Share your information with Victoria Wade

Victoria Wade

Pixie Dusting Plans

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" 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="header" subtype="h1" label="Questions For Your Trip"/>&#13;
		<field type="select" required="true" label="Select" name="select-which-destinations-you-wish-to-visit" className="form-control">&#13;
			<option label="Walt Disney World, Florida" value="walt-disney-world-florida" selected="selected">Walt Disney World, Florida</option>&#13;
			<option label="Disneyland, California" value="disneyland-california">Disneyland, California</option>&#13;
			<option label="Universal Studios Florida" value="universal-studios-florida">Universal Studios Florida</option>&#13;
			<option label="Universal Studios Hollywood" value="universal-studios-hollywood">Universal Studios Hollywood</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Adventures By Disney" value="adventures-by-disney">Adventures By Disney</option>&#13;
			<option label="Disneyland Paris" value="disneyland-paris">Disneyland Paris</option>&#13;
			<option label="Sands All Inclusive (For Adults Only" value="sands-all-inclusive-for-adults-only">Sands All Inclusive (For Adults Only</option>&#13;
			<option label="Beaches All Inclusive (For Families)" value="beaches-all-inclusive-for-families">Beaches All Inclusive (For Families)</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Your Preferred Check In Date" name="your-preferred-check-in-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Your Preferred Check Out Date" name="your-preferred-check-out-date" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Adults?" name="number-of-adults" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Children (&amp;nbsp; Age at Time of Check In Date)" name="number-of-children-age-at-time-of-check-in-date" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Full Names of Each Traveler Including Children with Ages" name="full-names-of-each-traveler-including-children-with-ages" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How Many Rooms? If More than one, please specify travelers in each room, including children (with ages)" name="how-many-rooms-if-more-than-one-please-specify-travelers-in-each-room-including-children-with-ages" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="What is Ideal Budget for all travelers (excluding airfare?)" name="what-is-ideal-budget-for-all-travelers-excluding-airfare" className="form-control">&#13;
			<option label="$1,500- $2,500" value="1500-2500" selected="selected">$1,500- $2,500</option>&#13;
			<option label="$2,500-$4,500" value="25004500">$2,500-$4,500</option>&#13;
			<option label="$4,500- $6,000" value="4500-6000">$4,500- $6,000</option>&#13;
			<option label="$6,500- $8,500" value="6500-8500">$6,500- $8,500</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Which best describes your hotel preference?" name="which-best-describes-your-hotel-preference" className="form-control">&#13;
			<option label="Value" value="value" selected="selected">Value</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Deluxe" value="deluxe">Deluxe</option>&#13;
			<option label="Villa" value="villa">Villa</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Disney Destinations Options" name="disney-destinations-options" className="form-control">&#13;
			<option label="Park Hopper Tickets" value="park-hopper-tickets" selected="selected">Park Hopper Tickets</option>&#13;
			<option label="Travel Protection" value="travel-protection">Travel Protection</option>&#13;
			<option label="Dining Plan" value="dining-plan">Dining Plan</option>&#13;
			<option label="Memory Maker" value="memory-maker">Memory Maker</option>&#13;
			<option label="N/A (Not Theme Park Related)" value="na-not-theme-park-related">N/A (Not Theme Park Related)</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything Else I Should Know ?" name="anything-else-i-should-know-" className="form-control"/>&#13;
		<field type="text" required="true" label="How did you hear about me?" name="how-did-you-hear-about-me" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>