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Julie Blanck

Magic Suitcase Getaways

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		<field type="header" subtype="h2" label="Vacation Inquiry"/>&#13;
		<field type="radio-group" required="true" label="PLEASE&amp;nbsp; CHOOSE&amp;nbsp; YOUR&amp;nbsp; &amp;nbsp;VACATION&amp;nbsp; OPTION&amp;nbsp; TO&amp;nbsp; BEGIN" description="Choose your destination" inline="true" name="what-type-of-vacation-are-you-looking-for-">&#13;
			<option label="Disney  Cruise" value="disney-cruise">Disney  Cruise</option>&#13;
			<option label="Walt Disney World" value="walt-disney-world">Walt Disney World</option>&#13;
			<option label="Disneyland" value="disneyland">Disneyland</option>&#13;
			<option label="Universal Orlando" value="universal-orlando">Universal Orlando</option>&#13;
			<option label="Universal Hollywood" value="universal-hollywood">Universal Hollywood</option>&#13;
		</field>&#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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
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		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1774127507056" rule="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"/>&#13;
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		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1774133341710" rule="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"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1774124659515" rule="eyJ3aGVuRmllbGQiOiJ3aGF0LXR5cGUtb2YtdmFjYXRpb24tYXJlLXlvdS1sb29raW5nLWZvci0iLCJ3aGVuQ29uZGl0aW9uIjoiZXF1YWxzIiwid2hlblZhbHVlIjoiZGlzbmV5LWNydWlzZSIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJkZXN0aW5hdGlvbiIsImRlcGFydHVyZS1jaXR5IiwidGV4dC0xNzcwNzYyNzMxMTI1IiwidGV4dC0xNzcwNzYzNDg0MDcyIiwidGV4dC0xNzcwNzYyODg3MDI0IiwidGV4dC0xNzcwNzYzNTIxNjAzIiwiZGF0ZXMtZmxleGlibGUiLCJoYXZlLXlvdS1jcnVpc2VkLXdpdGgtZGlzbmV5LWJlZm9yZS0iXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJkZXN0aW5hdGlvbiIsImxhYmVsIjoiV2hlcmUgd291bGQgeW91IGxpa2UgdG8gZ28/In0seyJuYW1lIjoiZGVwYXJ0dXJlLWNpdHkiLCJsYWJlbCI6IkRvIHlvdSBrbm93IHdoaWNoIHBvcnQgeW91IHdhbnQgdG8gZ28gb3V0IG9mPyZuYnNwOyJ9LHsibmFtZSI6InRleHQtMTc3MDc2MjczMTEyNSIsImxhYmVsIjoiSGF2ZSB5b3UgY3J1aXNlZCB3aXRoIERpc25leSBiZWZvcmU/Jm5ic3A7IElmIHNvIGxldCBtZSBrbm93IHlvdXIgQ2FzdGF3YXkgIyJ9LHsibmFtZSI6InRleHQtMTc3MDc2MzQ4NDA3MiIsImxhYmVsIjoiSG93IG1hbnkgY2FiaW5zIGFyZSBuZWVkZWQ/In0seyJuYW1lIjoidGV4dC0xNzcwNzYyODg3MDI0IiwibGFiZWwiOiJEbyB5b3UgaGF2ZSBhIHByZWZlcnJlZCBzaGlwPyZuYnNwOyJ9LHsibmFtZSI6InRleHQtMTc3MDc2MzUyMTYwMyIsImxhYmVsIjoiRG8geW91IG5lZWQgYW4gYWNjZXNzaWJsZSBjYWJpbj8mbmJzcDsifSx7Im5hbWUiOiJkYXRlcy1mbGV4aWJsZSIsImxhYmVsIjoiRG8geW91IG5lZWQgdHJhbnNmZXJzIHRvLyBmcm9tIGFpcnBvcnQgdG8gLyBmcm9tIHBpZXIgPyJ9LHsibmFtZSI6ImhhdmUteW91LWNydWlzZWQtd2l0aC1kaXNuZXktYmVmb3JlLSIsImxhYmVsIjoiUHJlZmVycmVkIERpbmluZyBUaW1lIn1dfQ=="/>&#13;
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		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1774133069213" rule="eyJ3aGVuRmllbGQiOiJ3aGF0LXR5cGUtb2YtdmFjYXRpb24tYXJlLXlvdS1sb29raW5nLWZvci0iLCJ3aGVuQ29uZGl0aW9uIjoiZXF1YWxzIiwid2hlblZhbHVlIjoidW5pdmVyc2FsLWhvbGx5d29vZCIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJob3RlbC1wcmVmZXJlbmNlLSIsInRleHQtMTc3NDExNzgxMDA5NyJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6ImhvdGVsLXByZWZlcmVuY2UtIiwibGFiZWwiOiJIb3RlbCBQcmVmZXJlbmNlPyZuYnNwOyJ9LHsibmFtZSI6InRleHQtMTc3NDExNzgxMDA5NyIsImxhYmVsIjoiVW5pdmVyc2FsIEhvbGx5d29vZCAtIFNpbmdsZSBkYXkgb3IgTWlsdGkgZGF5IHRpY2tldCJ9XX0="/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1774131336127" rule="eyJ3aGVuRmllbGQiOiJ3aGF0LXR5cGUtb2YtdmFjYXRpb24tYXJlLXlvdS1sb29raW5nLWZvci0iLCJ3aGVuQ29uZGl0aW9uIjoiY29udGFpbnMiLCJ3aGVuVmFsdWUiOiJVbml2ZXJzYWwiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicmFkaW8tZ3JvdXAtMTc3NDEyODcxNDI3NSJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InJhZGlvLWdyb3VwLTE3NzQxMjg3MTQyNzUiLCJsYWJlbCI6IlVOSVZFUlNBTCZuYnNwOyBESVNDT1VOVFMifV19"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1774134574454"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Caribbean" name="destination" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="text" required="true" label="Do