<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Let's Plan an Adventure!!"/> <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" 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="checkbox-group" label="Where would you like to go on your next adventure?" name="where-would-you-like-to-go-on-your-next-adventure" other="true"> <option label="Walt Disney World (Florida)" value="walt-disney-world-florida">Walt Disney World (Florida)</option> <option label="Disneyland (California) " value="disneyland-california-">Disneyland (California) </option> <option label="Disney Cruise " value="disney-cruise-">Disney Cruise </option> <option label="Universal Studios Orlando" value="universal-studios-orlando">Universal Studios Orlando</option> <option label="Universal Studios Hollywood " value="universal-studios-hollywood-">Universal Studios Hollywood </option> <option label="Sandals Resort" value="sandals-resort">Sandals Resort</option> <option label="Beaches Resort " value="beaches-resort-">Beaches Resort </option> <option label="All-Inclusive Resorts" value="allinclusive-resorts">All-Inclusive Resorts</option> <option label="Royal Caribbean Cruise" value="royal-caribbean-cruise">Royal Caribbean Cruise</option> <option label="Carnival Cruise " value="carnival-cruise-">Carnival Cruise </option> <option label="Destination Wedding" value="destination-wedding">Destination Wedding</option> </field> <field type="date" required="true" label="When would you like 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"/> <field type="date" required="true" label="When 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"/> <field type="checkbox-group" label="Are your dates flexible?" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="What is your departure city/airport?" placeholder="ATL (Atlanta) BHM (Birmingham) DTW (Detroit) etc." name="what-is-your-departure-cityairport" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers?" name="how-many-travelers" subtype="text" className="form-control"/> <field type="textarea" required="true" label="What are the first and last names and birthdates of all the adults?" name="what-are-the-first-and-last-name-of-all-the-adults" className="form-control"/> <field type="textarea" label="What are the first and last names and birthdates of all children?" name="what-are-the-first-and-last-names-of-all-the-children-plus-their-ages-" className="form-control"/> <field type="checkbox-group" label="What phase of planning are you in?" name="what-phase-of-planning-are-you-in"> <option label="Not a clue! I am open!" value="not-a-clue-i-am-open">Not a clue! I am open!</option> <option label="I only know dates and location " value="i-only-know-dates-and-location-">I only know dates and location </option> <option label="We booked flights but need a hotel!" value="we-booked-flights-but-need-a-hotel">We booked flights but need a hotel!</option> <option label="I know exactly what I want, and I want to book with you!" value="i-know-exactly-what-i-want-and-i-want-to-book-with-you">I know exactly what I want, and I want to book with you!</option> </field> <field type="checkbox-group" label="What areas of travel would you like my help with?" name="what-areas-of-travel-would-you-like-my-help-with"> <option label="Flights- (*all-inclusives only)" value="flights-allinclusives-only">Flights- (*all-inclusives only)</option> <option label="Accomodations" value="accomodations">Accomodations</option> <option label="Transportation" value="transportation">Transportation</option> <option label="Excursions and Tours" value="excursions-and-tours">Excursions and Tours</option> <option label="Insurance" value="insurance">Insurance</option> <option label="ALL THE ABOVE!" value="all-the-above">ALL THE ABOVE!</option> </field> <field type="radio-group" required="true" 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"> <option label="$2,500 or less" value="2500-or-less">$2,500 or less</option> <option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy" value="economy">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> </field> <field type="textarea" label="Any must-haves for this trip?" placeholder="All-inclusive resort, king bed, 2 queen beds, dining package, etc." name="any-musthaves-for-this-trip" className="form-control"/> <field type="checkbox-group" label="Do you qualify for any of these possible discounts?&nbsp;" name="do-you-qualify-for-any-of-these-possible-discounts-"> <option label="Florida Resident" value="florida-resident">Florida Resident</option> <option label="Disney Chase Visa Cardholder " value="disney-chase-visa-cardholder-">Disney Chase Visa Cardholder </option> <option label="Military (active or 100% disabled)" value="military-active-or-100-disabled">Military (active or 100% disabled)</option> <option label="Annual Passholder" value="annual-passholder">Annual Passholder</option> <option label="Disney+ Subscriber " value="disney-subscriber-">Disney+ Subscriber </option> <option label="First Responder" value="first-responder">First Responder</option> <option label="Healthcare employee" value="healthcare-employee">Healthcare employee</option> </field> <field type="checkbox-group" label="Are you celebrating anything special?" name="are-you-celebrating-anything-special" other="true"> <option label="Birthday" value="birthday">Birthday</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Anniversary " value="anniversary-">Anniversary </option> <option label="Graduation" value="graduation">Graduation</option> </field> <field type="textarea" label="Any Food Allergies/Medical Conditions to be made aware of?" name="notes" className="form-control"/> <field type="textarea" label="What else would you like me to know?" name="what-else-would-you-like-me-to-know" className="form-control"/> <field type="text" label="Were you referred by anyone? We want to be sure to thank them!&nbsp;" name="must-dos" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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