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Jermainne Biagas
JC Royalty Xcapes
<html> <body> <form-template> <fields> <field type="checkbox-group" label="Are you inquiring about a specific travel deal that was posted?" name="checkbox-group-1734374790912"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="If yes, please list travel deal." name="if-yes-please-list-travel-deal" subtype="text" className="form-control"/> <field type="text" required="true" label="Who referred you?&nbsp; How did you hear about JC Royalty Xcapes?" description="Repeat Customers get discounts on future trips" name="who-referred-you-how-did-you-hear-about-jc-royalty-xcapes" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Lead Traveler 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="date" required="true" label="Date of Birth" name="date-of-birth" 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="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="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="textarea" required="true" label="List the names, birth dates, and ages of ALL adults and children at the time of travel." placeholder="Failure to provide this information will prolong your travel planning services." name="list-the-names-birth-dates-and-ages-of-all-adults-and-children-at-the-time-of-travel" className="form-control"/> <field type="text" required="true" label="For hotel/how many guests PER ROOM?" name="for-hotelcruise-cabin-accommodations-how-many-guests-per-room" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Do you and/or guest have valid passports?" inline="true" name="do-you-andor-guest-have-valid-passports"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Need information to acquire one" value="need-information-to-acquire-one">Need information to acquire one</option> </field> <field type="header" subtype="h1" label="About Your Trip"/> <field type="date" required="true" label="When would you like to leave?" 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." placeholder="ex: 12/25/2023" name="ending-at" className="form-control"/> <field type="text" required="true" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." inline="true" name="budget"> <option label="$800 - $1200" value="800-1200">$800 - $1200</option> <option label="$1200 - $1500" value="1200-1500">$1200 - $1500</option> <option label="$1500 - $2500" value="1500-2500">$1500 - $2500</option> <option label="$2500 - 5000" value="2500-5000">$2500 - 5000</option> <option label="$5000 to $10,000" value="5000-to-10000">$5000 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="checkbox-group" required="true" label="Type of Trip" name="type-of-trip" other="true"> <option label="Destination Wedding" value="destination-wedding">Destination Wedding</option> <option label="Vow Renewal" value="vow-renewal">Vow Renewal</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Family Vacation" value="family-vacation">Family Vacation</option> <option label="Getaway" value="getaway">Getaway</option> <option label="Group Trip" value="group-trip">Group Trip</option> </field> <field type="checkbox-group" required="true" label="Special Occasion" inline="true" name="special-occasion" other="true"> <option label="Wedding" value="wedding">Wedding</option> <option label="Brithday" value="brithday">Brithday</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Promotion" value="promotion">Promotion</option> <option label="Graduation" value="graduation">Graduation</option> </field> <field type="checkbox-group" required="true" label="Services Needed (Check all that apply)" name="services-needed-check-all-that-apply" other="true"> <option label="Flights" value="flights">Flights</option> <option label="Hotel/Resorts" value="hotelresorts">Hotel/Resorts</option> <option label="Rental Car" value="rental-car">Rental Car</option> <option label="Rail" value="rail">Rail</option> <option label=" Entertainment" value="-entertainment"> Entertainment</option> <option label="Cruise" value="cruise">Cruise</option> <option label="Excursions/Activities/Tours" value="excursionsactivitiestours">Excursions/Activities/Tours</option> <option label="Flights only" value="flights-only">Flights only</option> <option label="Hotel Only" value="hotel-only">Hotel Only</option> <option label="Villa/Rental Home" value="villarental-home">Villa/Rental Home</option> </field> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> <option label="Multi-generational" value="multigenerational">Multi-generational</option> <option label="Adventure" value="adventure">Adventure</option> </field> <field type="text" required="true" label="Anything you absolutely must do or see?" placeholder="example; swimming with pigs; ATV horseback riding on beach etc." name="must-dos" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Preferences"/> <field type="checkbox-group" required="true" label="Airline Preference" description="Check all that apply" inline="true" name="activity-preferences" other="true"> <option label="No preference" value="no-preference">No preference</option> <option label="Delta" value="delta">Delta</option> <option label="American" value="american">American</option> <option label="United" value="united">United</option> <option label="Southwest" value="southwest">Southwest</option> <option label="Jet Blue" value="jet-blue">Jet Blue</option> <option label="Spirit" value="spirit">Spirit</option> <option label="Frontier" value="frontier">Frontier</option> <option label="No Flight Needed" value="no-flight-needed">No Flight Needed</option> </field> <field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="If multiple airports are needed, please list cities, name and the number of passengers for each airport." placeholder="example John & Liz (New Orleans) - Jaden (Dallas)" name="if-multiple-airports-please-list-cities-and-number-of-passengers-for-each" subtype="text" className="form-control"/> <field type="select" label="Outbound Preferred Departure Time" name="outbound-preferred-departure-time" className="form-control"> <option label="Early " value="early-">Early </option> <option label="Afternoon" value="afternoon">Afternoon</option> <option label="Late" value="late">Late</option> </field> <field type="select" label="Return Preferred Departure Time" name="return-preferred-departure-time" className="form-control"> <option label="Early " value="early-">Early </option> <option label="Afternoon" value="afternoon">Afternoon</option> <option label="Late" value="late">Late</option> </field> <field