Share your information with Lori Saia

Lori Saia

MickeyTravels

<html>
  <body>
    <form-template>&#13;
	<fields>&#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" 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="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="radio-group" required="true" label="Which vacation destination are you interested in?" name="where-would-you-like-to-go">&#13;
			<option label="Disney World (Florida)" value="disney-world-florida">Disney World (Florida)</option>&#13;
			<option label="Disneyland (California)" value="disneyland-california">Disneyland (California)</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Disneyland Paris" value="disneyland-paris">Disneyland Paris</option>&#13;
			<option label="Aulani Resort &amp; Spa (Hawaii)" value="aulani-resort-spa-hawaii">Aulani Resort &amp; Spa (Hawaii)</option>&#13;
			<option label="an Adventures by Disney destination" value="an-adventures-by-disney-destination">an Adventures by Disney destination</option>&#13;
			<option label="I only want to purchase theme park tickets" value="i-only-want-to-purchase-theme-park-tickets">I only want to purchase theme park tickets</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Which park do you want to purchase theme park tickets for?" name="checkbox-group-1770663867542" className="field-hidden">&#13;
			<option label="Disney World (Florida)" value="disney-world-florida">Disney World (Florida)</option>&#13;
			<option label="Disneyland (California)" value="disneyland-california">Disneyland (California)</option>&#13;
		</field>&#13;
		<field type="text" label="How many theme park ticket days would you like?" description="Room &amp;amp; ticket packages can have between 2 and 10 theme park ticket days." name="if-disney-world-or-disneyland-how-many-park-days-do-you-want" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="text" label="How many theme park ticket days would you like?" description="Room &amp;amp; ticket packages can have between 2 and 10 theme park ticket days." name="text-1770664551219" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="checkbox-group" label="Are you interested in a dining plan?" description="Disney World offers two dining plans: Quick Service Dining and Disney Dining" name="checkbox-group-1770662949929" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="date" label="What date do you want to check in?" 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"/>&#13;
		<field type="date" label="What date would you like to check out?" 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"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please list the age of each traveler divided by commas." name="text-1769815155157" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$2,000 to $3,000" value="2000-to-3000">$2,000 to $3,000</option>&#13;
			<option label="$3,000 to $5,000" value="3000-to-5000">$3,000 to $5,000</option>&#13;
			<option label="$5,000 to $7,000" value="5000-to-7000">$5,000 to $7,000</option>&#13;
			<option label="$7,000 to $8,000" value="7000-to-8000">$7,000 to $8,000</option>&#13;
			<option label="$8,000 to $10,000" value="8000-to-10000">$8,000 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="textarea" label="Are you celebrating anything special on this trip or is there anything special you would like me to know?" name="notes" className="form-control"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770662857196" rule="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"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770663822354" rule="eyJ3aGVuRmllbGQiOiJ3aGVyZS13b3VsZC15b3UtbGlrZS10by1nbyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJpLW9ubHktd2FudC10by1wdXJjaGFzZS10aGVtZS1wYXJrLXRpY2tldHMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiY2hlY2tib3gtZ3JvdXAtMTc3MDY2Mzg2NzU0MiJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6ImNoZWNrYm94LWdyb3VwLTE3NzA2NjM4Njc1NDIiLCJsYWJlbCI6IkNoZWNrYm94IEdyb3VwIn1dfQ=="/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770665126352" rule="eyJ3aGVuRmllbGQiOiJ3aGVyZS13b3VsZC15b3UtbGlrZS10by1nbyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJkaXNuZXlsYW5kLWNhbGlmb3JuaWEiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsidGV4dC0xNzcwNjY0NTUxMjE5Il0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoidGV4dC0xNzcwNjY0NTUxMjE5IiwibGFiZWwiOiJIb3cgbWFueSB0aGVtZSBwYXJrIHRpY2tldCBkYXlzIHdvdWxkIHlvdSBsaWtlPyJ9XX0="/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>