Share your information with Lea Martin

Lea Martin

Travel with the Magic

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Tell me about you:"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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="checkbox-group" label="Choose any which apply to you:" name="choose-any-which-apply-to-you" other="true">&#13;
			<option label="Disney+ Subscriber" value="disney-subscriber">Disney+ Subscriber</option>&#13;
			<option label="Disney Visa Cardholder" value="disney-visa-cardholder">Disney Visa Cardholder</option>&#13;
			<option label="Annual Passholder" value="annual-passholder">Annual Passholder</option>&#13;
			<option label="Active or Fully Retired Military" value="active-or-fully-retired-military">Active or Fully Retired Military</option>&#13;
			<option label="Florida Resident" value="florida-resident">Florida Resident</option>&#13;
			<option label="Loyalty Program" value="loyalty-program">Loyalty Program</option>&#13;
			<option label="Mobility or Hearing accessibility needs" value="mobility-or-hearing-accessibility-needs">Mobility or Hearing accessibility needs</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Tell me about your travel group:"/>&#13;
		<field type="text" required="true" label="How many TOTAL travelers are in your party, including adults and children?" name="how-many-total-travelers-are-in-your-party-including-adults-and-children" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please include full names of all adults here (ages 18+)" name="please-include-full-names-of-all-adults-here-ages-18" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please include names, ages at the time of travel for children here (ages infant-17)" name="please-include-names-ages-at-the-time-of-travel-for-children-here-ages-infant17" subtype="text" className="form-control"/>&#13;
		<field type="text" label="If you require more than one room, please list who you would like to be in each room here:&amp;nbsp;" name="if-you-require-more-than-one-room-please-list-who-you-would-like-to-be-in-each-room-here-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Transportation to Vacation destination&amp;nbsp; (driving or flying)" name="transportation-to-vacation-destination-driving-or-flying" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Tell me more about what you want:"/>&#13;
		<field type="radio-group" label="Where would you like to go?" inline="true" name="where-would-you-like-to-go" other="true">&#13;
			<option label="Walt Disney World Flordia" value="walt-disney-world-flordia">Walt Disney World Flordia</option>&#13;
			<option label="Disneyland California" value="disneyland-california">Disneyland California</option>&#13;
			<option label="Disney Cruise Lines" value="disney-cruise-lines">Disney Cruise Lines</option>&#13;
			<option label="Universal Studios Orlando" value="universal-studios-orlando">Universal Studios Orlando</option>&#13;
			<option label="Universal Studios California" value="universal-studios-california">Universal Studios California</option>&#13;
			<option label="Explore Cruise Lines" value="explore-cruise-lines">Explore Cruise Lines</option>&#13;
			<option label="Explore All Inclusive Resort Mexico/Caribbean" value="explore-all-inclusive-resort-mexicocaribbean">Explore All Inclusive Resort Mexico/Caribbean</option>&#13;
		</field>&#13;
		<field type="date" label="When would you like to depart?" 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="When would you like to return?" 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;
		</field>&#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" other="true">&#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="checkbox-group" label="What is important to you?" name="what-is-important-to-you" other="true">&#13;
			<option label="Multiple dining options at resort" value="multiple-dining-options-at-resort">Multiple dining options at resort</option>&#13;
			<option label="Multiple modes of transportation to theme parks" value="multiple-modes-of-transportation-to-theme-parks">Multiple modes of transportation to theme parks</option>&#13;
			<option label="Proximity to park(s)" value="proximity-to-parks">Proximity to park(s)</option>&#13;
			<option label="Budget" value="budget">Budget</option>&#13;
			<option label="No exterior doors/hallways" value="no-exterior-doorshallways">No exterior doors/hallways</option>&#13;
			<option label="View: Pool, Water, Beach" value="view-pool-water-beach">View: Pool, Water, Beach</option>&#13;
			<option label="We just want somewhere to sleep" value="we-just-want-somewhere-to-sleep">We just want somewhere to sleep</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Value" value="value">Value</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Deluxe" value="deluxe">Deluxe</option>&#13;
			<option label="Suite, multiple rooms" value="suite-multiple-rooms">Suite, multiple rooms</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have a resort in mind?&amp;nbsp; List here, if so:" name="do-you-have-a-resort-in-mind-list-here-if-so" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are there any extras you would like to consider?" name="are-there-any-extras-you-would-like-to-consider" other="true">&#13;
			<option label="Memory Maker/ Photo Package" value="memory-maker-photo-package">Memory Maker/ Photo Package</option>&#13;
			<option label="Park Hopper/ Park to Park Ticket" value="park-hopper-park-to-park-ticket">Park Hopper/ Park to Park Ticket</option>&#13;
			<option label="Water Park" value="water-park">Water Park</option>&#13;
			<option label="Travel Protection/ Cancel for Any Reason" value="travel-protection-cancel-for-any-reason">Travel Protection/ Cancel for Any Reason</option>&#13;
			<option label="Airport Transportation Options" value="airport-transportation-options">Airport Transportation Options</option>&#13;
			<option label="Club Level" value="club-level">Club Level</option>&#13;
			<option label="VIP Tours" value="vip-tours">VIP Tours</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="For Non Theme Park Vacations: What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="textarea" label="Would you like to schedule a consultation call so I can get to know you better before making recommendations for your vacation?" name="would-you-like-to-schedule-a-consultation-call-so-i-can-get-to-know-you-better-before-making-recommendations-for-your-vacation" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>