Share your information with Madalyn Pundsack

Madalyn Pundsack

Mama Madalyn Travels LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Let&#39;s Plan an Adventure!"/>&#13;
		<field type="header" subtype="h2" label="Please complete the form below to receive a custom vacation quote."/>&#13;
		<field type="text" required="true" label="Email" name="email" 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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Where would you like to go?&amp;nbsp;" name="where-would-you-like-to-go-" className="form-control">&#13;
			<option label="Disney World in Florida" value="disney-world-in-florida">Disney World in Florida</option>&#13;
			<option label="Universal in Florida" value="universal-in-florida">Universal in Florida</option>&#13;
			<option label="Disneyland in California" value="disneyland-in-california">Disneyland in California</option>&#13;
			<option label="Universal in California" value="universal-in-california">Universal in California</option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="Cruise (Carnival, Royal Caribbean, Norwegian, etc)" value="">Cruise (Carnival, Royal Caribbean, Norwegian, etc)</option>&#13;
			<option label="Sandals or Beaches Resort " value="sandals-or-beaches-resort-">Sandals or Beaches Resort </option>&#13;
			<option label="All-Inclusive Resort " value="allinclusive-resort-">All-Inclusive Resort </option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="date" label="Date you&#39;re considering arriving?" name="date-youre-considering-arriving" className="form-control"/>&#13;
		<field type="date" label="Date you&#39;re considering departing?" name="date-youre-considering-departing" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your approximate budget (not including travel to your destination)?" name="what-is-your-approximate-budget-not-including-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Who would be going on this trip? (Adult names, kiddos names and ages please!)" name="who-would-be-going-on-this-triop-adult-names-kiddos-names-and-ages-please" subtype="text" className="form-control"/>&#13;
		<field type="select" label="What type of package?&amp;nbsp;" name="what-type-of-package-" className="form-control">&#13;
			<option label="Room &amp; Tickets" value="room-tickets">Room &amp; Tickets</option>&#13;
			<option label="Room Only" value="room-only">Room Only</option>&#13;
			<option label="Tickets Only" value="tickets-only">Tickets Only</option>&#13;
		</field>&#13;
		<field type="text" label="What else should I know before putting a custom quote together for you?&amp;nbsp;" name="what-else-should-i-know-before-putting-a-custom-quote-together-for-you-" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Celebrating anything special?&amp;nbsp;" name="celebrating-anything-special-" className="form-control"/>&#13;
		<field type="text" label="Referred by someone?&amp;nbsp; Where did you find me?" name="referred-by-someone-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Thank you! Please allow 24-48 hours for a response.&amp;nbsp; All the best, Madalyn"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>