<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Client Information&nbsp;"/> <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" 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="header" subtype="h2" label="About Your Trip"/> <field type="select" required="true" label="What kind of trip are you planning?" name="what-kind-of-trip-are-you-planning" className="form-control"> <option label="Leisure" value="leisure">Leisure</option> <option label="Celebratory Travel (Ex. Honeymoon, Anniversary, Birthday, Graduation, Retirement)" value="celebratory-travel-ex-honeymoon-anniversary-birthday-graduation-retirement">Celebratory Travel (Ex. Honeymoon, Anniversary, Birthday, Graduation, Retirement)</option> <option label="Business Travel (Ex. Incentive, Client Appreciation / Advisory)" value="business-travel-ex-incentive-client-appreciation-advisory">Business Travel (Ex. Incentive, Client Appreciation / Advisory)</option> </field> <field type="radio-group" required="true" label="How are you traveling?" name="how-are-you-traveling" other="true"> <option label="Solo" value="solo">Solo</option> <option label="Couple / Duo" value="couple-duo">Couple / Duo</option> <option label="Family (Same household up to 5)" value="family-same-household-up-to-5">Family (Same household up to 5)</option> <option label="Group (10 or more travelers)" value="group-10-or-more-travelers">Group (10 or more travelers)</option> <option label="Large Group (100+ travelers)" value="large-group-100-travelers">Large Group (100+ travelers)</option> </field> <field type="text" required="true" label="Where would you like to travel to?" name="where-would-you-like-to-travel-to" subtype="text" className="form-control"/> <field type="text" required="true" label="Why did you choose this location?" name="why-did-you-choose-this-location" subtype="text" className="form-control"/> <field type="text" required="true" label="Is this vacation to celebrate any special occasion?" name="is-this-vacation-to-celebrate-any-special-occasion" subtype="text" className="form-control"/> <field type="text" required="true" label="What are the goals for your trip?" placeholder="(i.e. relax by pool see tourist sites immerse in the culture education)" name="what-are-the-goals-for-your-trip" subtype="text" className="form-control"/> <field type="date" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/> <field type="date" required="true" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/> <field type="select" required="true" label="Are your dates flexible?" name="are-your-dates-flexible" className="form-control"> <option label="Yes - open to best availability and/or value" value="yes-open-to-best-availability-andor-value">Yes - open to best availability and/or value</option> <option label="No - my dates are set and unable to change" value="no-my-dates-are-set-and-unable-to-change">No - my dates are set and unable to change</option> </field> <field type="textarea" required="true" label="Please list ALL traveler's full names (incl. middle) and birthdays AS ON PASSPORTS, with relationship to you." placeholder="(Ex. Brandy Lynn Wilson 12/01/1980 Mom)" name="how-many-travelers-in-total-include-all-names-and-relationships-to-you-if-there-are-children-in-your-party-please-include-their-ages" className="form-control"/> <field type="radio-group" required="true" label="What phase of the planning are you in?" name="what-phase-of-the-planning-are-you-in"> <option label="I'm just beginning the planning process" value="im-just-beginning-the-planning-process">I'm just beginning the planning process</option> <option label="We have dates, but no other details confirmed" value="we-have-dates-but-no-other-details-confirmed">We have dates, but no other details confirmed</option> <option label="We have hotels and flights already booked" value="we-have-hotels-and-flights-already-booked">We have hotels and flights already booked</option> </field> <field type="radio-group" required="true" label="What is your budget for all travelers (including anything you would like us to quote - airfare, hotels, transfers, excursions)?" name="what-is-your-budget-for-all-travelers"> <option label="Less than $5,000" value="less-than-5000">Less than $5,000</option> <option label="$5,000 - $10,000" value="5000-10000">$5,000 - $10,000</option> <option label="$10,000 - $25,000" value="10000-25000">$10,000 - $25,000</option> <option label="$25,000 - $50,000" value="25000-50000">$25,000 - $50,000</option> <option label="$50,000 - $100,000" value="50000-100000">$50,000 - $100,000</option> <option label="$100,000 - $150,000" value="100000-150000">$100,000 - $150,000</option> <option label="$150,000+" value="150000">$150,000+</option> </field> <field type="text" required="true" label="Will you be booking any portion of your trip with points?&nbsp;&nbsp;" placeholder="If so specify which components & plan to book air directly with the airline before moving forward." name="will-you-be-booking-any-portion-of-your-trip-with-points-" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="What travel components would you like us to assist you with? Please confirm they are included in the estimated budget provided.