Share your information with Carey Powell

Carey Powell

Travelmation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Disneyland Trip Quote Request"/>&#13;
		<field type="paragraph" subtype="p" label="Please fill out this form so we can start planning your Disneyland dream vacation!"/>&#13;
		<field type="header" subtype="h1" label="Personal Information"/>&#13;
		<field type="text" required="true" label="Email" placeholder="Your answer" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Lead Guest First Name" placeholder="Your answer" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Lead Guest Last Name" placeholder="Your answer" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred Name" placeholder="Your answer" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone Number" placeholder="Your answer" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Details"/>&#13;
		<field type="text" required="true" label="Will you be traveling with other adults? Please list their names &amp;nbsp;below. (Example: Susie Jones)" name="will-you-be-traveling-with-other-adults-list-their-names-and-birthdates-below-example-susie-jones-131985" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Will you be traveling with children? Please list their names and birthdates below. (Example: Susie Jones 1/3/2018)" name="will-you-be-traveling-with-children-list-their-names-and-birthdates-below-example-susie-jones-132018" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Departure Date" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" value="2023-02-07" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Return Date" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" value="2023-03-16" className="form-control"/>&#13;
		<field type="text" required="true" label="Will you be celebrating a special occasion? First Visit, Birthday, Anniversary, Honeymoon, etc." name="text-1736986374342" value="Your answer" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Have you visited Disneyland before? If so, when?&amp;nbsp;" placeholder="Your answer" name="if-you-want-to-stay-at-an-offsitegood-neighor-hotel-is-there-a-specific-one-your-are-interested-in" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Park and Ticket Preferences"/>&#13;
		<field type="text" label="Number of Park Days:" placeholder="Your answer" name="text-1736986534025" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Preferred Ticket Type:" name="will-you-need-the-following-">&#13;
			<option label="Park tickets: one park each day" value="park-tickets-one-park-each-day">Park tickets: one park each day</option>&#13;
			<option label="Park Hoppers (visit both parks in the same day)" value="park-hoppers-visit-both-parks-in-the-same-day">Park Hoppers (visit both parks in the same day)</option>&#13;
			<option label="Lightning Lane Multi Pass" value="lightning-lane-multi-pass">Lightning Lane Multi Pass</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have any must-do attractions or experiences?&amp;nbsp;" placeholder="Your answer" name="text-1736986473770" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Dining and Extras"/>&#13;
		<field type="checkbox-group" required="true" label="What type of dining are you interested in?&amp;nbsp;" name="do-you-want-to-stay-in-a-disneyland-resort-or-offsite">&#13;
			<option label="Quick Service" value="quick-service">Quick Service</option>&#13;
			<option label="Table Service" value="table-service">Table Service</option>&#13;
			<option label="Character Dining" value="character-dining">Character Dining</option>&#13;
		</field>&#13;
		<field type="text" label="Would you like assistance with dining reservations?&amp;nbsp;" placeholder="Your answer" name="text-1736986606191" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you have any dietary restrictions or allergies?&amp;nbsp;" placeholder="Your answer" name="text-1736986761715" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Accommodations"/>&#13;
		<field type="checkbox-group" required="true" label="Do you want to stay in a Disneyland Resort ? Or Off-site?" name="checkbox-group-1736986680222">&#13;
			<option label="Disneyland Resort Hotel" value="disneyland-resort-hotel">Disneyland Resort Hotel</option>&#13;
			<option label="Good Neighbor Hotel (near the theme parks)" value="good-neighbor-hotel-near-the-theme-parks">Good Neighbor Hotel (near the theme parks)</option>&#13;
			<option label="I am open to both" value="i-am-open-to-both">I am open to both</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Room Preference:&amp;nbsp;" name="checkbox-group-1736986843690">&#13;
			<option label="Standard" value="standard">Standard</option>&#13;
			<option label="View Room" value="view-room">View Room</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="If you want to stay at an Off-site/Good Neighbor Hotel is there a specific one you are interested in?" placeholder="Your answer" name="text-1736986733641" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Transportation"/>&#13;
		<field type="text" label="Do you need assistance with flights? If so, what is your departure airport?&amp;nbsp;" placeholder="Your answer" name="is-there-anything-nondisney-you-would-like-to-do-or-see-while-you-are-on-your-trip-example-spa-golf-other-amusement-parks-etc" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Details"/>&#13;
		<field type="text" label="Do you have any accessibility needs or special requests?" placeholder="Your answer" name="text-1736986904029" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Do any of the following apply to your travel party?" name="do-any-of-the-following-apply-to-your-travel-party">&#13;
			<option label="An active or retired member of the military" value="an-active-or-retired-member-of-the-military">An active or retired member of the military</option>&#13;
			<option label="A California resident" value="a-california-resident">A California resident</option>&#13;
			<option label="A disability or special needs" value="a-disability-or-special-needs">A disability or special needs</option>&#13;
			<option label="A DVC member" value="a-dvc-member">A DVC member</option>&#13;
			<option label="A Magic Key holder" value="a-magic-key-holder">A Magic Key holder</option>&#13;
			<option label="Other-please call me" value="otherplease-call-me">Other-please call me</option>&#13;
		</field>&#13;
		<field type="text" label="What is the most important part of this trip for you?&amp;nbsp;" placeholder="Your answer" name="text-1736986951543" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What is your Disneyland Dream Vacation budget?" name="what-is-your-disnland-dream-vacation-budget">&#13;
			<option label="$1500 to $2500" value="1500-to-2500">$1500 to $2500</option>&#13;
			<option label="$2500 to $4500" value="2500-to-4500">$2500 to $4500</option>&#13;
			<option label="$4500 to $6500" value="4500-to-6500">$4500 to $6500</option>&#13;
			<option label="$6500 to $8500" value="6500-to-8500">$6500 to $8500</option>&#13;
			<option label="$8500 to $10,000" value="8500-to-10000">$8500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="text" label="Anything else I should know to make this the most magical vacation for you?&amp;nbsp;" placeholder="Your answer" name="text-1736987057707" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>