<html> <body> <form-template> <fields> <field type="paragraph" subtype="p" label="In order to provide you with the best possible service, please complete the following information.&nbsp; This allows me to book, manage and monitor all your travel components, confirm that legal names and dates are correct to avoid change fees and to assist if you have any issues while traveling."/> <field type="header" subtype="h2" label="Traveler Information"/> <field type="text" label="Prefix" placeholder="Mrs. Ms. Miss Mr. Dr." 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" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" label="Suffix" placeholder="Jr. Sr. Esq III" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name (nickname)" placeholder="If different from your first name" name="preferred-name" subtype="text" className="form-control"/> <field type="radio-group" label="Gender" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> <option label="Unspecified" value="unspecified">Unspecified</option> </field> <field type="date" required="true" label="Date of birth" name="birthday" className="form-control"/> <field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Mailing Address - 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="checkbox-group" label="Possible Promotion Qualifiers" name="possible-promotion-qualifiers"> <option label="Active/Retired Military" value="activeretired-military">Active/Retired Military</option> <option label="1st responder/Medical Professional" value="1st-respondermedical-professional">1st responder/Medical Professional</option> <option label="Law Enforcement" value="law-enforcement">Law Enforcement</option> <option label="Age 55+" value="age-55">Age 55+</option> </field> <field type="clientLoyaltyPrograms" label="Traveler Numbers &amp; Loyalty Programs" description="i.e. TSA PreCheck Delta SkyMiles Norwegian Cruise Line Latitudes" 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="Travel Document Status"/> <field type="paragraph" subtype="p" label="CHECK YOUR PASSPORT EXPIRATION DATE: It must be valid for 6 MONTHS AFTER international travel is COMPLETED."/> <field type="checkbox-group" required="true" label="What is your passport status?" name="no-passport-select-status"> <option label="Current - will meet the 6 mth after requirement" value="current-will-meet-the-6-mth-after-requirement">Current - will meet the 6 mth after requirement</option> <option label="Need to renew" value="need-to-renew">Need to renew</option> <option label="Need to apply" value="need-to-apply">Need to apply</option> </field> <field type="text" required="true" label="Full legal name that IS or WILL BE on the passport" name="full-legal-name-that-will-be-on-the-passport" subtype="text" className="form-control"/> <field type="file" label="Passport photo" name="passport_photo" subtype="file" className="form-control"/> <field type="header" subtype="h2" label="Special Needs"/> <field type="textarea" label="Dietary restrictions or food allergies" placeholder="Anything you want the hotel or tour operator to be made aware of" name="dietary-restrictions-or-food-allergies" className="form-control"/> <field type="textarea" label="Medical Conditions" placeholder="Anything you want the hotel or tour operator to be made aware of: CPAP refrigerated medication epi pen etc." name="medical-conditions" className="form-control"/> <field type="text" label="Emergency Contact" description="This information will only be used in case of an emergency." placeholder="Someone who is not traveling with you" name="emergency-contact" subtype="text" className="form-control"/> <field type="text" label="Emergency Phone number" name="emergency-phone-number" subtype="text" className="form-control"/> <field type="text" label="Relationship to you" name="relationship-to-you" subtype="text" className="form-control"/> <field type="textarea" label="Additional Comments" name="additional-comments" className="form-control"/> <field