&nbsp; We recommend you take a quick look at flights before our intake call, to give yourself an idea of options and prices expected. Google Flights is a good resource." name="what-travel-components-would-you-like-us-to-assist-you-with" other="true"> <option label="Flights" value="flights">Flights</option> <option label="Accomodations" value="accomodations">Accomodations</option> <option label="Transportation (car rental, trains, etc.)" value="transportation-car-rental-trains-etc">Transportation (car rental, trains, etc.)</option> <option label="Excursions & tours" value="excursions-tours">Excursions & tours</option> <option label="Insurance" value="insurance">Insurance</option> </field> <field type="header" subtype="h1" label="Airline Preferences"/> <field type="text" required="true" label="What is your departure city and preferred airport?" description="Please include city and any preferred airports." name="what-is-your-departure-city-and-preferred-airport" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your arrival city and preferred airport?" description="Please include city and any preferred airports." name="text-1731876092240" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is a priority for making decisions about your airline travel?" name="what-is-your-preferred-form-of-airline-travel"> <option label="Type of travel (Ex. private vs. commercial)" value="type-of-travel-ex-private-vs-commercial">Type of travel (Ex. private vs. commercial)</option> <option label="Date & time of travel" value="date-time-of-travel">Date & time of travel</option> <option label="Cost" value="cost">Cost</option> </field> <field type="radio-group" required="true" label="What is your preferred time of travel?" name="radio-group-1731876214581" other="true"> <option label="5:00 - 10:00 am local time" value="500-1000-am-local-time">5:00 - 10:00 am local time</option> <option label="10:00 - 3:00 pm local time" value="1000-300-pm-local-time">10:00 - 3:00 pm local time</option> <option label="3:00 - 8:00 pm local time" value="300-800-pm-local-time">3:00 - 8:00 pm local time</option> <option label="8:00 - 5:00 am local time (all-nighter)" value="800-500-am-local-time-allnighter">8:00 - 5:00 am local time (all-nighter)</option> </field> <field type="radio-group" required="true" label="What is your preferred form of airline travel?" name="radio-group-1731876142152"> <option label="Commercial Airline" value="commercial-airline">Commercial Airline</option> <option label="Private Charter" value="private-charter">Private Charter</option> <option label="Already booked or no airline required" value="already-booked-or-no-airline-required">Already booked or no airline required</option> </field> <field type="text" required="true" label="Do you have a preferred airline?" placeholder="Enter N/A or please state an airline if it takes precedence over price. " name="if-yes-please-provide-additional-details-" subtype="text" className="form-control"/> <field type="text" required="true" label="Are there any airlines you will not fly?" name="text-1731876369035" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is the most important factor in sourcing your airfare?" name="what-is-your-preferred-class-of-airline-travel"> <option label="Arrival/departure city" value="arrivaldeparture-city">Arrival/departure city</option> <option label="Arrival/departure dates" value="arrivaldeparture-dates">Arrival/departure dates</option> <option label="Least number of stops" value="least-number-of-stops">Least number of stops</option> <option label="Price" value="price">Price</option> </field> <field type="radio-group" required="true" label="What is your preferred class of airline travel?" description="Please note if you are traveling domestically or prefer Economy class you can book directly with the airline. If you would like assistance sourcing the right flights please see our A La Carte Services Menu we would be happy to assist you!" name="radio-group-1731876523355"> <option label="First Class" value="first-class">First Class</option> <option label="Business Class" value="business-class">Business Class</option> </field> <field type="radio-group" required="true" label="What is your airline seat preference?" name="what-is-your-airline-seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Opposite Aisle" value="opposite-aisle">Opposite Aisle</option> </field> <field type="radio-group" required="true" label="Do you require a special request meal in-flight?" name="do-you-require-a-special-request-meal-inflight"> <option label="Low Sodium" value="low-sodium">Low Sodium</option> <option label="Vegetarian" value="vegetarian">Vegetarian</option> <option label="Low Calorie" value="low-calorie">Low Calorie</option> <option label="Kosher" value="kosher">Kosher</option> <option label="None" value="none">None</option> </field> <field type="radio-group" required="true" label="Do you require special assistance on your trip?" name="do-you-require-special-assistance-on-your-trip"> <option label="Yes " value="yes-">Yes </option> <option label="No" value="no">No</option> </field> <field type="text" label="If yes, please provide additional details.