileage Club)
Cathay Pacific (Asia Miles)
Fairmont President's Club
Qantas (Frequent Flyer)
Budget (Fastbreak)
La Quinta, etc. (Returns)
Iberia Plus
Kimpton (Karma Rewards)
Asiana Airlines (Asiana Club)
Omni Hotels (Select Guest)
AviancaTaca (LifeMiles)
Alamo
Etihad Airways (Etihad Guest)
Aegean Airlines (Miles & Bonus)
KLM (Flying Blue)
MGM Resorts (M life Players Club)
Japan Airlines (JMB)
AirBerlin (Topbonus)
LATAM (LATAM Pass)
Thrifty (Blue Chip Rewards)
Royal Caribbean (Crown & Anchor Society)
Alitalia (MilleMiglia)
Qatar Airways (Qmiles)
Jet Airways (JetPrivilege)
Turkish Airlines (Miles&Smiles)
Icelandair (Saga Club)
Dollar Rent A Car (Express)
Carnival (VIFP)
Eva Air (Infinity MileageLands)
Sun Country Airlines (Ufly Rewards)
Shangri-La (Golden Circle)
Air India (Flying Returns)
Sixt Rent-a-Car
BMI (Diamond Club)
Booking.com
Loews Hotels (YouFirst Rewards)
Norwegian Air Shuttle ASA (Norwegian Reward)
Stash Hotel Rewards
Scandinavian Airlines System (EuroBonus)
Norwegian Cruise Line (Latitudes)
Aeromexico (Club Premier)
Copa Airlines ConnectMiles (Prefer)
Celebrity Cruises (Captain's Club)
Drury Hotels (Gold Key Club)
Aer Lingus (Gold Circle)
Virgin Australia (Velocity Frequent Flyer)
EL AL Israel Airlines (Matmid)
Princess Cruise Lines (Captain Circle)
China Airlines (Dynasty Flyer)
Delta (SkyBonus Corporate)
Melia (Melia Rewards)
GHA (Discovery)
Air China (PhoenixMiles)
Air Asia (BIG)
Gol Airlines (Smiles)
Malaysia Airlines (Enrich)
Air New Zealand (Airpoints)
WestJet (Frequent Guest)
Porter (VIPorter)
Agoda Rewards
Thai Airways (Royal Orchid Plus)
VOILÀ Hotel Rewards
Preferred Hotels, etc. (iPrefer)
Red Roof Inn (RediCard)
Aeroflot Bonus
China Eastern (Eastern Miles)
Holland America Line (Mariner Society)
Philippine Airlines (Mabuhay Miles)
Bangkok Airways (FlyerBonus)
Hilton Grand Vacations (Club)
South African Airways (Voyager)
China Southern (Sky Pearl)
Finnair Plus
Small Luxury Hotels (The Club)
TAP Portugal (Victoria Miles)
Avianca (Amigo)
Langham Hotels (1865 Club)
Fox Rent A Car (Rewards)
Hainan Airlines (Fortune Wings)
AmericInn (Easy Rewards)
Disney Cruise Line (Castaway Club)
Payless Car Rental (Perks Club)
Azul (TudoAzul)
Starwood Hotels (Preferred Business)
My Europcar (Privilege)
Hyatt (Vacation Club)
Aerolineas Argentinas (Plus)
Taj (InnerCircle)
British Airways (On Business, Corporate)
Leading Hotels of the World (Leaders Club)
Eurostar Frequent Traveler
Red Lion (Hello Rewards)
Air Tahiti Nui (Club Tiare)
United PerksPlus (Corporate Program)
NH Hotels (NH World)
Swissotel Circle
Millennium & Copthorne (My Millennium)
Ethiopian Airlines (ShebaMiles)
Royal Air Maroc (Safar Flyer)
Alaska Airlines (EasyBiz Corporate)
Vueling Airlines (Punto Punto)
Gulf Air (Falconflyer)
Star Alliance Company (PlusAwards)
Coast Hotels (Coast Rewards)
Royal Jordanian Airlines (Royal Plus)
HotelClub (Member Rewards)
Czech Airlines (OK Plus)
VIA Rail Canada (VIA Preference)
Trump Card (Privileges Program)
Borgata (Rewards)
Saudi Arabian Airlines (Alfursan)
Vietnam Airlines (Golden Lotus Plus)
Egypt Air Plus
Scandic Hotels (Scandic Friends)
JetBlue Airways (CompanyBlue)
Hostelworld (My World)
Jumeirah (Sirius)
E-Z Rent-A-Car (E-Z Money)
Deutsche Bahn (BahnCard)
Garuda (Frequent Flyer)
TripAdvisor
Kuwait Airways (Oasis Club)
Cosmopolitan Hotels (Identity)
