<html> <body> <form-template> <fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field> <field type="header" subtype="h2" label="Questions about you!"/> <field type="header" subtype="h2" label="Primary Traveler Name"/> <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="radio-group" required="true" label="Gender" 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="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="header" subtype="h2" label="Passport Info"/> <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="header" subtype="h2" label="Cruise Preferences"/> <field type="select" label="Preferred Airline" name="preferred-airline" className="form-control"> <option label="" value=""/> <option label="Southwest Airlines" value="southwest-airlines">Southwest Airlines</option> <option label="Delta Airlines" value="delta-airlines">Delta Airlines</option> <option label="Spirit" value="spirit">Spirit</option> <option label="United Airlines" value="united-airlines">United Airlines</option> <option label="American Airlines" value="american-airlines">American Airlines</option> <option label="Other" value="other">Other</option> </field> <field type="text" required="true" label="What is your departure city?" description="Provide airport code (ex. DCA BWI etc.)" name="departure-city" subtype="text" className="form-control"/> <field type="select" required="true" label="Where would you like to cruise?" name="where-would-you-like-to-cruise" className="form-control"> <option label="Cuba" value="Cuba">Cuba</option> <option label="Alaska" value="Alaska">Alaska</option> <option label="Europe" value="Europe">Europe</option> <option label="Asia" value="Asia">Asia</option> <option label="South Pacific" value="South Pacific">South Pacific</option> <option label="Western Caribbean " value="Western Caribbean ">Western Caribbean </option> <option label="Southern Caribbean " value="Southern Caribbean ">Southern Caribbean </option> <option label="Eastern Caribbean " value="Eastern Caribbean" selected="selected">Eastern Caribbean </option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" required="true" label="Check the months that you ARE available to cruise" description="If you know the exact dates you'd like to cruise enter it in other." inline="true" name="check-the-months-that-you-are-available-to-cruise" other="true"> <option label="January" value="january">January</option> <option label="February" value="february">February</option> <option label="March" value="march">March</option> <option label="April" value="april">April</option> <option label="May" value="may">May</option> <option label="June" value="june">June</option> <option label="July" value="july">July</option> <option label="August" value="august">August</option> <option label="September" value="september">September</option> <option label="October" value="october">October</option> <option label="November" value="november">November</option> <option label="December" value="december">December</option> </field> <field type="checkbox-group" required="true" label="What is the purpose of this vacation?" name="vacation-purpose"> <option label="Romance" value="romance">Romance</option> <option label="Making family memories" value="Making family memories">Making family memories</option> <option label="Just for fun" value="Just for fun">Just for fun</option> <option label="To relax or recharge" value="To relax or recharge">To relax or recharge</option> <option label="Celebrating a special occasion" value="Celebrating a special occasion">Celebrating a special occasion</option> <option label="Other" value="other">Other</option> </field> <field type="select" required="true" label="What is the purpose of this vacation?" name="purpose-of-this-vacation" multiple="multiple" className="form-control"> <option label="Romance" value="romance">Romance</option> <option label="Making family memories" value="Making family memories">Making family memories</option> <option label="Just for fun" value="Just for fun">Just for fun</option> <option label="To relax or recharge" value="To relax or recharge">To relax or recharge</option> <option label="Celebrating a special occasion" value="Celebrating a special occasion">Celebrating a special occasion</option> <option label="Other" value="Other">Other</option> </field> <field type="radio-group" required="true" label="How long would you like to cruise?" name="how-long-would-you-like-to-cruise"> <option label="3-5 days" value="35-days">3-5 days</option> <option label="5-7 days" value="57-days">5-7 days</option> <option label="7+ days" value="7-days">7+ days</option> </field> <field type="radio-group" required="true" label="How much are you willing to invest in this experience PER PERSON?" description="This just gives me a general starting point and can always be changed later." name="how-much-are-you-willing-to-invest-in-this-experience"> <option label="$2,300 - $2,500" value="2300-2500">$2,300 - $2,500</option> <option label="$2,501 - $3,500" value="$2,501 - $3,500">$2,501 - $3,500</option> <option label="$3,501 - $4,500" value="$3,501 - $4,500">$3,501 - $4,500</option> <option label="$4,501 - $6,500" value="$4,501 - $6,500">$4,501 - $6,500</option> <option label="$6,501+" value="$6,501+">$6,501+</option> </field> <field type="select" required="true" label="How soon are you looking to book?" name="how-soon-are-you-looking-to-book" className="form-control"> <option label="Immediately" value="immediately" selected="selected">Immediately</option> <option label="Within the next week" value="within-the-next-week">Within the next week</option> <option label="Within the next month" value="within-the-next-month">Within the next month</option> <option label="Within the next two - three months" value="within-the-next-two-three-months">Within the next two - three months</option> <option label="In more than three months" value="in-more-than-three-months">In more than three months</option> </field> <field