type="header" subtype="h2" label="Travel Preferences"/> <field type="header" subtype="h1" label="Flights"/> <field type="text" label="Preferred departure airport codes (i.e. DFW, ATL, JFK)" name="preferred-departure-airport-codes-ie-dfw-atl-jfk" subtype="text" className="form-control"/> <field type="text" label="Preferred Airlines" name="preferred-airlines" subtype="text" className="form-control"/> <field type="checkbox-group" label="Preferred Cabin Category" name="cabin-category" other="true"> <option label="First Class" value="first-class">First Class</option> <option label="Business Class / Comfort+" value="business-class-comfort">Business Class / Comfort+</option> <option label="Main Cabin / Premium Economy" value="main-cabin-premium-economy">Main Cabin / Premium Economy</option> </field> <field type="checkbox-group" label="Acceptable Seat Locations" name="airplane-seat-preference" other="true"> <option label="Window" value="window">Window</option> <option label="Middle" value="middle">Middle</option> <option label="Aisle" value="aisle">Aisle</option> </field> <field type="header" subtype="h1" label="Land Accommodations"/> <field type="checkbox-group" label="Preferred Accommodation Care" name="preferred-accommodation-care"> <option label="Ultra Luxury - private staff" value="ultra-luxury-private-staff">Ultra Luxury - private staff</option> <option label="Luxury - often with butler service" value="luxury-often-with-butler-service">Luxury - often with butler service</option> <option label="Premium - excellent quality & care" value="premium-excellent-quality-care">Premium - excellent quality & care</option> </field> <field type="text" label="Preferred Hotel/Resort Brands" name="preferred-hotel-or-resort-brands" subtype="text" className="form-control"/> <field type="checkbox-group" label="Preferred Hotel/Resort Room" name="preferred-hotelresort-room" other="true"> <option label="Multi-Bedroom Suite" value="multibedroom-suite">Multi-Bedroom Suite</option> <option label="1 Bedroom Suite" value="1-bedroom-suite">1 Bedroom Suite</option> <option label="Concierge / Club Level" value="concierge-club-level">Concierge / Club Level</option> <option label="Standard Room" value="standard-room">Standard Room</option> <option label="Veranda / Balcony" value="veranda-balcony">Veranda / Balcony</option> <option label="Premium view" value="premium-view">Premium view</option> </field> <field type="checkbox-group" label="Acceptable Bed Options (Hotel/Resort)" description="Select all acceptable options" name="acceptable-bedding-options" other="true"> <option label="KIng" value="king">KIng</option> <option label="2 Queens" value="2-queens">2 Queens</option> <option label="2 Doubles" value="2-doubles">2 Doubles</option> <option label="2 Twins" value="2-twins">2 Twins</option> <option label="Sleeper sofa" value="sleeper-sofa">Sleeper sofa</option> </field> <field type="header" subtype="h1" label="Cruise Accommodations"/> <field type="text" label="Preferred Cruise Lines" name="text-1644424468837" subtype="text" className="form-control"/> <field type="checkbox-group" label="Preferred Cruise Stateroom" name="preferred-cruise-stateroom" other="true"> <option label="Luxury Suite" value="luxury-suite">Luxury Suite</option> <option label="1 Bedroom Suite" value="1-bedroom-suite">1 Bedroom Suite</option> <option label="Concierge / Club Level" value="concierge-club-level">Concierge / Club Level</option> <option label="Veranda / Balcony" value="veranda-balcony">Veranda / Balcony</option> <option label="Window only" value="window-only">Window only</option> <option label="Inside (No window)" value="inside-no-window">Inside (No window)</option> </field> <field type="checkbox-group" label="Preferred Bed Options (Cruise)" name="checkbox-group-1644423316043" other="true"> <option label="King/Queen (beds together)" value="kingqueen-beds-together">King/Queen (beds together)</option> <option label="2 