&nbsp;" name="text-1731876323719" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Ground Transportation Preferences"/> <field type="radio-group" required="true" label="What is your preference for transportation during your trip?" description="Please note to provide the level of service and quality we stand behind, we quote private transportation. Self service, public transportation and rental cars are included when appropriate and more reliable." name="what-best-describes-your-desired-accommodation-style" other="true"> <option label="Private car service" value="private-car-service">Private car service</option> <option label="Rental car" value="rental-car">Rental car</option> </field> <field type="radio-group" required="true" label="If you are planning to rent a car, please provide the car category preferred." description="Please note to provide the level of service and quality we stand behind, we will include rental cars when appropriate for destination and reliable." name="radio-group-1731876729432" other="true"> <option label="Economy" value="economy">Economy</option> <option label="Compact" value="compact">Compact</option> <option label="Mid-sized" value="midsized">Mid-sized</option> <option label="Full-sized" value="fullsized">Full-sized</option> <option label="Van" value="van">Van</option> <option label="SUV" value="suv">SUV</option> <option label="Convertible" value="convertible">Convertible</option> </field> <field type="header" subtype="h1" label="Hotel Preferences"/> <field type="radio-group" required="true" label="What best describes your desired accommodation style?" name="radio-group-1731876632514" other="true"> <option label="Luxury & exclusive (5*)" value="luxury-exclusive-5">Luxury & exclusive (5*)</option> <option label="Premium (4*)" value="premium-4">Premium (4*)</option> <option label="Boutique (smaller, niche, lifestyle)" value="boutique-smaller-niche-lifestyle">Boutique (smaller, niche, lifestyle)</option> <option label="Centrally located & functional" value="centrally-located-functional">Centrally located & functional</option> <option label="Private villa or home" value="private-villa-or-home">Private villa or home</option> </field> <field type="text" required="true" label="What is your ideal cost per night for hotel?" name="what-is-your-ideal-cost-per-night-for-hotel" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your preferred room category?" name="what-is-your-preferred-room-category"> <option label="King" value="king">King</option> <option label="2 Doubles / Queens" value="2-doubles-queens">2 Doubles / Queens</option> <option label="Junior Suite" value="junior-suite">Junior Suite</option> <option label="Executive Suite" value="executive-suite">Executive Suite</option> <option label="Villa " value="villa-">Villa </option> <option label="Condominium" value="condominium">Condominium</option> </field> <field type="textarea" required="true" label="Are there any special room requests we should be aware of for your group?" placeholder="Please include # of rooms by category (1-King + 1-Double/Queen for kids with requirement for rooms to be connected). Please note that many hotels in Europe are King rooms with one bed. If there are kids traveling with you please be specific of your expectations. We want to do our best to provide good options for your family or group. We can make connecting requests if available and communicate other options." name="are-there-any-special-room-requests-we-should-be-aware-of-for-your-group" className="form-control"/> <field type="textarea" required="true" label="What are your amenity "must haves?"" placeholder="(Ex. on-site restaurant pool in-room refrigerator etc.)" name="what-are-the-amenities-or-experiences-you-would-like-to-have-for-an-ideal-vacation" className="form-control"/> <field type="radio-group" required="true" label="Are there any additional requirements for your room?" name="are-there-any-additional-requirements-for-your-room" other="true"> <option label="Extra blankets / pillows" value="extra-blankets-pillows">Extra blankets / pillows</option> <option label="Allergy-free / feather-free bedding" value="allergyfree-featherfree-bedding">Allergy-free / feather-free bedding</option> <option label="Luggage assistance (unpacking/packing)" value="luggage-assistance-unpackingpacking">Luggage assistance (unpacking/packing)</option> <option label="None" value="none">None</option> </field> <field type="text" required="true" label="Describe your favorite hotel brand and why you love it." name="describe-your-favorite-hotel-brand-and-why-you-love-it" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Activity Preferences"/> <field type="checkbox-group" required="true" label="What best describes your travel priorities and activities you want to experience?" name="vibe-preference" other="true"> <option label="Adventure (Ex. Skiing, Parasailing, Zip line)" value="adventure-ex-skiing-parasailing-zip-line">Adventure (Ex. Skiing, Parasailing, Zip line)</option> <option label="Art, theatre & architecture (Ex. live music)" value="art-theatre-architecture-ex-live-music">Art, theatre & architecture (Ex. live music)</option> <option label="Celebration & fun" value="celebration-fun">Celebration & fun</option> <option label="Dramatic views & landscape" value="dramatic-views-landscape">Dramatic views & landscape</option> <option label="Family friendly (Ex. children, multi-gen, dog friendly)" value="family-friendly-ex-children-multigen-dog-friendly">Family friendly (Ex. children, multi-gen, dog friendly)</option> <option label="Food & wine (Ex. Wine tasting, cooking or mixology classes)" value="food-wine-ex-wine-tasting-cooking-or-mixology-classes">Food & wine (Ex. Wine tasting, cooking or mixology classes)</option> <option