Share your information with Rebecca Gibson

Rebecca Gibson

Anchors and Escapes Travel

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	<fields>&#13;
		<field type="header" subtype="h3" label="Welcome! Thank you for your interest in planning a group cruise with Rebecca Gibson Travel. This form helps us gather the essential details needed to create a customized group cruise proposal for your review. Once submitted, you’ll receive cruise options, pricing guidance, and next steps. No payment is required at this stage. If you have any questions, you can contact Rebecca at The Rebecca Gibson Travel Agency directly at RGibsonTravel@outlook.com or 513-463-6788. Once this form is received, you will receive a cruise proposal in 24-48 hours. Thank you.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Group Organizer Information&amp;nbsp;"/>&#13;
		<field type="text" required="true" label="Group Name&amp;nbsp;" description="What would you like to call your group? Example: Smith&#39;s Family Vacation" name="how-did-you-find-out-about-this-group-cruise-" subtype="text" className="form-control"/>&#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" 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="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="checkbox-group" required="true" label="Preferred Contact Method&amp;nbsp;" name="preferred-contact-method-">&#13;
			<option label="Call " value="Email ">Call </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Best Time to Contact You&amp;nbsp;" name="best-time-to-contact-you-" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Gender&amp;nbsp;" name="gender-" className="form-control">&#13;
			<option label="F" value="f">F</option>&#13;
			<option label="M" value="m">M</option>&#13;
			<option label="X " value="x-">X </option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Group Details"/>&#13;
		<field type="text" required="true" label="Estimated Total Numbers of Travels" name="estimated-total-numbers-of-travels" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Adults (21+)&amp;nbsp;" name="number-of-adults-21-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Children (Ages 0–11)&amp;nbsp;" description="N/A if it doesn&#39;t apply" name="number-of-children-ages-011-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Teens (Ages 12–20)&amp;nbsp;" description="N/A if it doesn&#39;t apply" name="number-of-teens-ages-1220-" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Anyone age 55 or older? (Yes / No)&amp;nbsp;" name="anyone-age-55-or-older-yes-no-">&#13;
			<option label="Yes" value="No">Yes</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Is this group celebrating something?" name="is-this-group-celebrating-something">&#13;
			<option label="NO-Just traveling " value="Birthday ">NO-Just traveling </option>&#13;
			<option label="Anniversary " value="Family Reunion ">Anniversary </option>&#13;
			<option label="Wedding/Vow Renewal " value="Girls Trip/Friends Trip ">Wedding/Vow Renewal </option>&#13;
			<option label="Couples Trip " value="Other ">Couples Trip </option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Cruise Experience Preferences"/>&#13;
		<field type="select" required="true" label="Have you cruised before?&amp;nbsp;" name="have-you-cruised-with-carnival-cruise-line-before-" className="form-control">&#13;
			<option label="Yes " value="">Yes </option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Have you cruised before?&amp;nbsp;" name="select-1768090194311" className="form-control">&#13;
			<option label="Yes " value="">Yes </option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you have a preferred cruise line?&amp;nbsp;" name="do-you-have-a-preferred-cruise-line-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Do you have a preferred destination(s)?" name="do-you-have-a-preferred-destinations" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Preferred Travel Month(s)?" name="preferred-travel-months" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?&amp;nbsp;" name="are-your-dates-flexible-">&#13;
			<option label="Yes " value="No ">Yes </option>&#13;
			<option label="Maybe -depending on price " value="maybe-depending-on-price-">Maybe -depending on price </option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Preferred Cruise Length" name="preferred-cruise-length" className="form-control">&#13;
			<option label="3-4 days " value="34-days-">3-4 days </option>&#13;
			<option label="5-7 days " value="57-days-">5-7 days </option>&#13;
			<option label="8+ days" value="8-days">8+ days</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Cabin &amp;amp; Comfort Needs&amp;nbsp;"/>&#13;
		<field type="select" required="true" label="Cabin Type Preference" name="what-cabin-type-are-you-looking-to-book-" className="form-control">&#13;
			<option label="Interior " value="interior-">Interior </option>&#13;
			<option label="Ocean View " value="ocean-view-">Ocean View </option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite " value="suite-">Suite </option>&#13;
			<option label="Another cabin type not listed " value="another-cabin-type-not-listed-">Another cabin type not listed </option>&#13;
			<option label="Doesn't matter as long as I'm on the ship" value="doesnt-matter-as-long-as-im-on-the-ship">Doesn't matter as long as I'm on the ship</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Requested Location?&amp;nbsp;" description="Preference on cabin location on the ship" name="requested-location-" className="form-control">&#13;
			<option label="Forward (Front of the ship) " value="forward-front-of-the-ship-">Forward (Front of the ship) </option>&#13;
			<option label="Mid Ship (Middle of the ship)" value="mid-ship-middle-of-the-ship">Mid Ship (Middle of the ship)</option>&#13;
			<option label="Aft (Back of the ship)" value="aft-back-of-the-ship">Aft (Back of the ship)</option>&#13;