Twins (beds apart)" value="2-twins-beds-apart">2 Twins (beds apart)</option> <option label="Sleeper sofa" value="sleeper-sofa">Sleeper sofa</option> <option label="Pullman bed" value="pullman-bed">Pullman bed</option> </field> <field type="header" subtype="h1" label="Experiences &amp; Activities"/> <field type="checkbox-group" label="Select all that apply for this particular trip" name="activity-preferences" other="true"> <option label="Private Tours" value="private-tours">Private Tours</option> <option label="Small Group Tours" value="small-group-tours">Small Group Tours</option> <option label="Explore on Own" value="explore-on-own">Explore on Own</option> <option label="Historical Landmarks" value="historical-landmarks">Historical Landmarks</option> <option label="Geographical Landmarks" value="geographical-landmarks">Geographical Landmarks</option> <option label="Museums / Art Galleries" value="museums-art-galleries">Museums / Art Galleries</option> <option label="Local Cultural Experience" value="local-cultural-experience">Local Cultural Experience</option> <option label="Food Tour" value="food-tour">Food Tour</option> <option label="Wine/Spirit Tasting" value="winespirit-tasting">Wine/Spirit Tasting</option> <option label="Culinary Class/Demonstration" value="culinary-classdemonstration">Culinary Class/Demonstration</option> <option label="Dine With Locals" value="dine-with-locals">Dine With Locals</option> <option label="Performance / Theater Show" value="performance-theater-show">Performance / Theater Show</option> <option label="Concert / Musical Experience" value="concert-musical-experience">Concert / Musical Experience</option> <option label="Rest & Relaxation" value="rest-relaxation">Rest & Relaxation</option> <option label="Connect with Friends/Family" value="connect-with-friendsfamily">Connect with Friends/Family</option> <option label="Quiet / Alone Time" value="quiet-alone-time">Quiet / Alone Time</option> <option label="Animal Encounter" value="animal-encounter">Animal Encounter</option> <option label="Gardens" value="gardens">Gardens</option> <option label="Hiking" value="hiking">Hiking</option> <option label="Biking" value="biking">Biking</option> <option label="Boating (kayaking, catamaran, sailing)" value="boating-kayaking-catamaran-sailing">Boating (kayaking, catamaran, sailing)</option> <option label="Lounge on Beach / Pool Deck" value="lounge-on-beach-pool-deck">Lounge on Beach / Pool Deck</option> <option label="Swimming" value="swimming">Swimming</option> <option label="Snorkel" value="snorkel">Snorkel</option> <option label="Scuba Diving" value="scuba-diving">Scuba Diving</option> <option label="Spa" value="spa">Spa</option> <option label="Golf" value="golf">Golf</option> <option label="Shopping" value="shopping">Shopping</option> <option label="Nightlife / Night Club" value="nightlife-night-club">Nightlife / Night Club</option> <option label="Gambling / Casino" value="gambling-casino">Gambling / Casino</option> </field> </fields> </form-template> </body> </html>
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American Airlines (AAdvantage)
United Airlines (Mileage Plus)
Delta Air Lines (SkyMiles)
Hilton (Honors)
Marriott Bonvoy
Southwest Airlines (Rapid Rewards)
IHG Rewards Club
Hyatt (World of Hyatt)
JetBlue Airways (trueBlue)
British Airways (Executive Club)
Alaska Airlines (Mileage Plan)
Hertz Gold Plus Rewards
Virgin America (eleVAte)
Club Carlson Hotels
Avis (Preferred)
Amtrak (Guest Rewards)
National (Emerald Club)
Wyndham Rewards (Days Inn, etc.)
Hawaiian Airlines (HawaiianMiles)
Choice Hotels (Choice Privileges)
Frontier Airlines (EarlyReturns)
Best Western Rewards
Lufthansa (Miles and More)
Virgin Atlantic (Flying Club)
Air Canada Aeroplan
Enterprise Rent-A-Car
Korean Air (SkyPass)
Air France (Flying Blue)
Singapore Airlines (KrisFlyer)
Emirates (Skywards)
Spirit Airlines (Free Spirit)
Le Club Accorhotels (Accor Hotels, Novotel, etc.)
