Share your information with Colleen Evans

Colleen Evans

Mixed Luggage Travel Company

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    <form-template>&#13;
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		<field type="paragraph" subtype="p" label="🌟 Ready to embark on an unforgettable river cruise adventure? Please fill out the booking form below to reserve your spot on this exclusive journey. Select your preferred cabin category, provide your details, and let us help craft a luxurious experience tailored just for you. We’ll be in touch promptly to confirm availability and assist with any special requests. Your dream cruise awaits!"/>&#13;
		<field type="paragraph" subtype="p" label="**** Please Note that this form only allows for one guest to submit their information at a time.&amp;nbsp; Please have the lead passenger complete the entire form to ensure all details are accurate. Additional passengers only need to fill out their basic information at the top (name, date of birth, etc.). There is a space to indicate who you&#39;re traveling with."/>&#13;
		<field type="paragraph" subtype="p" label="Please Feel Free to Email me at info@mixedluggage.com with any questions - Please Indicate the Subject Viking Cruise 2027 in the subject"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveling with..." name="text-1762180816950" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Cabin Details"/>&#13;
		<field type="text" label="Number of Guests in Cabin (max 2)" name="text-1762180713391" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Name of Guest Sharing Your Cabin" name="text-1762180738407" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Beds together or apart?" name="text-1762180816264" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Cabin Type" name="cabin-type">&#13;
			<option label="Explorer Suite " value="explorer-suite-">Explorer Suite </option>&#13;
			<option label="Veranda Suite" value="veranda-suite">Veranda Suite</option>&#13;
			<option label="Veranda Stateroom" value="veranda-stateroom">Veranda Stateroom</option>&#13;
			<option label="French Balcony" value="french-balcony">French Balcony</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Pre and Post Cruise Extensions"/>&#13;
		<field type="paragraph" subtype="p" label="Pre and post cruise extensions vary by itinerary and are subject to change."/>&#13;
		<field type="paragraph" subtype="p" label="More days means more to discover, with extension packages you can add before or after your Viking cruise or cruisetour. Enjoy additional days to explore your embarkation or disembarkation city, or see a new destination altogether with a choice of exciting cities."/>&#13;
		<field type="radio-group" label="Pre Land Packages" name="pre-land-packages">&#13;
			<option label="Lake Como - 3 Nights: $1499 pp" value="lake-como-3-nights-1499-pp">Lake Como - 3 Nights: $1499 pp</option>&#13;
			<option label="Lucerne - 2 Nights - $999 pp" value="lucerne-2-nights-999-pp">Lucerne - 2 Nights - $999 pp</option>&#13;
			<option label="Basel - 2 Nights - $699 pp" value="basel-2-nights-699-pp">Basel - 2 Nights - $699 pp</option>&#13;
			<option label="Swiss Alps &amp; Scenic Train - 4 Nights - $2999 pp" value="swiss-alps-scenic-train-4-nights-2999-pp">Swiss Alps &amp; Scenic Train - 4 Nights - $2999 pp</option>&#13;
			<option label="St Moritz, Lombardy &amp; Alpine Train - 4 Nights - $2299 pp" value="st-moritz-lombardy-alpine-train-4-nights-2299-pp">St Moritz, Lombardy &amp; Alpine Train - 4 Nights - $2299 pp</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Post Land Packages" name="post-land-packages">&#13;
			<option label="Amsterdam - 2 Nights - $799 pp" value="amsterdam-2-nights-799-pp">Amsterdam - 2 Nights - $799 pp</option>&#13;
			<option label="Premium Amsterdam - 2 Nights - $1299 pp" value="premium-amsterdam-2-nights-1299-pp">Premium Amsterdam - 2 Nights - $1299 pp</option>&#13;
			<option label="Best of Belgium - 3 Nights - $1599 ppp" value="best-of-belgium-3-nights-1599-ppp">Best of Belgium - 3 Nights - $1599 ppp</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Airfare (available 10 months prior to travel)"/>&#13;
		<field type="text" label="Will you need my assistance with airfare?" description="(airfare will not be available 10 months prior)" name="will-you-need-my-assistance-with-airfare" subtype="text" className="form-control"/>&#13;
		<field type="text" label="If Yes, Where will you fly from (Multiple Airports okay to list)" name="if-yes-where-will-you-fly-from-multiple-airports-okay-to-list" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Economy, Premium Economy or Business Class?" name="economy-premium-economy-or-business-class" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Please List Any Loyalty Programs (Frequent Fliers, Global Entry, TSA, etc...)" 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"/>&#13;
		<field type="textarea" label="Please Let us know any Special needs, dietary requirements or important information here:" name="please-let-us-know-any-special-needs-dietary-requirements-or-important-information-here" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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