<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Traveler Information"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-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="Suffix" name="suffix" 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="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="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" 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="header" subtype="h1" label="Your Travel Wish List"/> <field type="text" required="true" label="Where would you like to travel?&nbsp;" description="Please list all destinations you have considered." name="where-would-you-like-to-travel-is-this-a-multidestination-trip-" subtype="text" className="form-control"/> <field type="date" required="true" label="When would you like to depart?&nbsp;" name="when-would-you-like-to-depart-" className="form-control"/> <field type="date" required="true" label="When would you like to return?&nbsp;" name="when-would-you-like-to-return-" className="form-control"/> <field type="text" required="true" label="What is your departure city?&nbsp;" name="what-is-your-departure-city-" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Are your dates flexible?&nbsp;" name="are-your-dates-flexible-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="Is this trip to celebrate anything special?&nbsp;" placeholder="Anniversary Graduation Honeymoon Family Reunion, etc..." name="is-this-trip-to-celebrate-anything-special-" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers will there be?&nbsp;" name="how-many-travelers-will-there-be-" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Who is traveling with you?&nbsp; Please include the names and ages of all travelers.&nbsp;" name="who-is-traveling-with-you-please-include-the-names-and-ages-of-all-travelers-" className="form-control"/> <field type="checkbox-group" label="What type of experiences do you have in mind?&nbsp;" name="what-type-of-experiences-do-you-have-in-mind-" other="true"> <option label="Rest and Relaxation" value="rest-and-relaxation">Rest and Relaxation</option> <option label="Romance" value="romance">Romance</option> <option label="Family friendly " value="family-friendly-">Family friendly </option> <option label="Ocean Cruise " value="ocean-cruise-">Ocean Cruise </option> <option label="River Cruise" value="river-cruise">River Cruise</option> <option label="Local culture " value="local-culture-">Local culture </option> <option label="Food and wine" value="food-and-wine">Food and wine</option> <option label="Off the beaten path " value="off-the-beaten-path-">Off the beaten path </option> <option label="Adventure/Active" value="adventureactive">Adventure/Active</option> <option label="Escorted tours" value="escorted-tours">Escorted tours</option> <option label="I'm not sure" value="im-not-sure">I'm not sure</option> </field> <field type="radio-group" required="true" label="What is your ideal investment in this experience?&nbsp; (Per person and not including airfare)?" name="how-much-are-you-comfortable-investing-in-this-trip-per-person-and-not-including-airfare"> <option label="Up to $4,999" value="up-to-4999">Up to $4,999</option> <option label="$5,000 - $15,000" value="5000-15000">$5,000 - $15,000</option> <option label="$15,000 - $20,000" value="15000-20000">$15,000 - $20,000</option> <option label="$20,000 - $30,000" value="20000-30000">$20,000 - $30,000</option> <option label="$30,000 - $50,000" value="30000-50000">$30,000 - $50,000</option> <option label="$50,000 +" value="50000-">$50,000 +</option> </field> <field type="radio-group" label="Which best describes your desired accommodation style?&nbsp;" name="which-best-describes-your-desired-accommodation-style-" other="true"> <option label="Luxury & exclusive (5-star)" value="luxury-exclusive-5star">Luxury & exclusive (5-star)</option> <option label="Boutique & charming (4 to 5-star)" value="boutique-charming-4-to-5star">Boutique & charming (4 to 5-star)</option> <option label="Premium (4-star)" value="premium-4star">Premium (4-star)</option> <option label="Villa (Private/multi-bedroom accomodations)" value="villa-privatemultibedroom-accomodations">Villa (Private/multi-bedroom accomodations)</option> </field> <field type="checkbox-group" label="What is your preferred class of air travel?&nbsp;" name="checkbox-group-1740856716212"> <option label="Economy " value="economy-">Economy </option> <option label="Premium " value="premium-">Premium </option> <option label="First Class" value="first-class">First Class</option> <option label="Business" value="business">Business</option> <option label="Private Jet/Charter" value="private-jetcharter">Private Jet/Charter</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="Will you be booking any portion of your trip with loyalty points?" name="will-you-be-booking-any-portion-of-your-trip-with-loyalty-points"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="Is there anything you MUST see or do?&nbsp;" name="is-there-anything-you-must-see-or-do-" subtype="text" className="form-control"/> <field type="textarea" label="Is there anything else you would like for us to know that would help us design your ideal vacation?&nbsp;" placeholder="No detail is too small" name="is-there-anything-else-you-would-like-for-us-to-know-that-would-help-us-design-your-ideal-vacation-" className="form-control"/> <field type="text" label="How did find us?" placeholder="Referral , Signature Travel Website, Facebook etc.?" name="how-did-find-us" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Important Information"/> <field type="checkbox-group" required="true" label="Rozlyn Paige Travel specializes in crafting personalized travel experiences tailored to your unique preferences. Through close collaboration, we ensure every detail aligns with your vision. After completing this questionnaire, you will be invited to a complimentary discovery call to explore your ideal trip and determine if we’re the perfect fit for your travel needs." name="checkbox-group-1731716197666"> <option label="I confirm that I have reviewed and understand the information above. " value="i-confirm-that-i-have-reviewed-and-understand-the-information-above-">I confirm that I have reviewed and understand the information above. </option> </field> <field type="checkbox-group" required="true" label="Rozlyn Paige Travel is dedicated to providing unmatched expertise and personalized service, distinguishing us from online booking platforms and discount travel agents. Rather than focusing on price matching or competing on cost, we prioritize delivering exceptional care, meticulous attention to detail, in-travel support and thoughtfully curated experiences that our clients truly value." name="checkbox-group-1731716204844"> <option label="I confirm that I have reviewed and understand the information above. " value="i-confirm-that-i-have-reviewed-and-understand-the-information-above-">I confirm that I have reviewed and understand the information above. </option> </field> <field type="checkbox-group" required="true" label="Rozlyn Paige Travel’s professional planning fees are tailored to the length and complexity of your trip and will be discussed during our consultation. Our planning fees start at a minimum of $350. However, we waive planning fees for property-only, all-inclusive, and cruise-only bookings." name="checkbox-group-1731716203675"> <option label="I confirm that I have reviewed and understand the information above. " value="i-confirm-that-i-have-reviewed-and-understand-the-information-above-">I confirm that I have reviewed and understand the information above. </option> </field> <field type="checkbox-group" label="Would you like to subscribe to our bi-weekly newsletter for exclusive travel insights, expert tips, and the latest updates?" description="Don't worry. We don't like to receive an overwhelming number of emails so we won't wear out our welcome. Nor will we share your information." name="would-you-like-to-subscribe-to-our-newsletter-for-exclusive-travel-tips-and-updates-"> <option label="Yes, I would love to! " value="yes-i-would-love-to-">Yes, I would love to! </option> </field> </fields> </form-template> </body> </html>
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