<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="INQUIRY - AUSTRAILIA/NEW ZEALAND"/> <field type="header" subtype="h1" label="Client Information"/> <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="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="date" label="Birthday" name="birthday" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="textarea" label="Would you like to add anyone to our communications? Please list their name(s) and email(s) below.&nbsp;" name="would-you-like-to-add-anyone-to-our-communications-please-list-their-names-and-emails-below-" className="form-control"/> <field type="header" subtype="h1" label="About Your Trip"/> <field type="textarea" required="true" label="What is the purpose for this vacation? Can you explain a little bit about what you're looking for?&nbsp;" name="what-is-the-purpose-for-this-vacation-can-you-explain-a-little-bit-about-what-youre-look-for-" className="form-control"/> <field type="textarea" label="Please list the full names of travelers AND their birthdays. If there will be multiple rooms, please provide a breakdown of who goes in each room:&nbsp;" name="please-list-the-full-names-of-travelers-and-their-birthdays-if-there-will-be-multiple-rooms-please-provide-a-breakdown-of-who-goes-in-each-room-" className="form-control"/> <field type="checkbox-group" required="true" label="Preferred Destination(s) to visit on this trip:&nbsp;" name="preferred-destinations-to-visit-on-this-trip-" other="true"> <option label="New Zealand North Island" value="new-zealand-north-island">New Zealand North Island</option> <option label="New Zealand South Island" value="new-zealand-south-island">New Zealand South Island</option> <option label="Sydney" value="sydney">Sydney</option> <option label="Brisbane" value="brisbane">Brisbane</option> <option label="Great Barrier Reef" value="great-barrier-reef">Great Barrier Reef</option> <option label="Melbourne" value="melbourne">Melbourne</option> </field> <field type="text" label="Are there any destinations that you want to avoid:&nbsp;" name="are-there-any-destinations-that-you-want-to-avoid-" subtype="text" className="form-control"/> <field type="date" required="true" label="When would you like to depart?&nbsp;" name="when-would-you-like-to-depart-" className="form-control"/> <field type="date" required="true" label="When would you like to return?&nbsp;" name="when-would-you-like-to-return-" className="form-control"/> <field type="radio-group" required="true" label="Are your dates flexible?&nbsp;" name="are-your-dates-flexible-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="If flexible, please share a date range. *If sharing a range of dates, please list exact date ranges vs. general availability.&nbsp;" name="if-flexible-please-share-a-date-range-if-sharing-a-range-of-dates-please-list-exact-date-ranges-vs-general-availability-" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="What is your estimated investment for all travelers (excluding flights, excursions, and optional travel insurance)? For reference, our full-service itineraries including accommodations, private ground transportation and tours typically start at $8k-$12k/couple/week, depending on the destination" name="what-is-your-estimated-investment-for-all-travelers-excluding-flights-excursions-and-optional-travel-insurance-"> <option label="$8,000-$12,000" value="800012000">$8,000-$12,000</option> <option label="$12,000-$15,000" value="1200015000">$12,000-$15,000</option> <option label="$15,000+" value="15000">$15,000+</option> <option label="Not Listed Above" value="not-listed-above">Not Listed Above</option> </field> <field type="checkbox-group" required="true" label="Which of the following is important to you (check all that apply)?" name="which-of-the-following-is-important-to-you-check-all-that-apply" other="true"> <option label="Authentic/Local Accommodations (3-4 Star)" value="authenticlocal-accommodations-34-star">Authentic/Local Accommodations (3-4 Star)</option> <option label="Boutique Hotel " value="boutique-hotel-">Boutique Hotel </option> <option label="Villa/Condo Resort" value="villacondo-resort">Villa/Condo Resort</option> <option label="Luxury Resort (5 Star)" value="luxury-resort-5-star">Luxury Resort (5 Star)</option> <option label="Adult-Only Hotel " value="adultonly-hotel-">Adult-Only Hotel </option> <option label="Beach On-Site " value="beach-onsite-">Beach On-Site </option> <option label="Multiple Restaurants On-Site " value="multiple-restaurants-onsite-">Multiple Restaurants On-Site </option> <option label="Spa On-Site" value="spa-onsite">Spa On-Site</option> <option label="Gym On-Site " value="gym-onsite-">Gym On-Site </option> <option label="AC Required" value="ac-required">AC Required</option> <option label="Handicap Accessible " value="handicap-accessible-">Handicap Accessible </option> </field> <field type="checkbox-group" required="true" label="Room