<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="checkbox-group" label="(If an international trip)&nbsp; Does everyone in your party have a valid passport? (active until 6 months AFTER trip return date)" name="if-an-international-trip-does-everyone-in-your-party-have-a-valid-passport-active-until-6-months-after-trip-return-date"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h2" label="Full name"/> <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="Preferred Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Preferred Phone number" description="###-###-####" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Important Dates"/> <field type="date" label="Birthday" name="birthday" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" 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" required="true" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h2" label="Trip Information"/> <field type="text" required="true" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Land or Cruise?" inline="true" name="land-or-cruise"> <option label="Land" value="land">Land</option> <option label="River Cruise" value="river-cruise">River Cruise</option> <option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option> <option label="Cruisetour (Land and Cruise)" value="cruisetour-land-and-cruise">Cruisetour (Land and Cruise)</option> <option label="Chartered Yacht" value="chartered-yacht">Chartered Yacht</option> <option label="Large Sailboat Cruise" value="large-sailboat-cruise">Large Sailboat Cruise</option> </field> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" inline="true" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="What is your preferred departure airport/city?" description="Where will you be flying from?" placeholder="PHL EWR JFK etc" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="How many travelers, including yourself?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Names and Date of Births for all travelers in your party" placeholder="Full name on Photo ID and DOB (mm/dd/yyyy)" name="names-and-date-of-births-for-all-travelers-in-your-party-including-yourself" rows="8" className="form-control"/> <field type="radio-group" required="true" label="What is your total budget for all travelers?" description="This just gives me a general starting point and can always be changed later. Due to airline prices in most cases it will be difficult to have a budget lower than $3500.." inline="true" name="budget" other="true"> <option label="$5,000 to $7,500" value="5000-to-7500">$5,000 to $7,500</option> <option label="$7,500 to $10,000" value="7500-to-10000">$7,500 to $10,000</option> <option label="$10,000 to $15,000" value="10000-to-15000">$10,000 to $15,000</option> <option label="$15,000 to $20,000" value="15000-to-20000">$15,000 to $20,000</option> <option label="$20,000 +" value="20000-">$20,000 +</option> </field> <field type="checkbox-group" required="true" label="Is anyone in your party needing accessible hotel/cabin rooms?" inline="true" name="is-anyone-in-your-party-needing-accessible-hotelcabin-rooms"> <option label="No" value="no">No</option> <option label="Yes" value="yes">Yes</option> </field> <field type="radio-group" label="What best describes your hotel preference?" inline="true" name="hotel-preference"> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="radio-group" required="true" label="Is this a destination wedding, honeymoon or babymoon?" inline="true" name="is-this-a-honeymoon-or-babymoon"> <option label="None of the above" value="none-of-the-above">None of the above</option> <option label="Yes - DW (and possibly a honeymoon)" value="yes-dw-and-possibly-a-honeymoon">Yes - DW (and possibly a honeymoon)</option> <option label="Yes - honeymoon" value="yes-honeymoon">Yes - honeymoon</option> <option label="Yes - babymoon" value="yes-babymoon">Yes - babymoon</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." inline="true" 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="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" inline="true" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> <option label="Hiking" value="hiking">Hiking</option> <option label="Biking" value="biking">Biking</option> <option label="Fishing" value="fishing">Fishing</option> <option label="Deep Sea Fishing" value="deep-sea-fishing">Deep Sea Fishing</option> <option label="Kayaking" value="kayaking">Kayaking</option> </field> <field type="textarea" label="Anything you absolutely must do or see?" description="example: cities to see specific tours etc." name="anything-you-absolutely-must-do-or-see" rows="7" className="form-control"/> <field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="text" required="true" label="How did you hear about Bliss Trips etc?" description="ie Facebook Instagram TikTok Google a referral (include full name) etc." name="how-did-you-hear-about-bliss-trips-etc" subtype="text" className="form-control"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h2" label="Thank You!"/> <field type="paragraph" subtype="p" label="Thank you for taking the time to complete this questionnaire. After I review your answers, I will email you my calendar so you can schedule a time to chat with me over the phone. It is helpful that if you have other travelers in your party, that you have discussed your travel ideas together and you can relay those ideas to me during the free consultation phone call.&nbsp; The call should take no more than 30 minutes (60 min, if a group).&nbsp;"/> <field type="paragraph" subtype="p" label="At the end of that call, I will determine if I am the right fit for your travel needs and if yes, will discuss my fee structure. I have a 3-tiered fee menu; my non-refundable fee covers my research and design of your specific trip. My fees are not set in stone which is why we have the call to discuss the scope of work I will be doing for you. I will determine what my fee will be within 24 hours. You can then take the next few days to decide if you wish to hire me. During that time, you will receive my detailed Professional Services Fee Agreement and invoice."/> <field type="paragraph" subtype="p" label="I prioritize my work load based on three things, in this order:&nbsp; 1) first come, first serve&nbsp; 2) date of departure&nbsp; 3) Professional Services Fee paid.&nbsp; Because I must prioritize my work to our committed clients first, I am not able to start working on your trip's research and design until payment is received.&nbsp;"/> <field type="paragraph" subtype="p" label="If you choose not to use my services at this time, no hard feelings as I do not take it personally. I am here when you feel you need the assistance, whether that is now or in the future . I love helping people! I am a people pleaser! Travel design is my passion.&nbsp; This is my own local business which I take very seriously and I hope I can WOW you with my design, too!&nbsp;"/> <field type="paragraph" subtype="p" label="Please feel free to look at my website and read my reviews &gt; https://www.blisstripsetc.com.&nbsp; You can also Like/Follow my social media pages on Facebook, Instagram and TikTok, all under the name "Bliss Trips etc"."/> <field type="paragraph" subtype="p" label="Thank you for contacting Bliss Trips etc, LLC, a travel agency specializing in Destination Weddings, Honeymoons and Romance travel......Embrace the Bliss! --Janet Miller, CEO and Principal Travel Concierge"/> </fields> </form-template> </body> </html>
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