Advantage Rent a Car (Instant Rewards)
Cayman Airways (Sir Turtle Rewards)
Caribbean Airlines (Caribbean Miles)
RIU Hotels & Resorts (RIU Class)
Easyjet
SriLankan (FlySmiLes)
TabletHotels (Reward Dollars)
Ace Rent a Car
Thalys (The Card)
S7 Priority
Air Baltic (Pins)
Choice Hotels (Nordic Choice Club)
Trident Hotels (Trident Privilege)
Middle East Airlines (Cedar Miles)
Emirates for Kids (Skysurfer)
Rydges (PriorityGUEST)
Oman Air (Sindbad)
Island Air (Cloud 9)
Ukraine International Airlines (Panorama Club)
Flybe (Rewards4all)
SNCF (Voyageur)
Marriott Gift Cards
Qantas (Aquire)
Pegasus Airlines (Pegasus Plus)
Air Transat
Silver Cloud (Rewards)
Brussels Airlines (LOOPs)
JAL Hotels (One Harmony)
Eurowings (Boomerang)
Azamara (Le Club Voyage)
Otel.com (FivePlus)
Meridiana Fly (Hi-Fly)
Prince Resorts Hawaii (Prince Preferred)
PIA (Awards Plus)
Air Astana (Nomad Club)
Regal Hotels (Regal Rewards)
IndiGo
Era Alaska (FlyAway Rewards)
Red Spotted Hanky (Loyalty points)
Thon Hotels (Thon Member)
Air Jamaica (Seventh Heaven)
Trenitalia (FrecciaClub)
Air Malta (Flypass)
Splendia (Club Rewards)
Dorint (Card)
UTair (Status)
Tsogo Sun (Frequent Guest)
Sino Hotel Group (IPrestige)
KLM BlueBiz (Corporate)
RZD (Bonus)
Elite Hotels of Sweden
New Otani (Club International)
Air Algérie (Air Algérie Plus)
Ryanair
The Montcalm & Shaftsbury (Premier Club)
Dan Hotels (e-dan club)
Pestana Priority Guest
Macdonald Hotels (The Club)
Air Mauritius (Kestrelflyer)
Frasers Hospitality (Fraser World)
AirBerlin (business points)
Park-N-Go (Frequent Parker Rewards)
Localiza Rent a Car
Jurys Inn (Jurys Rewards)
Air Caraibes (Preference)
Bulgaria Air (Fly More)
Air Niugini (Destinations)
TUIfly.com
Cebu Pacific (Getgo)
Premier Hotels (Premier Club)
Jet2.com (My Jet2)
Air Austral (My Capricorne)
CAT (C-Club)
Opinion Miles Club
Ural Airlines (Wings)
Air Europa (SUMA)
Monarch (Vantage Club)
Stena Line (Extra)
La Compagnie (My Compagnie)
First Hotels (First Member)
Belavia (Leader)
Azerbaijan Airlines (Azal Miles)
Wizz Air (Discount Club)
Tunisair (Fidelys)
Paradores (Amigos de Paradores)
Vistara (Vistara Club)
Montenegro Airlines (Vision Team)
Asky Airlines (ASKY Club)
Jinling Hotels (Elite)
Moby Lines (Moby Club)
Jin Jiang Group (J-Club)
AtlasGlobal (AtlasMiles)
Qubus Hotel (Q-Club)
Braathens Regional Airlines (BRA Friends )
Hotelbooker.org
Flynas (NaSmiles)
Czech Airlines (OK Plus Corporate)
Uzbekistan Airways (UzAirPlus)
TAAG Angola Airlines (Umbi Umbi Club)
Yelloh! Village (Yelloh! Plus)
Future Inns (Rewards Club)
Nordavia (Golden Mile)
Air Arabia (Airewards)
Royal Brunei Airlines (Royal Skies)
Leonardo Hotels (AdvantageCLUB)
Air Moldova Club
Air Cote D'Ivoire (sMiles)
Air Macau (Privileges)
Etihad (BusinessConnect)
Gloria Hotels & Resorts (Gloria Partner)
Santos Hotels (Club Santos)
Known Traveler Number (KTN)
Global Entry ID
TSA PreCheck
NEXUS ID
SENTRI ID
American Automative Association (AAA)
Sandals Select Guest (SSG)
Mandarin Oriental Fan
Relais and Chateaux 5C
Four Seasons Preferred
Dorchester Diamond
Peninsula Pen
Belmond Bellini
Silversea Venetian
Oceania Cruise Lines
Regent Cruise Line
Seabourn Cruise Line
Lindblad Expeditions
SeaDream Yacht Club
Cunard
Virgin Voyages Sailing Club
AmaWaterways
Type
Draw
×
By signing, I understand that this is a legally binding contract.