Share your information with Yessy Yip-Martinez

Yessy Yip-Martinez

GenEscapes

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field>&#13;
		<field type="header" subtype="h2" label="Let&#39;s Go to Disney!"/>&#13;
		<field type="paragraph" subtype="p" label="Hi! My name is Yessy and I am so happy you chose me to help plan your Disney/Universal vacation!&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="Please keep in mind: Theme park tickets cost between $150 and $200 USD per ticket per day, and Disney/Universal hotels start at $200 USD per night."/>&#13;
		<field type="paragraph" subtype="p" label="To give you the service you deserve, please complete the following information and I will gladly contact you by phone to start planning your trip."/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" subtype="tel" required="true" label="Phone number" name="phone-number" className="form-control"/>&#13;
		<field type="text" subtype="email" required="true" label="Email Address" name="email" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Which destination would you like to visit?" name="destination" className="checkbox-group">&#13;
			<option label="Walt Disney World (Orlando, Florida)" value="walt-disney-world-orlando-florida">Walt Disney World (Orlando, Florida)</option>&#13;
			<option label="Disneyland (Los Angeles, California)" value="disneyland-los-angeles-california">Disneyland (Los Angeles, California)</option>&#13;
			<option label="Universal, Orlando" value="universal-orlando">Universal, Orlando</option>&#13;
			<option label="Universal California" value="universal-california">Universal California</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How many days do you want to visit the parks?" name="days-in-parks" className="radio-group">&#13;
			<option label="3 (I am unable to do less than 3)" value="3-i-am-unable-to-do-less-than-3">3 (I am unable to do less than 3)</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="More than 5" value="more-than-5">More than 5</option>&#13;
			<option label="I want a cruise" value="i-want-a-cruise">I want a cruise</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Select the month you would like to travel" name="month-to-travel" className="checkbox-group">&#13;
			<option label="September 2026" value="september-2026">September 2026</option>&#13;
			<option label="October 2026" value="october-2026">October 2026</option>&#13;
			<option label="November 2026" value="november-2026">November 2026</option>&#13;
			<option label="December 2026" value="december-2026">December 2026</option>&#13;
			<option label="January 2027" value="january-2027">January 2027</option>&#13;
			<option label="February 2027" value="february-2027">February 2027</option>&#13;
			<option label="March 2027" value="march-2027">March 2027</option>&#13;
			<option label="April 2027" value="april-2027">April 2027</option>&#13;
			<option label="May 2027" value="may-2027">May 2027</option>&#13;
			<option label="June 2027" value="june-2027">June 2027</option>&#13;
			<option label="July 2027" value="july-2027">July 2027</option>&#13;
			<option label="August 2027" value="august-2027">August 2027</option>&#13;
			<option label="September 2027" value="september-2027">September 2027</option>&#13;
			<option label="October 2027" value="october-2027">October 2027</option>&#13;
			<option label="November 2027 onwards..." value="november-2027-onwards">November 2027 onwards...</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How many people are traveling in your group?" name="number-of-travelers" className="radio-group">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7+" value="7-plus">7+</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="If there are children, please add their ages at the time of travel:" name="children-ages" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget per person?" description="This just gives me a general starting point and can always be changed later." name="budget" className="radio-group">&#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="textarea" required="true" label="How many rooms and beds are you looking for?" name="textarea-1785831358326" className="form-control"/>&#13;
		<field type="textarea" label="Will you need transportation?" name="textarea-1785831567749" className="form-control"/>&#13;
		<field type="textarea" label="Tell me a little about your trip :) Anything you&#39;d like to share to make your trip magical:" name="trip-notes" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="And lastly, how did you hear about us?" name="referral-source" className="radio-group">&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="TikTok" value="tiktok">TikTok</option>&#13;
			<option label="A friend traveled with you" value="friend-traveled">A friend traveled with you</option>&#13;
			<option label="I have already traveled with you :)" value="repeat-client">I have already traveled with you :)</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>