Share your information with Dawn Cooper

Dawn Cooper

Glammy Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Glammy Travel Airfare Intake Form"/>&#13;
		<field type="paragraph" subtype="p" label="Please complete this form with as much detail as possible so we can research the best flight options for your trip."/>&#13;
		<field type="header" subtype="h3" label="Traveler Information"/>&#13;
		<field type="text" required="true" label="First name" description="Full legal name (exactly as it appears on government ID/passport)" 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="date" required="true" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="text" required="true" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="text" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="text" subtype="tel" label="Phone number" name="phone-number" className="form-control"/>&#13;
		<field required="true"  type="text" subtype="email" label="Email address" name="email" className="form-control"/>&#13;
		<field type="text" label="Number of travelers" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Names and dates of birth for all travelers" name="names-and-dobs-for-all-travelers" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Trip Details"/>&#13;
		<field type="text" label="Departure city/airport" name="departure-city-airport" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Destination city/airport" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Desired departure date" name="starting-at" className="form-control"/>&#13;
		<field type="date" label="Desired return date" name="ending-at" className="form-control"/>&#13;
		<field type="textarea" label="Is your travel date flexible? If yes, please provide acceptable alternate dates" name="alternate-travel-dates" className="form-control"/>&#13;
		<field type="text" label="Preferred departure time" name="preferred-departure-time" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred return time" name="preferred-return-time" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="One-way or roundtrip" name="one-way-or-roundtrip" className="radio-group">&#13;
			<option label="One-way" value="one-way">One-way</option>&#13;
			<option label="Roundtrip" value="roundtrip">Roundtrip</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Flight Preferences"/>&#13;
		<field type="text" label="Preferred airline (if any)" name="preferred-airline" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred cabin" name="preferred-cabin" className="radio-group">&#13;
			<option label="Economy" value="economy">Economy</option>&#13;
			<option label="Premium Economy" value="premium-economy">Premium Economy</option>&#13;
			<option label="Business" value="business">Business</option>&#13;
			<option label="First" value="first">First</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Nonstop only, or are connections acceptable?" name="nonstop-or-connections" className="radio-group">&#13;
			<option label="Nonstop only" value="nonstop">Nonstop only</option>&#13;
			<option label="Connections acceptable" value="connections">Connections acceptable</option>&#13;
		</field>&#13;
		<field type="text" label="Maximum number of stops you will accept" name="max-number-of-stops" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Longest layover you will accept" name="longest-layover" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you prefer daytime, evening, or overnight flights?" name="flight-time-preference" other="true" className="radio-group">&#13;
			<option label="Daytime" value="daytime">Daytime</option>&#13;
			<option label="Evening" value="evening">Evening</option>&#13;
			<option label="Overnight" value="overnight">Overnight</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference" className="radio-group">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="No preference" value="no-preference">No preference</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you need seats selected in advance?" name="seats-selected-in-advance" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Any special assistance needed at the airport or during the flight?" name="special-assistance" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Baggage &amp;amp; Extras"/>&#13;
		<field type="radio-group" label="Will you need checked bags?" name="checked-bags" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Will you need carry-on bags?" name="carry-on-bags" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you interested in refundable or changeable fares?" name="refundable-or-changeable-fares" other="true" className="radio-group">&#13;
			<option label="Refundable" value="refundable">Refundable</option>&#13;
			<option label="Changeable" value="changeable">Changeable</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like travel protection quoted if available?" name="travel-protection-quoted" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Budget"/>&#13;
		<field type="text" label="Estimated budget per person for airfare" name="budget" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Is your budget firm or flexible?" name="budget-firm-or-flexible" className="radio-group">&#13;
			<option label="Firm" value="firm">Firm</option>&#13;
			<option label="Flexible" value="flexible">Flexible</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like the best value, shortest travel time, or preferred airline prioritized?" name="prioritize-value-time-or-airline" other="true" className="radio-group">&#13;
			<option label="Best value" value="best-value">Best value</option>&#13;
			<option label="Shortest travel time" value="shortest-travel-time">Shortest travel time</option>&#13;
			<option label="Preferred airline" value="preferred-airline">Preferred airline</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Travel Documents"/>&#13;
		<field type="text" label="TSA PreCheck / Global Entry / Known Traveler Number (if applicable)" name="known-traveler-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Redress number (if applicable)" name="redress-number" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Frequent flyer numbers (if applicable)" name="frequent-flyer-numbers" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Additional Notes"/>&#13;
		<field type="textarea" label="Any important notes, concerns, or preferences I should know before quoting flights?" name="important-notes-concerns-preferences" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Important Note"/>&#13;
		<field type="paragraph" subtype="p" label="Airfare is subject to change until ticketed. Pricing and availability are not guaranteed until payment is received and the booking is confirmed."/>&#13;
		<field type="paragraph" subtype="p" label="Please ensure all names and travel details are entered exactly as they appear on your government-issued identification."/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>