<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Traveler Information"/> <field type="paragraph" subtype="blockquote" label="Please make sure that you type in your first and last name as it will appear on your passport.&nbsp; You can still book your package without your passport information.&nbsp; Your PASSPORT must be VALID FOR 6 MONTHS AFTER YOUR VOYAGE END DATE.&nbsp; &nbsp;While our Sailors are free to voyage at will, some global rules for travel still apply.&nbsp; &nbsp;ALL VIRGIN VOYAGES REQUIRE A PASSPORT TO VOYAGE."/> <field type="header" subtype="h1" label="Travel Questions"/> <field type="radio-group" required="true" label="Please Choose Your Lady Ship Below:" name="please-choose-your-lady-ship-below"> <option label="Scarlet Lady" value="scarlet-lady">Scarlet Lady</option> <option label="Valiant Lady" value="valiant-lady">Valiant Lady</option> <option label="Resilient Lady" value="resilient-lady">Resilient Lady</option> <option label="Brilliant Lady" value="brilliant-lady">Brilliant Lady</option> </field> <field type="text" required="true" label="Please Indicate Dates of Travel: (Month/Day/Year) to (Month/Day/Year)" name="please-indicate-dates-of-travel-monthdayyear-to-monthdayyear" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Please choose your Voyage Accommodation below:" name="please-choose-your-suite-accommodation-below"> <option label="Solo Insider" value="solo-insider">Solo Insider</option> <option label="The Insider" value="the-insider">The Insider</option> <option label="Social Insider" value="social-insider">Social Insider</option> <option label="Solo Sea View" value="solo-sea-view">Solo Sea View</option> <option label="The Sea View" value="the-sea-view">The Sea View</option> <option label="XL Sea Terrace" value="xl-sea-terrace">XL Sea Terrace</option> <option label="Central Sea Terrace" value="central-sea-terrace">Central Sea Terrace</option> <option label="The Sea Terrace" value="the-sea-terrace">The Sea Terrace</option> <option label="Brilliant Suite" value="brilliant-suite">Brilliant Suite</option> <option label="Seriously Suite" value="seriously-suite">Seriously Suite</option> <option label="Gorgeous Suite" value="gorgeous-suite">Gorgeous Suite</option> </field> <field type="radio-group" required="true" label="How many total adults will be in your room?" description="Adults are ages 13 yrs+" inline="true" name="how-many-total-adults-will-be-in-your-room"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> </field> <field type="radio-group" required="true" label="Please select your bedding request" description="Please select the number of beds needed in each room" name="bed-preference"> <option label="1 Bed" value="1-bed">1 Bed</option> <option label="2 Beds" value="2-beds">2 Beds</option> </field> <field type="text" label="Do you have any special concerns or requests regarding your voyage?" description="Ex: Accessible Room Needs Connecting Rooms Dietary Concerns" name="do-you-have-any-special-concerns-or-requests-regarding-your-stay" subtype="text" className="form-control"/> <field type="text" required="true" label="Are you celebrating anything while on your voyage?" name="are-you-celebrating-anything-while-on-your-voyage" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Virgin Voyages Travel Protection (Additional Cost) - Highly Recommended" description="We will send you the pricing once you choose your voyage accomodations" name="cancel-for-any-reason-travel-protection-additional-cost-highly-recommended"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="Client Travel Documentation Information"/> <field type="radio-group" required="true" label="Gender" inline="true" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> <option label="X" value="other">X</option> </field> <field type="text" required="true" label="Prefix&nbsp; &nbsp; &nbsp; &nbsp; EXAMPLE:&nbsp; Mr. | Mrs. | Ms." name="prefix" subtype="text" className="form-control"/> <field type="text" required="true" label="First Name" description="*Please list your name EXACTLY as it appears on your State Issued ID/ Passport. ***If you are traveling Internationally please enter your name as it appears on your Passport." name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Middle Name" description="*if you do not have a middle name please type "n/a"" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last Name" description="*Please list your name EXACTLY as it appears on your State Issued ID/ Passport. ***If you are traveling Internationally please enter your name as it appears on your Passport." name="last-name" subtype="text" className="form-control"/> <field type="text" label="Suffix&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; EXAMPLE:&nbsp; Sr. | Jr. | II | III" name="suffix" subtype="text" className="form-control"/> <field type="date" required="true" label="Primary Traveler's Date of birth" name="birthday" className="form-control"/> <field type="header" subtype="h2" label="Passport Info"/> <field type="radio-group" required="true" label="Do you have a valid U.S. Passport?" description="Note: A VALID Un-Expired Passport is required to travel internationally" name="do-you-have-a-valid-us-passport"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="I am working on obtaining my passport" value="i-am-working-on-obtaining-my-passport">I am working on obtaining my passport</option> </field> <field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/> <field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/> <field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/> <field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/> <field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/> <field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/> <field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/> <field type="clientLoyaltyPrograms" label="Loyalty Programs" description="Ex: Airline Reward # - TSA Precheck # - Global Entry #" 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="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Street Address&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; EXAMPLE:&nbsp; &nbsp;8505 Queens Blvd" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" 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="header" subtype="h1" label="Contact Information"/> <field type="text" required="true" label="Email address" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Cell Phone Number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="TERMS &amp; CONDITIONS"/> <field type="paragraph" subtype="p" label="*ALL Prices are subject to change until Deposit is Made**"/> <field type="paragraph" subtype="p" label="However, no representation or description of the travel protection made by our staff constitutes a binding assurance or promise about the travel protection.*"/> <field type="paragraph" subtype="p" label="For your protection, we strongly recommend that you consider purchasing travel protection."/> <field type="header" subtype="h1" label="Payment Methods"/> <field type="radio-group" required="true" label="Please select your payment method below" name="please-select-the-payment-method-youd-like-to-use-for-this-trip"> <option label="Zelle Pay - The payment can be sent to admin@yourdoortotheworld.com " value="zelle-pay-the-payment-can-be-sent-to-adminyourdoortotheworldcom-">Zelle Pay - The payment can be sent to admin@yourdoortotheworld.com </option> <option label="PAYPAL - Log into your paypal account and please choose the "send to a friend option" and send the payment to this email address: faithtravelculture@gmail.com " value="paypal-log-into-your-paypal-account-and-please-choose-the-send-to-a-friend-option-and-send-the-payment-to-this-email-address-faithtravelculturegmailcom-">PAYPAL - Log into your paypal account and please choose the "send to a friend option" and send the payment to this email address: faithtravelculture@gmail.com </option> <option label="CREDIT / DEBIT CARD" value="credit-debit-card">CREDIT / DEBIT CARD</option> </field> <field type="header" subtype="h1" label="Trip Waiver Statement &amp; Acknowledgement"/> <field type="paragraph" subtype="p" label="By signing below, I hereby certify that I am at least 21 years of age or older. By signing below, I also hereby release Your Door To The World Travel, LLC , their officers, agents, employees and vendors from any and all liability, not caused directly by negligence of Your Door To The World Travel, LLC, or their representatives, arising out of or in any way related to the traveler's vacation.&nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="By signing below, I am also acknowledging that all of the information that I have filled out on this form is accurate. I have read over all of the information pertaining to this trip and agree to the outlined terms.&nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="I also acknowledge that I have checked this form and am confirming that there are no errors with the spelling of my name, rewards number( past guest number/ frequent flyer number, etc) date of birth, physical address or email address.&nbsp; I understand that if there are errors with any of the items listed in this paragraph, there may be fees assessed in order for Your Door To The World Travel, LLC to process any changes."/> <field type="paragraph" subtype="blockquote" label="Thank you for the opportunity to serve you for your next travel experience."/> </fields> </form-template> </body> </html>
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