Share your information with Memora Travel Co.

Memora Travel Co.

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		<field type="header" subtype="h3" label="CONTACT INFORMATION"/>&#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" label="Preferred name" name="preferred-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="textarea" required="true" label="Please provide legal names and birthdates with years for all travelers." name="please-provide-the-full-legal-name-as-is-on-your-passport-and-birthdates-for-all-travelers" className="form-control"/>&#13;
		<field type="text" label="Are there any allergies, mobility needs, or personal considerations we should be mindful of to ensure a comfortable travel experience for everyone?" name="are-there-any-allergies-mobility-needs-or-personal-considerations-we-should-be-mindful-of-to-ensure-a-comfortable-travel-experience-for-everyone" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Do you know where you would like to go, or are you looking for a curated proposal with ideas?" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="text" label="If you listed a general destination, is anywhere &quot;off limits&quot; for you?" name="text-1730131133521" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Date" name="when-would-you-like-to-depart" className="form-control"/>&#13;
		<field type="date" required="true" label="Return Date" name="when-would-you-like-to-return" className="form-control"/>&#13;
		<field type="text" label="Are your dates flexible? If so, please describe.&amp;nbsp;" name="are-your-dates-flexible-if-so-please-describe-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Where will you be flying from?" placeholder="Airport Code" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="YOUR TRAVEL STYLE"/>&#13;
		<field type="text" label="What inspired this trip? Are you celebrating anything special?" name="is-this-vacation-to-celebrate-anything-special-" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="What hotels do you typically gravitate towards? Any favorite hotels from past stays? Any amenity must haves?" description="Specific hotel or hotel group  boutique vs. large  etc. Examples of amenity must haves - gym  pool  spa  kids club  24 hr room service  etc." name="what-hotels-do-you-typically-gravitate-towards-any-favorite-hotels-from-past-stays" className="form-control"/>&#13;
		<field type="textarea" label="What are your room/bedding needs?" description="i.e. connecting rooms   door separation within a suite   a crib   separate beds" name="textarea-1738616888934" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What level of investment are you comfortable making for this trip? (Excluding international air and incidentals/meals while in destination)" description="Please note that budget ranges can vary significantly by destination  and we&#39;re happy to walk you through current pricing for your specific location during our call." name="what-is-your-travel-investment-for-all-travelers-not-including-airfare-or-food" other="true">&#13;
			<option label="Weekender/Overnight" value="weekenderovernight">Weekender/Overnight</option>&#13;
			<option label="Under $10,000" value="under-10000">Under $10,000</option>&#13;
			<option label="$10,000-15,000" value="1000015000">$10,000-15,000</option>&#13;
			<option label="$15,000-25,000" value="1500025000">$15,000-25,000</option>&#13;
			<option label="$25,000+" value="25000">$25,000+</option>&#13;
			<option label="I would like to see all my preferences and trip goals reached, no matter the cost" value="i-would-like-to-see-all-my-preferences-and-trip-goals-reached-no-matter-the-cost">I would like to see all my preferences and trip goals reached, no matter the cost</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you anticipate needing 24/7 on-call support while traveling?" description="MTC operates during standard business hours and is not a 24/7 service. Please let us know if you anticipate needing round-the-clock support while traveling   so we can plan accordingly." name="do-you-anticipate-needing-247-oncall-support-while-traveling">&#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="Please summarize your vision for this trip and what is most important to you.&amp;nbsp;" description="Is it the hotel product or the experiences? Do you like to be within walking distance to restaurants and shops? Any specific amenities you must have at a hotel? Do you just want to relax or are there any specific activities you would like to have planned?" name="is-there-anything-else-that-you-must-do-or-see" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Is there anything else that you “must do” or see? Feel free to elaborate on questions listed above." name="text-1729885384894" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="BEFORE WE START PLANNING&amp;nbsp;"/>&#13;
		<field type="checkbox-group" required="true" label="Trip Design &amp;amp; Planning Fees: To provide a personalized experience, we charge a trip design and/or travel planning fee. Are you comfortable with this investment to get started? Please note: If you already know the hotel you’d like to book, there is no planning fee for simple hotel-only reservations with added value perks.&amp;nbsp;" name="checkbox-group-1766265105836">&#13;
			<option label="I understand and agree." value="i-understand-and-agree">I understand and agree.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Accommodation Bookings: If you decide to move forward with full-service trip planning, we must be the booking agent for your accommodations. We are unable to offer full planning services involving points bookings, Airbnb, or VRBO. However, you are welcome to use points for flights." name="dr-luxury-travel-requires-that-we-are-the-booking-agent-for-your-accommodations-for-travel-planning-services-however-we-are-not-able-to-assist-with-bookings-that-involve-using-points-airbnb-or-vrbo-we-encourage-using-points-for-flights">&#13;
			<option label="I understand and agree." value="i-understand-and-agree">I understand and agree.</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like to receive our monthly newsletter with destination ideas and trip inspiration?" name="radio-group-1764431442692">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="How did you hear about us? If you were referred by someone else or saw them post about us on Instagram, please let us know who they are. We would love to thank them." name="who-can-i-thank-for-referring-you-to-us" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for taking the time to fill out our inquiry form. Once we receive your completed form, we will email you with next steps.&amp;nbsp;"/>&#13;
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