Share your information with Bertha Joshua

Bertha Joshua

Bertha's Vacations

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Save The Date for a Morocco Unique Luxury Experience"/>&#13;
		<field type="paragraph" subtype="p" label="Mark your calendar for this incredible adventure and prepare for the trip of a lifetime! 🕌🐪✨"/>&#13;
		<field type="paragraph" subtype="p" label="This private, escorted, and customized ten days/ nine nights trip is designed for travelers who crave unique experiences, unparalleled comfort, and intimate insights into the heart of Morocco.&amp;nbsp; November 5, 2026 to November 15, 2026."/>&#13;
		<field type="paragraph" subtype="p" label="🌟 Stay in Style: Rest in handpicked 4-star and above accommodations, blending modern luxury with Moroccan charm."/>&#13;
		<field type="paragraph" subtype="p" label="Immerse yourself in Moroccan culture, history, and cuisine with expert guides, a personal driver, and curated, authentic experiences."/>&#13;
		<field type="paragraph" subtype="p" label="Explore the cinematic landscapes of Skoura, the gateway to the desert."/>&#13;
		<field type="paragraph" subtype="p" label="Discover the vibrant cities of Casablanca, Fes, the Sahara Desert, and Marrakech."/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;Experience the Magic of Morocco!"/>&#13;
		<field type="header" subtype="h1" label="&amp;nbsp;Early Registration &amp;amp; Deposit"/>&#13;
		<field type="paragraph" subtype="p" label="The early registration fee is $200 per person is&amp;nbsp; Non Refundable &amp;amp; Non transferable due September 26, 2026.&amp;nbsp; The Non Refundable Deposit is $1,200 per person and&amp;nbsp; is payable in three installments of $400 each.&amp;nbsp; &amp;nbsp;The payment due dates are,&amp;nbsp; October 17, 2025,&amp;nbsp; October&amp;nbsp; 31, 2025 &amp;amp; November 14, 2025..&amp;nbsp; You can select your room category and pay your registration fee/ deposit per person once you have completed this save-the-date questionnaire."/>&#13;
		<field type="header" subtype="h1" label="Trip Cost Estimate"/>&#13;
		<field type="paragraph" subtype="p" label="Depending on your room category, double or single occupancy, your room&#39;s approximate cost is $7,900 (double) per person - $10,000 (single) per person which includes round trip airfare, round trip airport transfers, hotel accommodations, travel insurance, gratuities, three (3) lunches, four (4) dinners, (10) tours, a private (English speaking) guide, and a driver for nine (9) nights.&amp;nbsp; After deposit you can pay the balance through (9) monthly or (18)&amp;nbsp; bi-monthly installments.&amp;nbsp; Final payment is due no later than&amp;nbsp; 8/28/2026.&amp;nbsp; In addition financing options are available through FlexPay and Affirm.&amp;nbsp; All prices are subject to change according to group contract requirements and the number of participants.&amp;nbsp; &amp;nbsp; The flight department is on evening of November 4, 2026."/>&#13;
		<field type="header" subtype="h1" label="Lead Traveller Details"/>&#13;
		<field type="text" required="true" label="Lead Traveller Preferred Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your bedding preference?" name="what-is-your-bedding-preference">&#13;
			<option label="1 King" value="1-king">1 King</option>&#13;
			<option label="Doubles" value="doubles">Doubles</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Lead Traveller #1 Full name (as it appears on your Government ID)"/>&#13;
		<field type="text" label="Prefix (Dr, Mr, Mrs, Ms, Miss, etc)" 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" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Lead Traveller Mobile Number (include area code)" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Lead Traveller Date of Birth" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="text" required="true" label="Do you have any dietary restrictions or food allergies? Indicate &quot;no&quot; if not applicable." name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your preferred departure city / airport of choice?&amp;nbsp;" name="what-is-your-preferred-departure-city-airport-of-choice-" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What is your airline fare class preference?&amp;nbsp;" name="what-is-your-airline-fare-class-preference-">&#13;
			<option label="Least expensive - basic economy / economy" value="least-expensive-basic-economy-economy">Least expensive - basic economy / economy</option>&#13;
			<option label="Economy (Premium)" value="economy-premium">Economy (Premium)</option>&#13;
			<option label="Business / First Class" value="business-first-class">Business / First Class</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="For non-stop air which airport would you prefer to depart from?&amp;nbsp;" name="checkbox-group-1745278104411">&#13;
			<option label="New York JFK" value="new-york-jfk">New York JFK</option>&#13;
			<option label="Washington IAD" value="washington-iad">Washington IAD</option>&#13;
			<option label="Miami MIA" value="miami-mia">Miami MIA</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Visa Requirements"/>&#13;
