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<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Walt Disney World Vacation Package Quote Request"/>&#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" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Is this your first trip to Walt Disney World?" name="is-this-your-first-trip-to-walt-disney-world">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I've been before, but it's been a while!" value="ive-been-before-but-its-been-a-while">I've been before, but it's been a while!</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="How many adults (18+) are traveling in your party?" name="list-all-guests-and-their-age-at-the-time-of-travel" className="form-control"/>&#13;
		<field type="textarea" required="true" label="How many children and their ages at the time of travel?&amp;nbsp;" name="textarea-1734140820012" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Do you have any accessibility needs?" name="textarea-1739900968996" className="form-control"/>&#13;
		<field type="date" required="true" label="Start Date" name="start-date" className="form-control"/>&#13;
		<field type="date" required="true" label="End Date" name="end-date" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Number of Park Days" description="Magic Kingdom  Animal Kingdom  Epcot  Hollywood Studios  WaterParks" name="number-of-park-days">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget?" description="Having this info just gives us a good starting point.  Families can expect to spend around $1 000/pp for a week-long Disney World vacation." name="radio-group-1734141002670">&#13;
			<option label="$2500 and under (Small Family / Short Trip)" value="2500-and-under-small-family-short-trip">$2500 and under (Small Family / Short Trip)</option>&#13;
			<option label="$2,500 - $4,500" value="2500-4500">$2,500 - $4,500</option>&#13;
			<option label="$4,500 - $6,500" value="4500-6500">$4,500 - $6,500</option>&#13;
			<option label="$6,500 - $8,500" value="6500-8500">$6,500 - $8,500</option>&#13;
			<option label="$8,500 - $10,000" value="8500-10000">$8,500 - $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you driving or flying?" name="radio-group-1734141201315" other="true">&#13;
			<option label="Driving" value="driving">Driving</option>&#13;
			<option label="Flying" value="flying">Flying</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Which resorts are you interested in? Choose up to 3!" name="which-resorts-are-you-interested-in-choose-up-to-3">&#13;
			<option label="Pick for me!" value="pick-for-me">Pick for me!</option>&#13;
			<option label="Contemporary Resort" value="contemporary-resort">Contemporary Resort</option>&#13;
			<option label="All-Star Movies Resort" value="allstar-movies-resort">All-Star Movies Resort</option>&#13;
			<option label="All-Star Music Resort" value="allstar-music-resort">All-Star Music Resort</option>&#13;
			<option label="All-Star Sports Resort" value="allstar-sports-resort">All-Star Sports Resort</option>&#13;
			<option label="Animal Kingdom Lodge" value="animal-kingdom-lodge">Animal Kingdom Lodge</option>&#13;
			<option label="Art of Animation" value="art-of-animation">Art of Animation</option>&#13;
			<option label="Beach Club Resort" value="beach-club-resort">Beach Club Resort</option>&#13;
			<option label="BoardWalk Inn" value="boardwalk-inn">BoardWalk Inn</option>&#13;
			<option label="Caribbean Beach Resort" value="caribbean-beach-resort">Caribbean Beach Resort</option>&#13;
			<option label="Coronado Springs Resort" value="coronado-springs-resort">Coronado Springs Resort</option>&#13;
			<option label="Grand Floridian Resort &amp; Spa" value="grand-floridian-resort-spa">Grand Floridian Resort &amp; Spa</option>&#13;
			<option label="Old Key West Resort" value="old-key-west-resort">Old Key West Resort</option>&#13;
			<option label="Polynesian Village Resort" value="polynesian-village-resort">Polynesian Village Resort</option>&#13;
			<option label="Pop Century Resort" value="pop-century-resort">Pop Century Resort</option>&#13;
			<option label="Port Orleans - French Quarter" value="port-orleans-french-quarter">Port Orleans - French Quarter</option>&#13;
			<option label="Port Orleans - Riverside" value="port-orleans-riverside">Port Orleans - Riverside</option>&#13;
			<option label="Saratoga Springs Resort &amp; Spa" value="saratoga-springs-resort-spa">Saratoga Springs Resort &amp; Spa</option>&#13;
			<option label="Wilderness Lodge" value="wilderness-lodge">Wilderness Lodge</option>&#13;
			<option label="Yacht Club Resort" value="yacht-club-resort">Yacht Club Resort</option>&#13;
			<option label="Riviera Resort" value="riviera-resort">Riviera Resort</option>&#13;
			<option label="Cabins at Fort Wilderness Lodge" value="cabins-at-fort-wilderness-lodge">Cabins at Fort Wilderness Lodge</option>&#13;
			<option label="Campsites at Fort Wilderness Lodge" value="campsites-at-fort-wilderness-lodge">Campsites at Fort Wilderness Lodge</option>&#13;
			<option label="Disney Villas" value="disney-villas">Disney Villas</option>&#13;
			<option label="Information on Good Neighbor Hotels" value="information-on-good-neighbor-hotels">Information on Good Neighbor Hotels</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="There are special discounts for certain groups. Are you any of the below?" description="ctive Disney+ Subscription" name="checkbox-group-1734141487356" other="true">&#13;
			<option label="Active or retired members of US Military" value="active-or-retired-members-of-us-military">Active or retired members of US Military</option>&#13;
			<option label="Disney Chase Visa Cardholder" value="disney-chase-visa-cardholder">Disney Chase Visa Cardholder</option>&#13;
			<option label="DVC Member" value="dvc-member">DVC Member</option>&#13;
			<option label="Annual Passholder" value="annual-passholder">Annual Passholder</option>&#13;
			<option label="Florida Resident" value="florida-resident">Florida Resident</option>&#13;
			<option label="Active Disney+ Subscription " value="active-disney-subscription-">Active Disney+ Subscription </option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#13;
		<field type="textarea" label="If you chose &quot;Pick For Me&quot; in the last question, what are some of your interests? Any favorite characters or movies? The more information you share, the better job I can do!" name="if-you-chose-pick-for-me-in-the-last-question-what-are-some-of-your-interests-any-favorite-characters-or-movies-the-more-information-you-share-the-better-job-i-can-do" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you want to add Memory Maker (Digital Photo Package)?" name="do-you-want-to-add-memory-maker">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Maybe" value="maybe">Maybe</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you want to add travel protection?" name="do-you-want-to-add-travel-protection">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Maybe" value="maybe">Maybe</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you interested in a dining plan?" name="are-you-interested-in-a-dining-plan">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Maybe" value="maybe">Maybe</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you need more information on Disney&#39;s&amp;nbsp; Disability Access Service (DAS) registration?" name="do-you-need-more-information-on-disneys-disability-access-service-das-registration">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How did you hear about me?" placeholder="Friend  Google, Social Media, etc..." name="how-did-you-hear-about-me" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Any additional comments or questions? Use this space to elaborate on any answers to above questions. Anything else you want me to know? (Celebrations, special requests, etc)&amp;nbsp;" name="any-additional-comments-or-questions-use-this-space-to-elaborate-on-any-answers-to-above-questions" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>