label="Local culture, history & education" value="local-culture-history-education">Local culture, history & education</option> <option label="Nightlife (Ex. Casinos, Clubs)" value="nightlife-ex-casinos-clubs">Nightlife (Ex. Casinos, Clubs)</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Philanthropy / Volunteerism" value="philanthropy-volunteerism">Philanthropy / Volunteerism</option> <option label="Rest & relaxation (Ex. Sun, sand, pool)" value="rest-relaxation-ex-sun-sand-pool">Rest & relaxation (Ex. Sun, sand, pool)</option> <option label="Romantic" value="romantic">Romantic</option> <option label="Spa & wellness (Ex. yoga & meditation)" value="spa-wellness-ex-yoga-meditation">Spa & wellness (Ex. yoga & meditation)</option> <option label="Sporting events" value="sporting-events">Sporting events</option> <option label="Beach & water sports (Ex. Sporting events, scuba diving, snorkeling, sailing, boating, fishing)" value="beach-water-sports-ex-sporting-events-scuba-diving-snorkeling-sailing-boating-fishing">Beach & water sports (Ex. Sporting events, scuba diving, snorkeling, sailing, boating, fishing)</option> <option label="Land sports (Ex. Biking, golf, hiking)" value="land-sports-ex-biking-golf-hiking">Land sports (Ex. Biking, golf, hiking)</option> </field> <field type="textarea" required="true" label="Please list anything you "must see or do" that was not included above." name="is-there-anything-else-you-must-do-or-see" className="form-control"/> <field type="textarea" required="true" label="What is one of your favorite memories from a past vacation and why." name="what-is-one-of-your-favorite-vacations-and-why-was-it-memorable" className="form-control"/> <field type="textarea" required="true" label="What does an ideal day on vacation look like to you." name="what-does-an-ideal-day-on-vacation-look-like-to-you" className="form-control"/> <field type="header" subtype="h1" label="Travel Insurance"/> <field type="radio-group" required="true" label="By making an insurance selection below, I understand that declining insurance could result in the loss of my travel cost and/or require more money to correct the situation.&nbsp; I also acknowledge that without insurance, there may be no way to recoup any losses, costs or expenses incurred.&nbsp;&nbsp;" name="by-making-an-insurance-selection-below-i-understand-that-declining-insurance-could-result-in-the-loss-of-my-travel-cost-andor-require-more-money-to-correct-the-situation-i-also-acknowledge-that-without-insurance-there-may-be-no-way-to-recoup-any-losses-costs-or-expenses-incurred-"> <option label="I accept insurance and would like to receive a quote. " value="i-accept-insurance-and-would-like-to-receive-a-quote-">I accept insurance and would like to receive a quote. </option> <option label="I decline insurance and understand this could result in the loss of all travel costs associated with this booking." value="i-decline-insurance-and-understand-this-could-result-in-the-loss-of-all-travel-costs-associated-with-this-booking">I decline insurance and understand this could result in the loss of all travel costs associated with this booking.</option> </field> <field type="radio-group" required="true" label="Luxury Experiences by Melissa custom curates all itineraries based on client needs and wishes. Due to the amount of time allocated to the customization of each proposal, there is a planning fee due prior to a proposal being compiled, created and/or presented. By moving forward and scheduling a call, you agree and understand that you will be quoted a planning fee based on the intricacies of your specific trip. All planning fees are non-refundable, regardless of trip outcome." name="i-understand-there-are-agency-fees-attached-to-this-professional-service"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="Luxury Experiences by Melissa acts solely as a booking agent for disclosed principal Suppliers and is not the source or provider of any travel service. Each Supplier is an independent entity with its own management and is not subject to the control of Luxury Experiences by Melissa. For this reason, you will see all pricing as bundled rates and not broken out by component. Our partners do not provide component pricing to protect their contracts, therefore Luxury Experiences by Melissa is not able to provide /disclose component pricing. Do you agree and understand that you will receive all pricing as a "package rate.” service." name="i-understand-all-proposals-will-be-presented-as-bundled-pricing"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" other="true"> <option label="Friend " value="friend-">Friend </option> <option label="Instagram" value="instagram">Instagram</option> <option label="Facebook" value="facebook">Facebook</option> <option label="LinkedIn" value="linkedin">LinkedIn</option> <option label="Podcast" value="podcast">Podcast</option> <option label="Web Search" value="web-search">Web Search</option> <option label="Advertisement" value="advertisement">Advertisement</option> </field> <field type="text" required="true" label="If you were referred to us, please provide their name so we can thank them." name="who-can-i-thank-for-referring-you-to-us" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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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