Share your information with Ashley Ridgeway

Ashley Ridgeway

Ashley Ridgeway Travels MMT

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="🌟Request a FREE Travel Insurance Quote🌟"/>&#13;
		<field type="header" subtype="h3" label="Because Your Memories Matter. Let’s Keep Them Protected."/>&#13;
		<field type="paragraph" subtype="p" label="✨ I partner with Travel Insured to offer comprehensive protection tailored to your trip. Complete the form below and I will prepare a personalized quote to help you travel with peace of mind."/>&#13;
		<field type="header" subtype="h1" label="Traveler 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" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State of Residence" name="state-of-residence" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip Code" name="zip-code" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of Birth" name="birthday" className="form-control"/>&#13;
		<field type="text" label="How many travelers should be included on this policy?" name="text-1763348463487" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Dates of birth for all travelers" name="dates-of-birth-for-all-travelers" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Do all adult travelers reside in the same household?" name="do-all-adult-travelers-reside-in-the-same-household" 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="h1" label="Trip Details"/>&#13;
		<field type="checkbox-group" label="Type of Trip" description="Please Select the Closest Match to Your Vacation" name="what-type-of-vacation-are-we-planning-for">&#13;
			<option label="Walt Disney World - Florida" value="walt-disney-world-florida">Walt Disney World - Florida</option>&#13;
			<option label="Disneyland - California" value="disneyland-california">Disneyland - California</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Disney's Aulani Resort &amp; Spa - Hawaii" value="disneys-aulani-resort-spa-hawaii">Disney's Aulani Resort &amp; Spa - Hawaii</option>&#13;
			<option label="Disneyland Paris - France" value="disneyland-paris-france">Disneyland Paris - France</option>&#13;
			<option label="Universal Orlando Resort - Florida" value="universal-orlando-resort-florida">Universal Orlando Resort - Florida</option>&#13;
			<option label="Universal Hollywood Resort - California" value="universal-hollywood-resort-california">Universal Hollywood Resort - California</option>&#13;
			<option label="All-Inclusive Resort in Mexico or the Caribbean" value="allinclusive-resort-in-mexico-or-the-caribbean">All-Inclusive Resort in Mexico or the Caribbean</option>&#13;
			<option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option>&#13;
			<option label="River Cruise" value="river-cruise">River Cruise</option>&#13;
			<option label="Land Tour (private, semi-private or group)" value="land-tour-private-semiprivate-or-group">Land Tour (private, semi-private or group)</option>&#13;
			<option label="Adventures by Disney" value="adventures-by-disney">Adventures by Disney</option>&#13;
			<option label="Expedition Cruise" value="expedition-cruise">Expedition Cruise</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="Destination or Destinations Visiting" name="destination-or-destinations-visiting" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Initial Trip Deposit Date" description="The date you first paid anything toward this trip" name="date-1762822569632" className="form-control"/>&#13;
		<field type="date" label="Arrival Date" name="starting-at" className="form-control"/>&#13;
		<field type="date" label="Departure Date" name="ending-at" className="form-control"/>&#13;
		<field type="text" label="Per traveler trip cost" description="(Include flights  accommodations  tours  and any other prepaid travel expenses)" name="per-traveler-trip-cost" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Total trip cost for all travelers" name="total-trip-cost-for-all-travelers" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know about this trip?" name="what-else-would-you-like-me-to-know" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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