<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Disney World Vacation Request"/> <field type="paragraph" subtype="p" label="I appreciate your interest in working with me to plan your Walt Disney World vacation. Please complete the below information so I can plan the most magical vacation for you.&nbsp;"/> <field type="header" subtype="h1" label="Your Contact Information&nbsp;"/> <field type="paragraph" subtype="p" label="Please Note: The name and date of birth that appear on your identification card must exactly match the data that is listed on your tickets and booking records.&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp;"/> <field type="text" required="true" label="First name" name="first-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="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="h1" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" 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="header" subtype="h1" label="Important Dates"/> <field type="date" required="true" label="Date of Birth" name="birthday" className="form-control"/> <field type="date" label="Anniversary" name="wedding-anniversary" className="form-control"/> <field type="header" subtype="h1" label="Additional Traveler Details"/> <field type="text" required="true" label="How many people will be traveling?&nbsp;" description="Clients will be asked to complete traveler information for all travelers prior to booking." name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" label="Please provide the ages of any travelers who will be under 18 years old at the time of travel." name="please-list-the-date-of-birth-for-any-children-traveling-with-you-" subtype="text" className="form-control"/> <field type="text" label="Accommodation Needs/Requests" description="Visual Auditory Mobility issues/wheelchair use cribs etc." name="accommodation-needsrequests" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Tell me about your trip"/> <field type="checkbox-group" label="Is this your first trip to Walt Disney World?&nbsp;" name="is-this-your-first-trip-to-walt-disney-world-"> <option label="Yes! " value="yes-">Yes! </option> <option label="I've been once before" value="ive-been-once-before">I've been once before</option> <option label="I've been 2-5 times" value="ive-been-25-times">I've been 2-5 times</option> <option label="I've been more than 5 times" value="ive-been-more-than-5-times">I've been more than 5 times</option> </field> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> </field> <field type="text" required="true" label="What is your trip budget?&nbsp; Please indicate a dollar amount as this helps me provide quotes that meet your financial preferences.&nbsp;" placeholder="$5000" name="what-is-your-trip-budget-" subtype="text" className="form-control"/> <field type="radio-group" label="Are you celebrating any special occasions?&nbsp;" inline="true" name="are-you-celebrating-any-special-occasions-" other="true"> <option label="Birthday" value="birthday">Birthday</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Reunion" value="reunion">Reunion</option> <option label="Wedding" value="wedding">Wedding</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> </field> <field type="paragraph" subtype="p" label="&nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h1" label="Resort&nbsp;"/> <field type="checkbox-group" required="true" label="What Resort Category are you interested in?&nbsp;&nbsp;" name="what-type-of-trip-are-you-planning-"> <option label="Value (e.g. Art of Animation)" value="value-eg-art-of-animation">Value (e.g. Art of Animation)</option> <option label="Moderate (e.g. Caribbean Beach)" value="moderate-eg-caribbean-beach">Moderate (e.g. Caribbean Beach)</option> <option label="Deluxe (e.g. Animal Kingdom Lodge)" value="deluxe-eg-animal-kingdom-lodge">Deluxe (e.g. Animal Kingdom Lodge)</option> <option label="We will be booking at Shades of Green (for eligible guests only)" value="we-will-be-booking-at-shades-of-green-for-eligible-guests-only">We will be booking at Shades of Green (for eligible guests only)</option> </field> <field type="text" label="Do you have a preferred resort?&nbsp;" description="If you have more than 1 please list them in order of preference" placeholder="ex: Caribbean Beach" name="destination" subtype="text" className="form-control"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h1" label="Tickets"/> <field type="checkbox-group" required="true" label="How many days would you like to visit the parks?&nbsp;" name="how-many-days-would-you-like-for-your-park-tickets-" other="true"> <option label="Full length of stay (including arrival and departure days)" value="full-length-of-stay-including-arrival-and-departure-days">Full length of stay (including arrival and departure days)</option> <option label="1 per hotel night excluding arrival or departure day (e.g. 5 nights in hotel would be 4 days of tickets)" value="1-per-hotel-night-excluding-arrival-or-departure-day-eg-5-nights-in-hotel-would-be-4-days-of-tickets">1 per hotel night excluding arrival or departure day (e.g. 5 nights in hotel would be 4 days of tickets)</option> <option label="1 per hotel night excluding arrival and departure day (e.g. 5 night stay would be 3 day tickets)" value="1-per-hotel-night-excluding-arrival-and-departure-day-eg-5-night-stay-would-be-3-day-tickets">1 per hotel night excluding arrival and departure day (e.g. 5 night stay would be 3 day tickets)</option> <option label="We'll be purchasing military tickets " value="well-be-purchasing-military-tickets-">We'll be purchasing military tickets </option> </field> <field type="checkbox-group" required="true" label="What type of tickets would you like?&nbsp;&nbsp;" description="Please choose one" name="what-type-of-tickets-would-you-like-"> <option label="Base- Includes admission to one park per day." value="base-includes-admission-to-one-park-per-day">Base- Includes admission to one park per day.