Share your information with Missy Rodriguez

Missy Rodriguez

Missy with Pixie Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Name &amp;amp; Contact 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" 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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many people are going on this trip?" name="how-many-people-are-going-on-this-trip" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are children going on this trip?" description="Under 18" name="radio-group-1768930626479">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768930681116" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzY4OTMwNjI2NDc5Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJwbGVhc2UtbGlzdC10aGUtY2hpbGRyZW5zLWFnZXMiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJwbGVhc2UtbGlzdC10aGUtY2hpbGRyZW5zLWFnZXMiLCJsYWJlbCI6IlBsZWFzZSBsaXN0IHRoZSBjaGlsZHJlbidzIGFnZXMgYXQgdGltZSBvZiB0cmlwLiJ9XX0="/>&#13;
		<field type="text" label="Please list the children&#39;s ages at time of trip." name="please-list-the-childrens-ages" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="pageBreak" name="pageBreak-1771466778939" next="Next" previous="Previous"/>&#13;
		<field type="date" required="true" label="What is your Preferred Check In Date?" name="date-1771466554036" className="form-control"/>&#13;
		<field type="date" required="true" label="What is your Preferred Check Out Date?" name="date-1771466574060" className="form-control"/>&#13;
		<field type="radio-group" label="Are these dates flexible?" name="radio-group-1768930072124">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What TWO things are most important to you when choosing your resort?" name="what-two-things-are-most-important-to-you-when-choosing-your-resort">&#13;
			<option label="Price" value="price">Price</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Amenities" value="amenities">Amenities</option>&#13;
			<option label="Multiple Transportation Options to Parks" value="multiple-transportation-options-to-parks">Multiple Transportation Options to Parks</option>&#13;
			<option label="Proximity to the Parks" value="proximity-to-the-parks">Proximity to the Parks</option>&#13;
			<option label="Suite/Villa Availability" value="suitevilla-availability">Suite/Villa Availability</option>&#13;
			<option label="Universal Express Passes Included" value="universal-express-passes-included">Universal Express Passes Included</option>&#13;
			<option label="Club Level" value="club-level">Club Level</option>&#13;
		</field>&#13;
		<field type="textarea" label="Is there a specific resort you&amp;nbsp; would like included in your quote?" name="textarea-1771466834445" className="form-control"/>&#13;
		<field type="textarea" label="Is there anything else you&#39;d like to tell me about this trip? Any special needs or concerns? Any special celebrations?" name="textarea-1771466858401" className="form-control"/>&#13;
		<field type="text" label="If someone referred you, please share their name here so that I may thank them!" name="text-1771466870640" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>