Share your information with Allysa Hall

Allysa Hall

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let&#39;s Plan your Disney Vacation!"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex:  Walt Disney World, Disneyland, Disney Cruise Line, or Disneyland Paris" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" 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" required="true" label="When would you like to return?" 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="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many travelers? Ages of children?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#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="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What kind of Disney Resort vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Family Magic" value="family-magic">Family Magic</option>&#13;
			<option label="Romantic Escape" value="romantic-escape">Romantic Escape</option>&#13;
			<option label="Celebration" value="celebration">Celebration</option>&#13;
			<option label="Adult Only" value="adult-only">Adult Only</option>&#13;
			<option label="Disney Themed" value="disney-themed">Disney Themed</option>&#13;
			<option label="Large Family" value="large-family">Large Family</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Permissions" description="Check all that apply." name="checkbox-group-1766875666362">&#13;
			<option label="YES! I give permission for Pixie Perfect Vacations LLC to contact me via email, text and/or phone regarding my travel inquiry and trip planning!" value="yes-i-give-permission-for-pixie-perfect-vacations-llc-to-contact-me-via-email-text-andor-phone-regarding-my-travel-inquiry-and-trip-planning">YES! I give permission for Pixie Perfect Vacations LLC to contact me via email, text and/or phone regarding my travel inquiry and trip planning!</option>&#13;
			<option label="YES! Sign me up for email updates, exclusive travel offers, and a little extra pixie dust from Pixie Perfect Vacations LLC." value="yes-sign-me-up-for-email-updates-exclusive-travel-offers-and-a-little-extra-pixie-dust-from-pixie-perfect-vacations-llc">YES! Sign me up for email updates, exclusive travel offers, and a little extra pixie dust from Pixie Perfect Vacations LLC.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>