<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Client Travel Profile Update"/> <field type="paragraph" subtype="p" label="We appreciate you taking the time to update your information. This helps us to keep your information current for better accuracy on travel documents and more accurate pricing on your quote. We look forward to servicing your travel and event needs. "/> <field type="header" subtype="h1" label="&nbsp;"/> <field type="paragraph" subtype="p" label="PLEASE NOTE THIS INFORMATION BECOMES PART OF YOUR TRAVEL PROFILE AND IT IS YOUR RESPONSIBILITY TO KEEP IT UPDATED AND ACCURATE.&nbsp; Changes may incur and change fee from our travel suppliers and Creative Travel &amp; Events LLC"/> <field type="header" subtype="h1" label="&nbsp;"/> <field type="date" required="true" label="Today's Date" name="todays-date" className="form-control"/> <field type="checkbox-group" label="Do you have any travel plans coming up that you would like assistance on? If you selected yes, we will send you a different form to tell us more about your travel needs. " name="do-you-have-any-travel-plans-coming-up-that-you-would-like-assistance-on-if-you-selected-yes-we-will-send-you-a-different-form-to-tell-us-more-about-your-travel-needs-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Maybe" value="maybe">Maybe</option> </field> <field type="checkbox-group" required="true" label="Who is your Travel &amp; Event Specialist?" description="Please let us know who are working with so we can make sure your information gets to the correct specialist." name="who-is-your-travel-event-specialist"> <option label="Sutra Borgeson" value="sutra-borgeson">Sutra Borgeson</option> <option label="Melanie Light" value="melanie-light">Melanie Light</option> <option label="Jennifer Johnson" value="jennifer-johnson">Jennifer Johnson</option> <option label="Wendy Boone" value="wendy-boone">Wendy Boone</option> <option label="Velvet Bern-Radel" value="velvet-bernradel">Velvet Bern-Radel</option> <option label="Don't have one yet" value="dont-have-one-yet">Don't have one yet</option> </field> <field type="header" subtype="h1" label="&nbsp;"/> <field type="header" subtype="h1" label="Name of Traveler"/> <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 (nickname)" 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="Other" value="other">Other</option> </field> <field type="checkbox-group" required="true" label="Special Affiliations" name="us-active-military-or-veteran"> <option label="Yes, Active Duty/Veteran/Retired" value="yes-active-dutyveteranretired">Yes, Active Duty/Veteran/Retired</option> <option label="Yes, 1st Responder: Fire/ Medical/ Police" value="yes-1st-responder-fire-medical-police">Yes, 1st Responder: Fire/ Medical/ Police</option> <option label="Yes, Teacher" value="yes-teacher">Yes, Teacher</option> <option label="No Affliations" value="no-affliations">No Affliations</option> </field> <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="header" subtype="h1" label="&nbsp;"/> <field type="header" subtype="h1" label="Current Mailing Address (No PO Boxes)"/> <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="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="&nbsp;"/> <field type="header" subtype="h1" label="Emergency Contact Information"/> <field type="text" label="Emergency Contact Name" name="emergency-contact-name" subtype="text" className="form-control"/> <field type="text" label="Relation to Emergency Contact" name="relation-to-emergency-contact" subtype="text" className="form-control"/> <field type="text" label="Emergency Contact Phone Number" name="emergency-contact-phone-number" subtype="text" className="form-control"/> <field type="text" label="Emergency Contact Email" name="emergency-contact-email" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Additional Contact Info"/> <field type="text" label="Company" name="company" subtype="text" className="form-control"/> <field type="text" label="Job title" name="job-title" subtype="text" className="form-control"/> <field type="text" label="Website" name="website" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="&nbsp;"/> <field type="header" subtype="h1" label="Are You On The VIP List?"/> <field type="paragraph" subtype="p" label="The VIP Listing means would like to receive emails informing me of Exclusive Vacation Offers, Travel News &amp; Tips, Announcements and other pertinent travel information. Are you in? (you can always change your mind later or the amount of information you receive)"/> <field type="checkbox-group" required="true" label="Receive Travel Information" name="receive-travel-information"> <option label="Yes," value="yes">Yes,</option> <option label="No" value="no">No</option> <option label="Not sure, but I will try it for now" value="not-sure-but-i-will-try-it-for-now">Not sure, but I will try it for now</option> </field> <field type="checkbox-group" label="How often can we share information with you?" name="how-often-can-we-share-information-with-you"> <option label="Once a Week" value="once-a-week">Once a Week</option> <option label="Every 2 weeks" value="every-2-weeks">Every 2 weeks</option> <option label="Once a Month" value="once-a-month">Once a Month</option> </field> <field type="checkbox-group" required="true" label="I acknowledge that this information is correct and accurate and I understand that providing incorrect information, may result in a change fee with travel suppliers and Creative Travel &amp; Events LLC once booked. " name="i-acknowledge-that-this-information-is-correct-and-accurate-and-i-understand-that-providing-incorrect-information-may-result-in-a-change-fee-with-travel-suppliers-and-creative-travel-events-llc-once-booked-"> <option label="Yes, I have reviewed my information and it is correct and accurate." value="yes-i-have-reviewed-my-information-and-it-is-correct-and-accurate">Yes, I have reviewed my information and it is correct and accurate.</option> </field> <field type="header" subtype="h1" label="&nbsp;"/> <field type="header" subtype="h1" label="Thank You! "/> </fields> </form-template> </body> </html>
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