<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions For Your Upcoming Trip "/> <field type="radio-group" required="true" label="Would you like to be included on our email list to receive travel related information (deals/promotions)?" name="would-you-like-to-be-included-on-our-email-list-to-receive-travel-related-information-dealspromotions"> <option label="YES" value="yes">YES</option> <option label="NO" value="no">NO</option> </field> <field type="text" label="Trip ID # (if you saw a Vacation Promotion you liked)" description="ex - V101" name="trip-id-if-you-saw-a-vacation-promotion-you-liked" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="CLIENT CONTACT INFORMATION"/> <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="date" label="Birthday" name="birthday" className="form-control"/> <field type="text" required="true" label="Address" name="address-line-1" subtype="text" className="form-control"/> <field type="text" required="true" 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" label="Country" name="address-country" 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="h1" label="BASIC TRIP INFORMATION"/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a couple destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <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?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="How Many Adult Travelers?" name="how-many-adult-travelers" subtype="text" className="form-control"/> <field type="textarea" label="Please list all the names and birthday of each ADULT Traveler:" placeholder="Ex: John Smith - 01/27/1989 Ana Smith - 07/20/1991" name="please-list-all-the-names-and-birthday-of-each-adult-traveler" className="form-control"/> <field type="text" label="How Many&nbsp; Children Travelers?" placeholder="Children" name="number-of-travelers" subtype="text" className="form-control"/> <field type="textarea" label="Please list all the names and birthday of each CHILD Traveler:" placeholder="Ex: Jane Smith - 01/27/2010 Kate Smith - 07/20/2015" name="please-list-all-the-names-and-birthday-of-each-child-traveler" className="form-control"/> <field type="textarea" label="Do you all have a valid passport with at least 6 months left until the expiration date, from the date of your trip? (If traveling Internationally)" name="do-you-all-have-a-valid-passport-with-at-least-6-months-left-until-the-expiration-date-from-the-date-of-your-trip-if-traveling-internationally" className="form-control"/> <field type="textarea" label="Add all adult traveler names and emails here. This is necessary to provide the traveler with the necessary form(s) for proposals." placeholder="Ex. John Jones johnjones@gmail.com; Marie Jones mariejones@gmail.com" name="add-all-adult-traveler-names-and-emails-here-this-is-necessary-to-provide-the-traveler-with-the-necessary-forms-for-proposals" className="form-control"/> <field type="header" subtype="h1" label="HOTEL INFORMATION"/> <field type="radio-group" label="Hotel Preference" name="hotel-preference"> <option label="All Inclusive" value="all-inclusive">All Inclusive</option> <option label="Adult Only" value="adult-only">Adult Only</option> <option label="Family Friendly " value="family-friendly-">Family Friendly </option> <option label="Near Air Port/Cruise Port" value="near-air-portcruise-port">Near Air Port/Cruise Port</option> </field> <field type="checkbox-group" label="What Vibe Are You Trying To Create On Your Trip?" description="Check all that apply." name="vibe-preference"> <option label="Adults Only" value="adults-only">Adults Only</option> <option label="Family Friendly" value="family-friendly">Family Friendly</option> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Adventure" value="adventure">Adventure</option> <option label="Food and wine" value="food-wine">Food and wine</option> <option label="Local Culture" value="local-culture">Local Culture</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="LGBT" value="lgbt">LGBT</option> <option label="Multi-generational" value="multigenerational">Multi-generational</option> </field> <field type="radio-group" label="Hotel Room Preference" name="hotel-room-preference" other="true"> <option label="Standard Room" value="standard-room">Standard Room</option> <option label="Garden Room" value="garden-room">Garden Room</option> <option label="Pool View" value="pool-view">Pool View</option> <option label="Ocean View/Front" value="ocean-viewfront">Ocean View/Front</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Scuba/ Snorkle" value="scuba-snorkle">Scuba/ Snorkle</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> <option label="Family Friendly Fun" value="family-friendly-fun">Family Friendly Fun</option> <option label="Golf" value="golf">Golf</option> <option label="Food Experiences" value="food-experiences">Food Experiences</option> <option label="Beer & Wine Experiences" value="beer-wine-experiences">Beer & Wine Experiences</option> </field> <field type="radio-group" label="Bed Preference" name="bed-preference" other="true"> <option label="King" value="king">King</option> <option label="2 Double/Queen" value="2-doublequeen">2 Double/Queen</option> <option label="Multiple Rooms" value="multiple-rooms">Multiple Rooms</option> </field> <field type="text" required="true" label="How many rooms do you need?" name="how-many-rooms-do-you-need" subtype="text" className="form-control"/> <field type="textarea" label="If you need more than one room, let us know which adults and children will be on each room." placeholder="Ex. Room1: John and Ana Room2: Liza Kate and Jane" name="if-you-need-more-than-one-room-let-us-know-which-adults-and-children-will-be-on-each-room" className="form-control"/> <field type="textarea" label="If you stayed on a hotel on the past, which hotels do you usually stay? (This is to know which hotels do you prefer)" name="if-you-stayed-on-a-hotel-on-the-past-which-hotels-do-you-usually-stay-this-is-to-know-which-hotels-do-you-prefer" className="form-control"/> <field type="header" subtype="h1" label="TRANSPORTATION INFORMATION"/> <field type="radio-group" required="true" label="Will You Be Flying?" name="will-you-be-flying"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Airline Class Preference " name="airline-class-preference-"> <option label="1st Class" value="1st-class">1st Class</option> <option label="Business Class" value="business-class">Business Class</option> <option label="Economy Plus (Seat Selection)" value="economy-plus-seat-selection">Economy Plus (Seat Selection)</option> <option label="Economy Basic (Non refundable)" value="economy-basic-non-refundable">Economy Basic (Non refundable)</option> </field> <field type="radio-group" label="Seat preference" name="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="header" subtype="h1" label="BUDGET INFORMATION"/> <field type="radio-group" required="true" label="What is the budget for each traveler? This is important information to ensure I provide you with the best value for your price point. Select the budget per person." name="what-is-the-budget-for-each-traveler-this-is-important-information-to-ensure-i-provide-you-with-the-best-value-for-your-price-point-select-the-budget-per-person"> <option label="$1,500 to $2,500/per person" value="1500-to-2500per-person">$1,500 to $2,500/per person</option> <option label="$2,500 to $4,500/per person" value="2500-to-4500per-person">$2,500 to $4,500/per person</option> <option label="$4,500 to $6,500/per person" value="4500-to-6500per-person">$4,500 to $6,500/per person</option> <option label="$6,500 to $8,500/per person" value="6500-to-8500per-person">$6,500 to $8,500/per person</option> <option label="$8,500 to $10,000/per person" value="8500-to-10000per-person">$8,500 to $10,000/per person</option> <option label="$10,000+/per person" value="10000per-person">$10,000+/per person</option> </field> <field type="radio-group" required="true" label="How soon can you make a deposit?" name="how-soon-can-you-make-a-deposit"> <option label="Today" value="today">Today</option> <option label="1-2 Weeks" value="12-weeks">1-2 Weeks</option> <option label="3 weeks +" value="3-weeks-">3 weeks +</option> </field> <field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/> <field type="textarea" label="Anything you absolutely must do or see?" name="anything-you-absolutely-must-do-or-see" 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"/> </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.