<html> <body> <form-template> <fields> <field type="checkbox-group" label="Which Agent Would You Like To Contact You?" inline="true" name="which-agent-would-you-like-to-contact-you"> <option label="T'Sheeka" value="tsheeka">T'Sheeka</option> <option label="Belinda" value="belinda">Belinda</option> <option label="Adjournia " value="adjournia-">Adjournia </option> <option label="Elizabeth " value="elizabeth-">Elizabeth </option> </field> <field type="header" subtype="h1" label="DISNEY VACATION INQUIRY FORM"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <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" required="true" 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="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="radio-group" label="Please select all that apply to you:" name="please-select-all-that-apply-to-you"> <option label="Disney Visa Cardholder" value="disney-visa-cardholder">Disney Visa Cardholder</option> <option label="Annual Passholder" value="annual-passholder">Annual Passholder</option> <option label="Military" value="military">Military</option> <option label="Other" value="other">Other</option> <option label="None of the above" value="none-of-the-above">None of the above</option> </field> <field type="text" label="Number of Adults (18 and older):" name="number-of-adults-18-and-older" subtype="text" className="form-control"/> <field type="text" required="true" label="Number of Children:" name="number-of-children" subtype="text" className="form-control"/> <field type="text" required="true" label="Names and dates of birth for everyone travelling if available." name="names-and-dates-of-birth-for-everyone-travelling-if-available" subtype="text" className="form-control"/> <field type="text" required="true" label="Travel Dates:" name="travel-dates" subtype="text" className="form-control"/> <field type="text" label="Comments?" name="comments" subtype="text" className="form-control"/> <field type="radio-group" label="Which Disney destination are you inquiring about?" name="which-disney-destination-are-you-inquiring-about"> <option label="Walt Disney World" value="walt-disney-world">Walt Disney World</option> <option label="Disneyland" value="disneyland">Disneyland</option> <option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option> <option label="Adventures by Disney" value="adventures-by-disney">Adventures by Disney</option> <option label="Other" value="other">Other</option> </field> <field type="text" required="true" label="Do you need rental car? If yes, how many day?" name="do-you-need-rental-car-if-yes-how-many-day" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="If interested in traveling to Walt Disney World...."/> <field type="radio-group" label="Which resort would you like to stay at?" name="which-resort-would-you-like-to-stay-at"> <option label="Value Resorts $" value="value-resorts-">Value Resorts $</option> <option label="Moderate Resorts $$" value="moderate-resorts-">Moderate Resorts $$</option> <option label="Deluxe Resorts $$$" value="deluxe-resorts-">Deluxe Resorts $$$</option> <option label="Deluxe Villas $$$$" value="deluxe-villas-">Deluxe Villas $$$$</option> </field> <field type="text" required="true" label="Number of rooms needed:" name="number-of-rooms-needed" subtype="text" className="form-control"/> <field type="text" required="true" label="How many days of Base Disney Park Tickets would you like?" name="how-many-days-of-base-disney-park-tickets-would-you-like" subtype="text" className="form-control"/> <field type="radio-group" label="Additional Park Ticket Upgrades (please select one, if applicable):" name="additional-park-ticket-upgrades-please-select-one-if-applicable"> <option label="Park Hopper Option (includes same-day admission to all four parks)" value="park-hopper-option-includes-sameday-admission-to-all-four-parks">Park Hopper Option (includes same-day admission to all four parks)</option> <option label="Water Park & Sports (includes admission to one park per day plus visits to water parks and other fun)" value="water-park-sports-includes-admission-to-one-park-per-day-plus-visits-to-water-parks-and-other-fun">Water Park & Sports (includes admission to one park per day plus visits to water parks and other fun)</option> <option label="Park Hopper Plus Option (includes same-day admission to all four parks plus visits to water parks and other fun)" value="park-hopper-plus-option-includes-sameday-admission-to-all-four-parks-plus-visits-to-water-parks-and-other-fun">Park Hopper Plus Option (includes same-day admission to all four parks plus visits to water parks and other fun)</option> </field> <field type="radio-group" label="Additional Add-Ons / Interests (please select all that apply):" name="additional-addons-interests-please-select-all-that-apply"> <option label="Disney Golf" value="disney-golf">Disney Golf</option> <option label="Cirque du Soleil" value="cirque-du-soleil">Cirque du Soleil</option> <option label="Airfare" value="airfare">Airfare</option> <option label="Ground Transportation" value="ground-transportation">Ground Transportation</option> </field> <field type="text" label="If airfare is needed, from what city?" name="if-airfare-is-needed-from-what-city" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="If interested in sailing on the Disney Cruise Line..."/> <field type="text" label="Sail Dates:" name="sail-dates" subtype="text" className="form-control"/> <field type="radio-group" label="Ship Preference" name="ship-preference"> <option label="Disney Magic " value="disney-magic-">Disney Magic </option> <option label="Disney Wonder " value="disney-wonder-">Disney Wonder </option> <option label="Disney Dream" value="disney-dream">Disney Dream</option> <option label="Disney Fantasy" value="disney-fantasy">Disney Fantasy</option> <option label="Disney Wish" value="disney-wish">Disney Wish</option> <option label="Disney Treasure - Coming2024" value="disney-treasure-coming2024">Disney Treasure - Coming2024</option> </field> <field type="radio-group" label="Stateroom Type:" name="stateroom-type"> <option label="Inside Stateroom " value="inside-stateroom-">Inside Stateroom </option> <option label="Ocean View Stateroom " value="ocean-view-stateroom-">Ocean View Stateroom </option> <option label="Verandah Stateroom " value="verandah-stateroom-">Verandah Stateroom </option> <option label="Concierge Level" value="concierge-level">Concierge Level</option> </field> <field type="text" label="Number of Staterooms needed:" name="number-of-staterooms-needed" subtype="text" className="form-control"/> <field type="text" label="If there is anything else that you would like us to know about your vacation, please share!" description="Examples: Dietary Restrictions Special Occasions etc." name="if-there-is-anything-else-that-you-would-like-us-to-know-about-your-vacation-please-share" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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