Preference:&nbsp;" name="room-preference-" other="true"> <option label="King Preferred (with Sleeper Sofa, if applicable) " value="king-preferred-with-sleeper-sofa-if-applicable-">King Preferred (with Sleeper Sofa, if applicable) </option> <option label="2 Queens (or 2 beds)" value="2-queens-or-2-beds">2 Queens (or 2 beds)</option> <option label="Connecting Rooms" value="connecting-rooms">Connecting Rooms</option> <option label="Suite (Bedroom and Den Space separated by a door)" value="suite-bedroom-and-den-space-separated-by-a-door">Suite (Bedroom and Den Space separated by a door)</option> <option label="Villa/Condo/House (Multiple Bedrooms and Living Space)" value="villacondohouse-multiple-bedrooms-and-living-space">Villa/Condo/House (Multiple Bedrooms and Living Space)</option> </field> <field type="radio-group" label="If applicable, is it a deal breaker if rooms do not connect?&nbsp;" name="if-applicable-is-it-a-deal-breaker-if-rooms-do-not-connect-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="Activities of Interest: (this helps us place you in the correct locations)&nbsp;" name="activities-of-interest-this-helps-us-place-you-in-the-correct-locations-" other="true"> <option label="Jetboating" value="jetboating">Jetboating</option> <option label="Kayak/Canoe" value="kayakcanoe">Kayak/Canoe</option> <option label="Bungy" value="bungy">Bungy</option> <option label="Zip-lining" value="ziplining">Zip-lining</option> <option label="Hang-gliding/Parasailing" value="hangglidingparasailing">Hang-gliding/Parasailing</option> <option label="Hiking" value="hiking">Hiking</option> <option label="Mountain Biking" value="mountain-biking">Mountain Biking</option> <option label="Horseback Riding" value="horseback-riding">Horseback Riding</option> <option label="Whitewater rafting" value="whitewater-rafting">Whitewater rafting</option> <option label="Helicopter/Small Plane Tour" value="helicoptersmall-plane-tour">Helicopter/Small Plane Tour</option> <option label="Cultural Visits" value="cultural-visits">Cultural Visits</option> <option label="Interaction With Wildlife " value="interaction-with-wildlife-">Interaction With Wildlife </option> <option label="Wineries" value="wineries">Wineries</option> <option label="Surfing" value="surfing">Surfing</option> </field> <field type="radio-group" required="true" label="These locations require longer travel times and transfers. Does anyone in your party get car sick?&nbsp;" name="these-locations-require-longer-travel-times-and-transfers-does-anyone-in-your-party-get-car-sick-" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Is everyone a US citizen, with a passport valid for at least 6 months after your return?&nbsp;" name="is-everyone-a-us-citizen-with-a-passport-valid-for-at-least-6-months-after-your-return-" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Final Notes To Further Customize Your Travel"/> <field type="radio-group" required="true" label="Are you interested in adding our Concierge Services for detailed itinerary planning to include dining reservations, spa, and recreational bookings?&nbsp;" name="are-you-interested-in-adding-our-concierge-services-for-detailed-itinerary-planning-to-include-dining-reservations-spa-and-recreational-bookings-"> <option label="Yes, I am interested" value="yes-i-am-interested">Yes, I am interested</option> <option label="No, I will book these myself" value="no-i-will-book-these-myself">No, I will book these myself</option> <option label="Unsure, can we talk about this more?" value="unsure-can-we-talk-about-this-more">Unsure, can we talk about this more?</option> </field> <field type="radio-group" required="true" label="I understand Professional Planning Fees are associated based on the level of services required. Please note, that we have a Fee Structure for our professional planning services. These fees vary based on the type of trip and level of service required. This will be discussed on your complimentary planning call with your agent." name="i-understand-professional-planning-fees-are-associated-based-on-the-level-of-services-required-please-note-that-we-have-a-fee-structure-for-our-professional-planning-services-these-fees-vary-based-on-the-type-of-trip-and-level-of-service-required-this-will-be-discussed-on-your-complimentary-planning-call-with-your-agent"> <option label="Yes, I understand" value="yes-i-understand">Yes, I understand</option> <option label="I'm confused, please explain further" value="im-confused-please-explain-further">I'm confused, please explain further</option> </field> <field type="textarea" label="Any other notes on your preferences or dreams for this trip to help me tailor it for you?" name="any-other-notes-on-your-preferences-or-dreams-for-this-trip-to-help-me-tailor-it-for-you" className="form-control"/> </fields> </form-template> </body> </html>
SUBMIT FORM
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