			<option label="Doesn't matter (As long as I'm on the ship) " value="doesnt-matter-as-long-as-im-on-the-ship-">Doesn't matter (As long as I'm on the ship) </option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Does anyone require an accessible cabin?&amp;nbsp;" description="For wheelchair  vision/hearing impaired  limited mobility, etc." name="does-anyone-require-an-accessible-cabin-" className="form-control">&#13;
			<option label="No " value="no-">No </option>&#13;
			<option label="Yes- hearing or vision impaired " value="yes-hearing-or-vision-impaired-">Yes- hearing or vision impaired </option>&#13;
			<option label="Yes- for limited mobility " value="yes-for-limited-mobility-">Yes- for limited mobility </option>&#13;
			<option label="Yes- fully accessible for use of wheelchair or scooter" value="yes-fully-accessible-for-use-of-wheelchair-or-scooter">Yes- fully accessible for use of wheelchair or scooter</option>&#13;
		</field>&#13;
		<field type="text" label="Does anyone require any special accommodations or have allergies? If so please list details below.&amp;nbsp;" description="This would include cpap machine  insulin  oxygen concentrator  etc." name="does-anyone-require-any-special-accommodations-or-have-allergies-if-so-please-list-details-below-" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Group placement&amp;nbsp;" description="The location of the rooms on the ship" name="group-placement-" className="form-control">&#13;
			<option label="I would like for the rooms to be on the same floor " value="i-would-like-for-the-rooms-to-be-on-the-same-floor-">I would like for the rooms to be on the same floor </option>&#13;
			<option label="I would like for the room to be on the same side of the ship" value="i-would-like-for-the-room-to-be-on-the-same-side-of-the-ship">I would like for the room to be on the same side of the ship</option>&#13;
			<option label="It doesn't matter as long as we are all on the boat " value="it-doesnt-matter-as-long-as-we-are-all-on-the-boat-">It doesn't matter as long as we are all on the boat </option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Will anyone be pregnant on this sailing?" name="will-anyone-be-pregnant-on-this-sailing" className="form-control">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Does not apply" value="does-not-apply">Does not apply</option>&#13;
			<option label="Unsure" value="unsure">Unsure</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Add-Ons &amp;amp; Services"/>&#13;
		<field type="checkbox-group" required="true" label="Would you like assistance with flights?&amp;nbsp;" name="would-you-like-assistance-with-flights-">&#13;
			<option label="Yes " value="No">Yes </option>&#13;
			<option label="Not Sure " value="not-sure-">Not Sure </option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Will your group need cruise transfers?&amp;nbsp;" description="Transportation from the airport/hotel to and from the cruise port" name="will-your-group-need-cruise-transfers-">&#13;
			<option label="Yes " value="No">Yes </option>&#13;
			<option label="Not Sure " value="not-sure-">Not Sure </option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Are pre- or post-cruise hotels needed?&amp;nbsp;" description="Transportation from the airport/hotel to and from the cruise port" name="are-pre-or-postcruise-hotels-needed-">&#13;
			<option label="Yes " value="No">Yes </option>&#13;
			<option label="Not Sure " value="not-sure-">Not Sure </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Departure city / airport code&amp;nbsp;" description="Example: CVG- Cincinnati/KY Airport" name="what-is-your-airport-code-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What state are you are resident of?&amp;nbsp;" description="Discounts are often associated with state of residence." name="what-state-are-you-are-resident-of-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Gratuities &amp;amp; Insurance"/>&#13;
		<field type="select" required="true" label="Would you like gratuities included in pricing?&amp;nbsp;" description="Gratuities are tips added into your cruise fare" name="would-you-like-to-add-on-the-prepaid-gratuities-during-sailing-" className="form-control">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Are you interested in travel insurance?" description="Insurance is highly recommended and is a great benefit." name="are-you-adding-insurance-to-your-sailing-" className="form-control">&#13;
			<option label="Yes - I want to add insurance " value="yes-i-want-to-add-insurance-">Yes - I want to add insurance </option>&#13;
			<option label="No - I  do not want insurance " value="no-i-do-not-want-insurance-">No - I  do not want insurance </option>&#13;
			<option label="I am unsure - I would like to hear more. " value="i-am-unsure-i-would-like-to-hear-more-">I am unsure - I would like to hear more. </option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like to add on the prepaid gratuities?&amp;nbsp; during sailing.&amp;nbsp;" description="I understand that If I do not prepay now they will automatically  add it to my onboard account during sailing." name="select-1768090975977" className="form-control">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Budget &amp;amp; Notes&amp;nbsp;"/>&#13;
		<field type="textarea" label="Estimated budget range per person or per cabin&amp;nbsp;" description="This helps with drafting the proposal" name="estimated-budget-range-per-person-or-per-cabin-" className="form-control"/>&#13;
		<field type="textarea" label="Any additional notes, requests, or questions?" description="This helps with drafting the proposal" name="any-additional-notes-requests-or-questions" rows="1" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Final Disclaimer (Important) Submitting this form does not confirm a booking or reserve space. Cruise availability and pricing are subject to change until deposits are made. Group space is limited and not guaranteed until confirmed."/>&#13;
	</fields>&#13;
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