		<field type="radio-group" required="true" label="• U.S. citizens do not need a visa for stays up to 90 days. Ensure your passport is stamped upon entry to avoid complications when departing. • Morocco has lifted all COVID-19-related entry restrictions. Travelers are no longer required to present a vaccination certificate or a negative PCR test upon arrival. Entry Requirements: • Passport Validity: Your passport must be valid for at least six months beyond your date of entry into Morocco with expiration no earlier than May of&amp;nbsp; 2027.&amp;nbsp; You must have at least one blank page for the entry stamp." name="radio-group-1656096227881">&#13;
			<option label="Yes - I agree" value="yes-i-agree">Yes - I agree</option>&#13;
			<option label="Yes - I acknowledge" value="yes-i-acknowledge">Yes - I acknowledge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Mailing Address (for Travel Documents and Trip Insurance)"/>&#13;
		<field type="text" required="true" 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" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" 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="h1" label="Travel Details"/>&#13;
		<field type="checkbox-group" required="true" label="Are you a First Responder, Healthcare Professional, Law Enforcement Officer, Active Duty or Veteran?" name="are-you-a-first-responder-healthcare-professional-law-enforcement-officer-active-duty-or-veteran">&#13;
			<option label="No I am not. " value="no-i-am-not-">No I am not. </option>&#13;
			<option label="First Responder" value="first-responder">First Responder</option>&#13;
			<option label="Healthcare Professional" value="healthcare-professional">Healthcare Professional</option>&#13;
			<option label="Law Enforcement" value="law-enforcement">Law Enforcement</option>&#13;
			<option label="Veteran / Active Duty" value="veteran-active-duty">Veteran / Active Duty</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="paragraph" subtype="p" label="If you don&#39;t have your passport (which is needed for international travel), please upload a photo of your current driver&#39;s license and enter the expiration, issue date and number below.&amp;amp;nbsp;"/>&#13;
		<field type="select" required="true" label="Do you have a valid passport that expires after May 2027?" description="International travel requires 6 months validity at minimum after travel return date." name="do-you-have-a-valid-passport-that-expires-after-april-2024" className="form-control">&#13;
			<option label="Yes - I have a valid passport" value="yes-i-have-a-valid-passport">Yes - I have a valid passport</option>&#13;
			<option label="Yes - My passport expires before May 2026 so I have to renew it. " value="yes-my-passport-expires-before-may-2026-so-i-have-to-renew-it-">Yes - My passport expires before May 2026 so I have to renew it. </option>&#13;
			<option label="No -I need help to apply for a passport before the trip." value="no-i-need-help-to-apply-for-a-passport-before-the-trip">No -I need help to apply for a passport before the trip.</option>&#13;
		</field>&#13;
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number (or Driver&#39;s License for USA travel)" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country/State of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Nationality" name="nationality" subtype="text" className="form-control"/>&#13;
		<field type="file" required="true" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="If you have an TSA Pre/Global Entry number, Airline or Hotel Frequent Traveler # please provide it here." 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) ***"/>&#13;
		<field type="header" subtype="h1" label="Roommate Details"/>&#13;
		<field type="paragraph" subtype="p" label="If you will be sharing a room please indicate additional traveller details here. Please indicate the legal name of your roommate as well as date of birth. If applicable, your roommate will receive a form to upload passport details after the deposit has been processed.&amp;nbsp;"/>&#13;
		<field type="radio-group" required="true" label="Will you have a Roommate?" name="will-you-have-a-roommate">&#13;
			<option label="No, I will not share a room. I'm traveling solo." value="no-i-will-not-share-a-room-im-traveling-solo">No, I will not share a room. I'm traveling solo.</option>&#13;
			<option label="Yes, my Roommate details are below. I am financially responsible for everyone in my room and need a single invoice." value="yes-my-roommate-details-are-below-i-am-financially-responsible-for-everyone-in-my-room-and-need-a-single-invoice">Yes, my Roommate details are below. I am financially responsible for everyone in my room and need a single invoice.</option>&#13;
			<option label="Yes, my Roommate details are below. Please send an invoice separately to anyone sharing my room for registration fee and deposit." value="yes-my-roommate-details-are-below-please-send-an-invoice-separately-to-anyone-sharing-my-room-for-registration-fee-and-deposit">Yes, my Roommate details are below. Please send an invoice separately to anyone sharing my room for registration fee and deposit.</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Please indicate how many adults &amp;amp; how many children will be sharing your room (including yourself)." name="please-indicate-how-many-adults-how-many-children-will-be-sharing-your-room" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Do any of the people in your room (including yourself) have any medical conditions, allergies or undergoing any treatment that we need to be aware of? Do you require a wheelchair, scooter or other accessible equipment in your accommodations ? Indicate &quot;no&quot; if not applicable." name="do-you-have-any-medical-conditions-or-undergoing-any-treatment-that-we-need-to-be-aware-of-do-you-require-a-wheelchair-scooter-or-other-accessible-equipment-in-your-accommodations-indicate-no-if-not-applicable" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Traveller #2"/>&#13;