type="checkbox-group" label="Seat Preference (Check all that apply)" name="seat-preference-check-all-that-apply"> <option label="Economy" value="economy">Economy</option> <option label="Extra Leg Room/Premium" value="extra-leg-roompremium">Extra Leg Room/Premium</option> <option label="Business Class" value="business-class">Business Class</option> <option label="First Class" value="first-class">First Class</option> <option label=" Window Seat" value="-window-seat"> Window Seat</option> <option label="Middle Seat" value="middle-seat">Middle Seat</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Exit Row" value="exit-row">Exit Row</option> </field> <field type="checkbox-group" required="true" label="Hotel/Resort Room Type (Check all that apply)" name="room-type-check-all-that-apply" other="true"> <option label="Standard Room " value="standard-room-">Standard Room </option> <option label="Mountain View" value="mountain-view">Mountain View</option> <option label="Pool View" value="pool-view">Pool View</option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Ocean Front" value="ocean-front">Ocean Front</option> <option label="Swim-Up " value="swimup-">Swim-Up </option> <option label="Swim-Out" value="swimout">Swim-Out</option> <option label="Garden View" value="garden-view">Garden View</option> </field> <field type="checkbox-group" required="true" label="Interested in an Villa/ Vacation Home" inline="true" name="checkbox-group-1736112674097"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Price that too" value="price-that-too">Price that too</option> </field> <field type="checkbox-group" label="Hotel/Resort Features (Check all that apply)" name="hotelresort-features-check-all-that-apply" other="true"> <option label=" All-Inclusive" value="-allinclusive"> All-Inclusive</option> <option label="Adults only" value="adults-only">Adults only</option> <option label="On the Beach" value="on-the-beach">On the Beach</option> <option label=" Luxury Resort" value="-luxury-resort"> Luxury Resort</option> <option label="Concierge Level" value="concierge-level">Concierge Level</option> <option label="Butler Service" value="butler-service">Butler Service</option> <option label="Activities On-Site" value="activities-onsite">Activities On-Site</option> <option label="Kids Club" value="kids-club">Kids Club</option> <option label="Family Friendly" value="family-friendly">Family Friendly</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="checkbox-group" label="Preferred Car Rental" name="preferred-car-rental" other="true"> <option label="Alamo" value="alamo">Alamo</option> <option label="Avis" value="avis">Avis</option> <option label="Budget" value="budget">Budget</option> <option label="Dollar" value="dollar">Dollar</option> <option label="Enterprise" value="enterprise">Enterprise</option> <option label="Hertz" value="hertz">Hertz</option> <option label="Sixt" value="sixt">Sixt</option> <option label="Thrifty" value="thrifty">Thrifty</option> </field> <field type="checkbox-group" label="Car Rental Category" inline="true" name="car-rental-category" other="true"> <option label=" Compact" value="-compact"> Compact</option> <option label=" Mid Size" value="-mid-size"> Mid Size</option> <option label="Full Size" value="full-size">Full Size</option> <option label="Luxury" value="luxury">Luxury</option> </field> <field type="header" subtype="h1" label="Important Questions"/> <field type="radio-group" required="true" label="Do want travel protection/insurance to protect you while traveling?" name="do-want-travel-protectioninsurance-to-protect-you-while-traveling"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="Are you ready to make a deposit?" inline="true" name="are-you-ready-to-make-a-deposit"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="date" required="true" label="If you answered no to the question above, what date will you be able to make a deposit? (Note: Full payment is required if travel is within 60 days)" description="Prices are subject to change if deposit isn't made within 24-48 hours." name="if-no-then-while-will-you-be-able-to-make-a-deposit" className="form-control"/> <field type="clientLoyaltyPrograms" label="Loyalty Programs ( Please list all to get all of your points)" 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="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"/> <field type="header" subtype="h1" label="TERMS &amp; CONDITIONS"/> <field type="paragraph" subtype="p" label="STOP...... Please ensure you have the completed all sections relating to your Xcape Getaway. You will receive 3 Quotes with the best travel deals that is within your budget. It's not just about finding you a great deal but it's about creating a memorable travel experience that leaves you satisfied, but also eager to travel more. Upon booking with me, you will receive pre-trip travel tips and advisories; email/phone assistance before, during and after your travel. I take pride in my finding your dream vacation and the happiness and satisfaction of my travelers is of the utmost importance to me.&nbsp;"/> <field type="header" subtype="h1" label="INSURANCE"/> <field type="paragraph" subtype="p" label="As a valued client, we want to do everything possible to make your trip enjoyable and worry free. Emergencies and unforeseen issues can occur when you least expect it. We highly recommend that you protect your vacation with a travel insurance policy. The cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all."/> <field type="paragraph" subtype="p" label="Without travel insurance, you’re on your own in a medical emergency because health policies will not cover you when you are outside of the United States. Most hospitals overseas will not accept your domestic health insurance card. They want your credit card instead because they expect payment up front before you receive care. When you have travel insurance, all you must do is call the travel insurance 24-hour assistance hotline. And finally, because loss bags, delayed and canceled flights are more common today than ever before -- TRAVEL INSURANCE PROVIDES PEACE OF MIND!!"/> <field type="paragraph" subtype="p" label="For this reason, we require that all clients complete, sign and submit our Travel Insurance (Request and Waiver) Form indicating that you have been offered travel insurance, and should you choose not to purchase travel insurance you accept all responsibility."/> </fields> </form-template> </body> </html>
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