Share your information with Leila Shiekhy

Leila Shiekhy

Beyond Grace Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let’s plan your next vacation! ✨&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="Since 2026, I’ve been helping families create amazing trips full of memories to last a lifetime. Now, I’d love to do the same for you!"/>&#13;
		<field type="paragraph" subtype="p" label="To get started, I’ll just need a few details about your family and your travel wishes. My goal is simple: to understand what matters most to you, so I can recommend the perfect vacation that fits you personally!"/>&#13;
		<field type="header" subtype="h2" label="Client 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="checkbox-group" label="By providing your phone number below, you agree to receive text messages from me as your Travel Advisor. Do you understand?" toggle="true" name="checkbox-group-1763328412223">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Privacy Policy can be found here: https://www.beyondgracetravels.com/privacy-policy"/>&#13;
		<field type="header" subtype="h2" label="Trip Questions"/>&#13;
		<field type="checkbox-group" label="Where would you like to go?" name="where-would-you-like-to-go" other="true">&#13;
			<option label="Disney World (FL)" value="disney-world-fl">Disney World (FL)</option>&#13;
			<option label="Disneyland (CA)" value="disneyland-ca">Disneyland (CA)</option>&#13;
			<option label="Disney's Aulani Resort in Hawaii" value="disneys-aulani-resort-in-hawaii">Disney's Aulani Resort in Hawaii</option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="Disney Escapes" value="disney-escapes">Disney Escapes</option>&#13;
			<option label="Adventures by Disney" value="adventures-by-disney">Adventures by Disney</option>&#13;
			<option label="Universal Orlando" value="universal-orlando">Universal Orlando</option>&#13;
			<option label="Universal Hollywood" value="universal-hollywood">Universal Hollywood</option>&#13;
			<option label="Royal Caribbean Cruise" value="royal-caribbean-cruise">Royal Caribbean Cruise</option>&#13;
			<option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option>&#13;
		</field>&#13;
		<field type="date" label="Desired date of arrival?" 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" label="Desired date of departure?" 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="radio-group" required="true" label="What is your approximate budget for the accommodations and/or park tickets?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$2000-$4000" value="20004000">$2000-$4000</option>&#13;
			<option label="$4,000 to $6,000" value="4000-to-6000">$4,000 to $6,000</option>&#13;
			<option label="$6,000 to $8,000" value="6000-to-8000">$6,000 to $8,000</option>&#13;
			<option label="$8,000+" value="8000">$8,000+</option>&#13;
		</field>&#13;
		<field type="textarea" label="How many adults will be traveling?&amp;nbsp;" name="please-list-all-adult-traveler-names-18" className="form-control"/>&#13;
		<field type="textarea" label="How many children will be traveling? Please include their ages at time of travel for accurate pricing." name="please-list-names-and-dates-of-birth-for-all-travelers" className="form-control"/>&#13;
		<field type="select" label="What type of package are you interested in?" name="what-type-of-package-are-you-interested-in" className="form-control">&#13;
			<option label="Room &amp; Tickets" value="room-tickets">Room &amp; Tickets</option>&#13;
			<option label="Room Only" value="room-only">Room Only</option>&#13;
			<option label="Tickets Only" value="tickets-only">Tickets Only</option>&#13;
			<option label="Cruise" value="Cruise-only">Cruise</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you eligible for any of the following discounts?" name="are-you-eligible-for-any-of-the-following-discounts">&#13;
			<option label="None" value="none">None</option>&#13;
			<option label="Active, Retired, or 100% Disabled Military" value="active-retired-or-100-disabled-military">Active, Retired, or 100% Disabled Military</option>&#13;
			<option label="Disney Chase Visa Cardholder" value="disney-chase-visa-cardholder">Disney Chase Visa Cardholder</option>&#13;
			<option label="Annual Passholder" value="annual-passholder">Annual Passholder</option>&#13;
			<option label="Active Disney+ Subscriber" value="active-disney-subscriber">Active Disney+ Subscriber</option>&#13;
			<option label="Florida Resident" value="florida-resident">Florida Resident</option>&#13;
			<option label="California Resident" value="california-resident">California Resident</option>&#13;
			<option label="Canadian Resident" value="canadian-resident">Canadian Resident</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What additional extras or activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
			<option label="Bibbidi Bobbidi Boutique " value="bibbidi-bobbidi-boutique-">Bibbidi Bobbidi Boutique </option>&#13;
			<option label="Memory Maker" value="memory-maker">Memory Maker</option>&#13;
			<option label="Help with Dining Reservations" value="help-with-dining-reservations">Help with Dining Reservations</option>&#13;
			<option label="Enchanting Extras" value="enchanting-extras">Enchanting Extras</option>&#13;
			<option label="VIP Tour" value="vip-tour">VIP Tour</option>&#13;
		</field>&#13;
		<field type="text" label="Celebrating anything on this trip?" description="ex: Birthday  Wedding  Anniversary  Personal Triumph?" placeholder="Ex: First Visit  Birthday  Anniversary  Etc." name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Anything else that you&#39;d like me to know about this trip?" placeholder="Ex: Traveling with others | King sized bed | Resort Choice | Ground Floor | Accessible Room" name="notes" className="form-control"/>&#13;
		<field type="text" label="How did you hear about me?" description="ex: Facebook  Instagram  Friend Referral" name="how-did-you-hear-about-me" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Thank you!"/>&#13;
		<field type="paragraph" subtype="p" label="I look forward to working with you! Please allow 24-48 hours for a response."/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>