		<field type="text" label="Additional Traveller #2 / Roommate Legal Name" name="additional-traveller-2-roommate-legal-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Additional Traveller #2 / Roommate Email Address" name="additional-traveller-2-roommate-email-address" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Additional Traveller #2 / Roommate Date of Birth" name="additional-traveller-2-roommate-date-of-birth" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Traveller #3"/>&#13;
		<field type="text" label="Additional Traveller #3 / Roommate Legal Name" name="additional-traveller-3-roommate-legal-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Additional Traveller #3 / Roommate Email Address" name="additional-traveller-3-roommate-email-address" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Additional Traveller #3 / Roommate Date of Birth" name="additional-traveller-3-roommate-date-of-birth" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Traveller #4"/>&#13;
		<field type="text" label="Additional Traveller #4 / Roommate Legal Name" name="additional-traveller-4-roommate-legal-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Additional Traveller #4 / Roommate Email Address" name="additional-traveller-4-roommate-email-address" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Additional Traveller #4 / Roommate Date of Birth" name="additional-traveller-4-roommate-date-of-birth" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Traveller #5"/>&#13;
		<field type="text" label="Additional Traveller #5 / Roommate Legal Name" name="additional-traveller-5-roommate-legal-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Additional Traveller #5 / Roommate Email Address" name="additional-traveller-5-roommate-email-address" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Additional Traveller #5 / Roommate Date of Birth" name="additional-traveller-5-roommate-date-of-birth" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="DEPOSIT"/>&#13;
		<field type="header" subtype="h3" label="To secure your space for this trip, please remit your payment below for the Early Registration fee and/or the&amp;nbsp; deposit as listed per person for each individual traveler who you are financially responsible for. As space is limited, you will receive a personalized invitation via email to select your room category and provide additional information for travelers sharing your room. You have the option of paying the full deposit of $1,200, or paying it in three installments of $400 each (October 17, October 31 and November 14, 2025).&amp;nbsp; The registration fee is due by September 26, 2025 and the&amp;nbsp; full deposit is due on or before November 14, 2025.&amp;nbsp; The REGISTRATION FEE &amp;amp; DEPOSIT ARE NON-REFUNDABLE &amp;amp; NON TRANSFERABLE.&amp;nbsp; Financing options are available via Flexpay or Affirm.&amp;nbsp; Please inquire."/>&#13;
		<field type="radio-group" required="true" label="I am interested in the Morocco Luxury Unique Experience" name="i-understand-there-is-a-nonrefundable-plan-to-go-ticket-processing-fee-charged-by-many-airlines-travel-agencies-please-indicate-that-you-understand-and-agree-by-selecting-yes-below-if-you-do-not-accept-we-will-not-proceed-with-processing-your-trip-request-we-will-email-you-your-receipt-after-your-trip-is-booked-">&#13;
			<option label="Yes - I am paying the $200 registration fee now" value="yes-i-am-paying-the-200-registration-fee-now">Yes - I am paying the $200 registration fee now</option>&#13;
			<option label="Yes - I am paying the $200 registration fee &amp; the $1200 deposit now. " value="yes-i-am-paying-the-200-registration-fee-the-1200-deposit-now-">Yes - I am paying the $200 registration fee &amp; the $1200 deposit now. </option>&#13;
			<option label="Yes - I am paying the $200 registration fee &amp; $1,200 deposit via 3 monthly installments fee of $400, 10/17, 10/31. &amp;11 14, 2025" value="yes-i-am-paying-the-200-registration-fee-1200-deposit-via-3-monthly-installments-fee-of-400-1017-1031-11-14-2025">Yes - I am paying the $200 registration fee &amp; $1,200 deposit via 3 monthly installments fee of $400, 10/17, 10/31. &amp;11 14, 2025</option>&#13;
			<option label="Yes - I'm interested but need more time.  Please send me additional information." value="yes-im-interested-but-need-more-time-please-send-me-additional-information">Yes - I'm interested but need more time.  Please send me additional information.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Enter the amount you would like to authorize:

Please add or choose card to authorize:

Sign and agree to the terms and conditions:

By signing below, I authorize Bertha's Vacations to charge the credit card provided herein.

Click to sign