Share your information with Liz Costello

Liz Costello

A Dream & A Wish Travel Co

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Ready to plan your adventure with Liz?"/>&#13;
		<field type="paragraph" subtype="p" label="-Thinking about Disney, Universal, a cruise, Europe or a trip literally anywhere?! Have the perfect vacation in mind but need help with all the details?"/>&#13;
		<field type="paragraph" subtype="p" label="-Did you know it doesn&#39;t cost you anything extra to use a travel agent?! The fee is included in the price whether you use one or not. All the tips and tricks for no extra charge!"/>&#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" description="I&#39;ll send your customized quote via email." name="email" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Contact Preference" name="contact-preference" className="form-control">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Call" value="call">Call</option>&#13;
		</field>&#13;
		<field type="text" label="Phone number" description="Optional if you prefer to talk or text." name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Where would you like to go?&amp;nbsp;" description="This can be anywhere! Disney  Europe  cruises, etc!" name="text-1732671989443" subtype="text" className="form-control"/>&#13;
		<field type="date" label="When would you like to leave?&amp;nbsp;" description="If you have a specific date in mind  please list it here!" name="when-would-you-like-to-leave-" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How many nights would you like to stay?&amp;nbsp;" name="dates-flexible" other="true">&#13;
			<option label="2-6" value="26">2-6</option>&#13;
			<option label="7-10" value="710">7-10</option>&#13;
			<option label="11-14" value="1114">11-14</option>&#13;
			<option label="14+ Days" value="14-days">14+ Days</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many adults?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many children? Please include their ages at the time of travel for accurate pricing." name="how-many-children-please-include-their-ages-at-the-time-of-travel-for-accurate-pricing" 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="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know?" description="Any celebrations? Need an accessible room? Kids&#39; favorite characters?" name="notes" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Once I review all your info, I&#39;ll be in touch within 24 hours!"/>&#13;
	</fields>&#13;
</form-template>
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