Hotels.com Rewards
All Nippon Airways (ANA Mileage Club)
Cathay Pacific (Asia Miles)
Fairmont President's Club
Qantas (Frequent Flyer)
Budget (Fastbreak)
La Quinta, etc. (Returns)
Iberia Plus
Kimpton (Karma Rewards)
Asiana Airlines (Asiana Club)
Omni Hotels (Select Guest)
AviancaTaca (LifeMiles)
Alamo
Etihad Airways (Etihad Guest)
Aegean Airlines (Miles & Bonus)
KLM (Flying Blue)
MGM Resorts (M life Players Club)
Japan Airlines (JMB)
AirBerlin (Topbonus)
LATAM (LATAM Pass)
Thrifty (Blue Chip Rewards)
Royal Caribbean (Crown & Anchor Society)
Alitalia (MilleMiglia)
Qatar Airways (Qmiles)
Jet Airways (JetPrivilege)
Turkish Airlines (Miles&Smiles)
Icelandair (Saga Club)
Dollar Rent A Car (Express)
Carnival (VIFP)
Eva Air (Infinity MileageLands)
Sun Country Airlines (Ufly Rewards)
Shangri-La (Golden Circle)
Air India (Flying Returns)
Sixt Rent-a-Car
BMI (Diamond Club)
Booking.com
Loews Hotels (YouFirst Rewards)
Norwegian Air Shuttle ASA (Norwegian Reward)
Stash Hotel Rewards
Scandinavian Airlines System (EuroBonus)
Norwegian Cruise Line (Latitudes)
Aeromexico (Club Premier)
Copa Airlines ConnectMiles (Prefer)
Celebrity Cruises (Captain's Club)
Drury Hotels (Gold Key Club)
Aer Lingus (Gold Circle)
Virgin Australia (Velocity Frequent Flyer)
EL AL Israel Airlines (Matmid)
Princess Cruise Lines (Captain Circle)
China Airlines (Dynasty Flyer)
Delta (SkyBonus Corporate)
Melia (Melia Rewards)
GHA (Discovery)
Air China (PhoenixMiles)
Air Asia (BIG)
Gol Airlines (Smiles)
Malaysia Airlines (Enrich)
Air New Zealand (Airpoints)
WestJet (Frequent Guest)
Porter (VIPorter)
Agoda Rewards
Thai Airways (Royal Orchid Plus)
VOILÀ Hotel Rewards
Preferred Hotels, etc. (iPrefer)
Red Roof Inn (RediCard)
Aeroflot Bonus
China Eastern (Eastern Miles)
Holland America Line (Mariner Society)
Philippine Airlines (Mabuhay Miles)
Bangkok Airways (FlyerBonus)
Hilton Grand Vacations (Club)
South African Airways (Voyager)
China Southern (Sky Pearl)
Finnair Plus
Small Luxury Hotels (The Club)
TAP Portugal (Victoria Miles)
Avianca (Amigo)
Langham Hotels (1865 Club)
Fox Rent A Car (Rewards)
Hainan Airlines (Fortune Wings)
AmericInn (Easy Rewards)
Disney Cruise Line (Castaway Club)
Payless Car Rental (Perks Club)
Azul (TudoAzul)
Starwood Hotels (Preferred Business)
My Europcar (Privilege)
Hyatt (Vacation Club)
Aerolineas Argentinas (Plus)
Taj (InnerCircle)
British Airways (On Business, Corporate)
Leading Hotels of the World (Leaders Club)
Eurostar Frequent Traveler
Red Lion (Hello Rewards)
Air Tahiti Nui (Club Tiare)
United PerksPlus (Corporate Program)
NH Hotels (NH World)
Swissotel Circle
Millennium & Copthorne (My Millennium)
Ethiopian Airlines (ShebaMiles)
Royal Air Maroc (Safar Flyer)
Alaska Airlines (EasyBiz Corporate)
Vueling Airlines (Punto Punto)
Gulf Air (Falconflyer)
Star Alliance Company (PlusAwards)
Coast Hotels (Coast Rewards)
Royal Jordanian Airlines (Royal Plus)
HotelClub (Member Rewards)
Czech Airlines (OK Plus)
VIA Rail Canada (VIA Preference)
Trump Card (Privileges Program)
Borgata (Rewards)
Saudi Arabian Airlines (Alfursan)
Vietnam Airlines (Golden Lotus Plus)
Egypt Air Plus
Scandic Hotels (Scandic Friends)
JetBlue Airways (CompanyBlue)
Hostelworld (My World)
Jumeirah (Sirius)
E-Z Rent-A-Car (E-Z Money)
Deutsche Bahn (BahnCard)
Garuda (Frequent Flyer)
TripAdvisor
Kuwait Airways (Oasis Club)
Cosmopolitan Hotels (Identity)
