Perla Ceron

PerLuxe Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Plan Your Next Vacation With Us!"/>&#13;
		<field type="paragraph" subtype="p" label="Let us help you plan your next vacation! No request is too big or too small. We are here to facilitate your travel plans and create an unforgettable experience. In order for us to accomplish this, we need a little bit more information! Once we receive your responses, we will contact you within 48-72 hours.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Basic Information"/>&#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="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Details/Preferences"/>&#13;
		<field type="checkbox-group" required="true" label="Select All That Apply" name="select-all-that-apply">&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All-Inclusive" value="allinclusive">All-Inclusive</option>&#13;
			<option label="Shows/Concerts" value="showsconcerts">Shows/Concerts</option>&#13;
			<option label="Tours/Excursions" value="toursexcursions">Tours/Excursions</option>&#13;
			<option label="Vacation Home/Villa" value="vacation-homevilla">Vacation Home/Villa</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where Would You Like To Go?" description="If you're not sure  just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is Your Departure City?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How Many Travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How Many Adults?" description="Adults 18 years of age or older" name="text-1738459053700" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How Many Children?" name="text-1738459077103" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Age of Children at Time of Travel" placeholder="4  8  12" name="text-1738459096031" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Accommodation Type" name="hotel-preference" other="true">&#13;
			<option label="Standard Room" value="standard-room">Standard Room</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Oceanfront" value="oceanfront">Oceanfront</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is Your Desired Budget per Person?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Protection"/>&#13;
		<field type="paragraph" subtype="p" label="Declining to purchase travel insurance offered to you could make you vulnerable to the following potential risks or financial loss that may be experienced during travel:&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="-Unconventional Risk"/>&#13;
		<field type="paragraph" subtype="p" label="-Delayed/Lost Baggage Risk"/>&#13;
		<field type="paragraph" subtype="p" label="-Emergency Medical Risks and expenses"/>&#13;
		<field type="paragraph" subtype="p" label="-Risk of Delay"/>&#13;
		<field type="paragraph" subtype="p" label="-Risk of Cancellation"/>&#13;
		<field type="radio-group" required="true" label="Are You Interested in Travel Insurance?&amp;nbsp;" name="are-you-interested-in-travel-insurance-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="text" required="true" label="If you were referred to us, who may we thank for the referral?&amp;nbsp;" name="if-you-were-referred-to-us-who-may-we-thank-for-the-referral-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Bonus Information"/>&#13;
		<field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" 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="header" subtype="h1" label="PerLuxe Travels Services"/>&#13;
		<field type="paragraph" subtype="p" label="PerLuxe Travels offers custom quotes and consultations to all clients. Our services include finding/recommending the best properties for you, along with helping to navigate the ever-changing rules of travel, including the latest updates from the tour operators, airlines, and resorts in addition to the entry requirements per destination. While we know that anyone can book for themselves using the internet, our professional services ensure that you will not be alone with your vacation. If any issues arise, we are the ones to handle those for you every step of the way. "/>&#13;
		<field type="radio-group" required="true" label="Once you fill out this form and agree to the terms and conditions, a complimentary consultation phone call will be set up. During that phone call, if both parties decide to move forward, your preliminary quote will be emailed within 48-72 hours." name="once-you-fill-out-this-form-and-agree-to-the-terms-and-conditions-a-complimentary-consultation-phone-call-will-be-set-up-during-that-phone-call-if-both-parties-decide-to-move-forward-your-preliminary-quote-will-be-emailed-within-4872-hours">&#13;
			<option label="I am excited to have my vacation planned by PerLuxe Travels!" value="i-am-excited-to-have-my-vacation-planned-by-perluxe-travels">I am excited to have my vacation planned by PerLuxe Travels!</option>&#13;
			<option label="I cannot wait!! So excited!!" value="i-cannot-wait-so-excited">I cannot wait!! So excited!!</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>