type="checkbox-group" label="Cabin Location Preference" name="cabin-location-preference"> <option label="Front of ship" value="front-of-ship">Front of ship</option> <option label="Mid ship" value="mid-ship">Mid ship</option> <option label="Back of ship" value="back-of-ship">Back of ship</option> </field> <field type="radio-group" required="true" label="Stateroom Type Preference" description="What type of cabin do you like to cruise in?" name="cruise-cabin-preference"> <option label="Interior or Inside" value="interior-or-inside">Interior or Inside</option> <option label="Outside or Oceanview" value="outside-or-oceanview">Outside or Oceanview</option> <option label="Balcony or Verandah" value="balcony-or-verandah">Balcony or Verandah</option> <option label="Suite" value="suite">Suite</option> </field> <field type="header" subtype="h1" label="Supplemental Info"/> <field type="select" label="Have you ever cruised before?" description="If you have please enter which cruise line" name="have-you-sailed-with-carnival-before" className="form-control"> <option label="Yes" value="yes" selected="selected">Yes</option> <option label="No" value="no">No</option> <option label="other" value="other">other</option> </field> <field type="checkbox-group" label="If so, which line?" description="Select all that apply" name="if-so-which-line"> <option label="Carnival Cruise Line" value="Carnival Cruise Line">Carnival Cruise Line</option> <option label="Royal Caribbean Cruise Line" value="Royal Caribbean Cruise Line">Royal Caribbean Cruise Line</option> <option label="Norwegian Cruise Line" value="Norwegian Cruise Line">Norwegian Cruise Line</option> <option label="MSC Cruise Line" value="MSC Cruise Line">MSC Cruise Line</option> <option label="Celebrity Cruises " value="Celebrity Cruises ">Celebrity Cruises </option> <option label="Disney Cruise Line" value="Disney Cruise Line">Disney Cruise Line</option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" required="true" label="Check off top 3 most important amenities that you would like included in your quote" name="check-off-top-3-most-important-amenities-that-you-would-like-included-in-your-quote" other="true"> <option label="Roundtrip Flights and Transfers" value="roundtrip-flights-and-transfers">Roundtrip Flights and Transfers</option> <option label="Pre-Cruise Stay" value="precruise-stay">Pre-Cruise Stay</option> <option label="Post-Cruise Stay" value="postcruise-stay">Post-Cruise Stay</option> <option label="Specialty Dining" value="specialty-dining">Specialty Dining</option> <option label="Beverage Packages" value="beverage-packages">Beverage Packages</option> <option label="Wifi" value="wifi">Wifi</option> <option label="Onboard Credit" value="onboard-credit">Onboard Credit</option> <option label="Shore Excursions" value="shore-excursions">Shore Excursions</option> <option label="None of these" value="none-of-these">None of these</option> </field> <field type="checkbox-group" required="true" label="Check off top 3 most important features for you when selecting a cruise." name="check-off-top-3-most-important-features-for-you-when-selecting-a-cruise"> <option label="Onboard Entertainment" value="onboard-entertainment">Onboard Entertainment</option> <option label="Onboard Activities" value="onboard-activities">Onboard Activities</option> <option label="Variety of Ports" value="variety-of-ports">Variety of Ports</option> <option label="COVID-19 Appropriate Excursions" value="covid19-appropriate-excursions">COVID-19 Appropriate Excursions</option> <option label="Health/Wellness Services (Spa Services, Gym, etc.)" value="healthwellness-services-spa-services-gym-etc">Health/Wellness Services (Spa Services, Gym, etc.)</option> </field> <field type="radio-group" label="Will other passengers will join you?" name="will-other-passengers-will-join-you"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="Please include the names and DOB of all OTHER cruisers who will be joining you." name="please-include-the-names-and-dob-of-all-other-cruisers-who-will-be-joining-you" rows="4" className="form-control"/> <field type="textarea" label="Do you have any dietary needs or special restrictions?" name="do-you-have-any-dietary-needs-or-special-restrictions" className="form-control"/> <field type="checkbox-group" label="Do you or anyone in your party fit the following?" description="Select all that apply" name="do-you-or-anyone-in-your-party-fit-the-following"> <option label="Senior 55+" value="senior-55">Senior 55+</option> <option label="Active or retired military" value="active-or-retired-military">Active or retired military</option> </field> <field type="text" label="Is there anything else you'd like for me to know?" name="is-there-anything-else-youd-like-for-me-to-know" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Which type of travel insurance would you like included in your quote." description="Travel insurance will be included as a separate line." name="travel-insurance-type"> <option label="Please quote me travel insurance through Allianz" value="Allianz.">Please quote me travel insurance through Allianz</option> <option label="Please quote me travel protection through the cruise line." value="Cruise Line Insurance">Please quote me travel protection through the cruise line.</option> <option label="Please quote me both and detail the differences" value="Allianz and Cruise Line">Please quote me both and detail the differences</option> <option label="Do NOT quote travel insurance." value="Neither">Do NOT quote travel insurance.</option> </field> <field type="textarea" label="Do you have any concerns about traveling?" name="do-you-have-any-concerns-about-traveling" rows="2" className="form-control"/> <field type="date" required="true" label="Best date to follow up with your proposal" name="best-date-to-follow-up-with-your-proposal" className="form-control"/> </fields> </form-template> </body> </html>
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