Advantage Rent a Car (Instant Rewards)
Cayman Airways (Sir Turtle Rewards)
Caribbean Airlines (Caribbean Miles)
RIU Hotels & Resorts (RIU Class)
Easyjet
SriLankan (FlySmiLes)
TabletHotels (Reward Dollars)
Ace Rent a Car
Thalys (The Card)
S7 Priority
Air Baltic (Pins)
Choice Hotels (Nordic Choice Club)
Trident Hotels (Trident Privilege)
Middle East Airlines (Cedar Miles)
Emirates for Kids (Skysurfer)
Rydges (PriorityGUEST)
Oman Air (Sindbad)
Island Air (Cloud 9)
Ukraine International Airlines (Panorama Club)
Flybe (Rewards4all)
SNCF (Voyageur)
Marriott Gift Cards
Qantas (Aquire)
Pegasus Airlines (Pegasus Plus)
Air Transat
Silver Cloud (Rewards)
Brussels Airlines (LOOPs)
JAL Hotels (One Harmony)
Eurowings (Boomerang)
Azamara (Le Club Voyage)
Otel.com (FivePlus)
Meridiana Fly (Hi-Fly)
Prince Resorts Hawaii (Prince Preferred)
PIA (Awards Plus)
Air Astana (Nomad Club)
Regal Hotels (Regal Rewards)
IndiGo
Era Alaska (FlyAway Rewards)
Red Spotted Hanky (Loyalty points)
Thon Hotels (Thon Member)
Air Jamaica (Seventh Heaven)
Trenitalia (FrecciaClub)
Air Malta (Flypass)
Splendia (Club Rewards)
Dorint (Card)
UTair (Status)
Tsogo Sun (Frequent Guest)
Sino Hotel Group (IPrestige)
KLM BlueBiz (Corporate)
RZD (Bonus)
Elite Hotels of Sweden
New Otani (Club International)
Air Algérie (Air Algérie Plus)
Ryanair
The Montcalm & Shaftsbury (Premier Club)
Dan Hotels (e-dan club)
Pestana Priority Guest
Macdonald Hotels (The Club)
Air Mauritius (Kestrelflyer)
Frasers Hospitality (Fraser World)
AirBerlin (business points)
Park-N-Go (Frequent Parker Rewards)
Localiza Rent a Car
Jurys Inn (Jurys Rewards)
Air Caraibes (Preference)
Bulgaria Air (Fly More)
Air Niugini (Destinations)
TUIfly.com
Cebu Pacific (Getgo)
Premier Hotels (Premier Club)
Jet2.com (My Jet2)
Air Austral (My Capricorne)
CAT (C-Club)
Opinion Miles Club
Ural Airlines (Wings)
Air Europa (SUMA)
Monarch (Vantage Club)
Stena Line (Extra)
La Compagnie (My Compagnie)
First Hotels (First Member)
Belavia (Leader)
Azerbaijan Airlines (Azal Miles)
Wizz Air (Discount Club)
Tunisair (Fidelys)
Paradores (Amigos de Paradores)
Vistara (Vistara Club)
Montenegro Airlines (Vision Team)
Asky Airlines (ASKY Club)
Jinling Hotels (Elite)
Moby Lines (Moby Club)
Jin Jiang Group (J-Club)
AtlasGlobal (AtlasMiles)
Qubus Hotel (Q-Club)
Braathens Regional Airlines (BRA Friends )
Hotelbooker.org
Flynas (NaSmiles)
Czech Airlines (OK Plus Corporate)
Uzbekistan Airways (UzAirPlus)
TAAG Angola Airlines (Umbi Umbi Club)
Yelloh! Village (Yelloh! Plus)
Future Inns (Rewards Club)
Nordavia (Golden Mile)
Air Arabia (Airewards)
Royal Brunei Airlines (Royal Skies)
Leonardo Hotels (AdvantageCLUB)
Air Moldova Club
Air Cote D'Ivoire (sMiles)
Air Macau (Privileges)
Etihad (BusinessConnect)
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Santos Hotels (Club Santos)
Known Traveler Number (KTN)
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TSA PreCheck
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American Automative Association (AAA)
Sandals Select Guest (SSG)
Mandarin Oriental Fan
Relais and Chateaux 5C
Four Seasons Preferred
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Peninsula Pen
Belmond Bellini
Silversea Venetian
Oceania Cruise Lines
Regent Cruise Line
Seabourn Cruise Line
Lindblad Expeditions
SeaDream Yacht Club
Cunard
Virgin Voyages Sailing Club
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