</option> <option label="Park Hopper- Includes same-day admission to all 4 theme parks. (Please note park hopping is available after 2pm only)" value="park-hopper-includes-sameday-admission-to-all-4-theme-parks-please-note-park-hopping-is-available-after-2pm-only">Park Hopper- Includes same-day admission to all 4 theme parks. (Please note park hopping is available after 2pm only)</option> <option label="Water Park and Sports Option- Includes admission to one park per day plus visits to a water park or other fun." value="water-park-and-sports-option-includes-admission-to-one-park-per-day-plus-visits-to-a-water-park-or-other-fun">Water Park and Sports Option- Includes admission to one park per day plus visits to a water park or other fun.</option> <option label="Park Hopper Plus Option- Includes same-day admission to all 4 theme parks plus visits to a water park or other fun." value="park-hopper-plus-option-includes-sameday-admission-to-all-4-theme-parks-plus-visits-to-a-water-park-or-other-fun">Park Hopper Plus Option- Includes same-day admission to all 4 theme parks plus visits to a water park or other fun.</option> <option label="We'll be purchasing military tickets" value="well-be-purchasing-military-tickets">We'll be purchasing military tickets</option> </field> <field type="paragraph" subtype="p" label="&nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h1" label="Transporation"/> <field type="checkbox-group" label="How will you be getting to Walt Disney World?&nbsp;" name="how-will-you-be-getting-to-walt-disney-world-" other="true"> <option label="Flying (Please note Disney does not offer packages with flights. That Vacation Lady will help with booking tips)" value="flying-please-note-disney-does-not-offer-packages-with-flights-that-vacation-lady-will-help-with-booking-tips">Flying (Please note Disney does not offer packages with flights. That Vacation Lady will help with booking tips)</option> <option label="Driving" value="driving">Driving</option> <option label="Train" value="train">Train</option> </field> <field type="checkbox-group" required="true" label="Will you need a transportation to/from the resort?&nbsp;" description="Transfers will be included in your quote if needed" name="will-you-need-a-rental-car-"> <option label="Yes- Roundtrip " value="yes-roundtrip-">Yes- Roundtrip </option> <option label="Yes- One Way to the resort only. I will make my own plans for the return to the airport/train station" value="yes-one-way-to-the-resort-only-i-will-make-my-own-plans-for-the-return-to-the-airporttrain-station">Yes- One Way to the resort only. I will make my own plans for the return to the airport/train station</option> <option label="Yes- One Way to the airport only. I will make my own plans for the trip to the resort from the airport/train station." value="yes-one-way-to-the-airport-only-i-will-make-my-own-plans-for-the-trip-to-the-resort-from-the-airporttrain-station">Yes- One Way to the airport only. I will make my own plans for the trip to the resort from the airport/train station.</option> <option label="No Thanks- I will make my own transportation plans (Uber/Lyft/etc)" value="no-thanks-i-will-make-my-own-transportation-plans-uberlyftetc">No Thanks- I will make my own transportation plans (Uber/Lyft/etc)</option> <option label="I'm interested in a rental car" value="im-interested-in-a-rental-car">I'm interested in a rental car</option> </field> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;"/> <field type="header" subtype="h1" label="Strollers, Scooters, Wheelchairs"/> <field type="paragraph" subtype="p" label="All parks at the WDW resort offer stroller, scooter, and wheelchair rentals. These items are available on a first-come-first-served basis in the parks. Guests can not reserve these items in advance and they can sell out. Additionally, you will not be able to remove the rental from the park. Guests who are interested in renting a stroller, scooter, or wheelchair may want to consider using a third-party company. These companies offer rentals for up to your length of stay and can be used at the parks and your resort.&nbsp;"/> <field type="checkbox-group" label="Would you like a quote for a third party rental?&nbsp;" description="Check all that apply" name="would-you-like-a-quote-for-a-third-party-rental-"> <option label="Yes- Single Stroller" value="yes-single-stroller">Yes- Single Stroller</option> <option label="Yes- Double Stroller" value="yes-double-stroller">Yes- Double Stroller</option> <option label="Yes- Wheelchair" value="yes-wheelchair">Yes- Wheelchair</option> <option label="Yes- Scooter" value="yes-scooter">Yes- Scooter</option> <option label="No thanks" value="no-thanks">No thanks</option> </field> <field type="paragraph" subtype="p" label="&nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h1" label="Additional Information"/> <field type="checkbox-group" label="Disney occasionally offers discounts to their Visa and Disney+ members. Please let me know if you have either of these.&nbsp;" inline="true" name="disney-occasionally-offers-discounts-to-their-visa-and-disney-members-please-let-me-know-if-you-have-either-of-these-"> <option label="Disney Visa" value="disney-visa">Disney Visa</option> <option label="Disney+ Subscription" value="disney-subscription">Disney+ Subscription</option> </field> <field type="textarea" label="How did you hear about That Vacation Lady?&nbsp;" name="how-did-you-hear-about-us-" className="form-control"/> <field type="textarea" label="What else would you like me to know?" description="Please add any additional information you would like me to know about your trip." name="notes" className="form-control"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;"/> <field type="paragraph" subtype="p" label="Thank you for completing the above information. My office hours are M - Th 9 am - 5 pm, Fri 9 am - 4 pm, Sat by appointment only. Please allow me 1 business day from the date you submit this form to review your information and contact you with our next steps. If you have not received a response within 1 business day please check your promotions and/or spam/junk mail folders as some email providers will route my emails there. I'm looking forward to working with you!&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp; &nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="That Vacation Lady, LLC is an independent agent of Outside Agents/Cruises and Tours Unlimited. Florida Seller of Travel Ref. No. ST15578 – CST 2090937-50 – Washington UBID No. 603189022"/> </fields> </form-template> </body> </html>
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