you know which port you want to go out of?&amp;nbsp;" description="ex. Port Canaveral  San Diego" name="departure-city" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="text" required="true" label="How many travelers and ages if you have children traveling?&amp;nbsp;" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="PREFERRED&amp;nbsp; DATES&amp;nbsp; &amp;nbsp;OF&amp;nbsp; TRAVEL" name="text-1774120168946" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" inline="true" name="checkbox-group-1770762983807">&#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&amp;nbsp; MANY&amp;nbsp; &amp;nbsp;HOTEL&amp;nbsp; &amp;nbsp;NIGHTS ?" name="text-1774121422322" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Any accessibility assistance needed?&amp;nbsp;" name="text-1774117032353" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="UNIVERSAL VACATION OPTIONS" inline="true" name="disneyland-accommodations" other="true">&#13;
			<option label="ROOM ONLY" value="room-only">ROOM ONLY</option>&#13;
			<option label="Park tickets Only" value="park-tickets-only">Park tickets Only</option>&#13;
			<option label="Universal package - Room &amp; Tickets" value="universal-package-room-tickets">Universal package - Room &amp; Tickets</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="UNIVERSAL&amp;nbsp; DISCOUNTS" inline="true" name="radio-group-1774128714275" other="true" className="field-hidden">&#13;
			<option label="Annual Passholder" value="annual-passholder">Annual Passholder</option>&#13;
			<option label="Military" value="military">Military</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="DISNEYLAND&amp;nbsp; &amp;nbsp;ACCOMMODATIONS" description="If undecided choose other  - we will work together to find your perfect place" name="radio-group-1774128221910" other="true" className="field-hidden">&#13;
			<option label="NO ROOM NEEDED" value="no-room-needed">NO ROOM NEEDED</option>&#13;
			<option label="Disneyland Hotel/ DVC Villas" value="disneyland-hotel-dvc-villas">Disneyland Hotel/ DVC Villas</option>&#13;
			<option label="Grand Californian Hotel" value="grand-californian-hotel">Grand Californian Hotel</option>&#13;
			<option label="Pixar Place Hotel" value="pixar-place-hotel">Pixar Place Hotel</option>&#13;
			<option label="Good Neighbor Hotel (offsite)" value="good-neighbor-hotel-offsite">Good Neighbor Hotel (offsite)</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="ORLANDO&amp;nbsp; &amp;nbsp;HOTEL&amp;nbsp; OPTIONS" description="If undecided choose other  - we will work together to find your perfect place" name="radio-group-1774127541448" other="true" className="field-hidden">&#13;
			<option label="NO ROOM NEEDED" value="no-room-needed">NO ROOM NEEDED</option>&#13;
			<option label="Loews Portofino Bay Hotel - Signature" value="loews-portofino-bay-hotel-signature">Loews Portofino Bay Hotel - Signature</option>&#13;
			<option label="Hard Rock Hotel - Signature" value="hard-rock-hotel-signature">Hard Rock Hotel - Signature</option>&#13;
			<option label="Loews Royal Pacific Resort - Signature" value="loews-royal-pacific-resort-signature">Loews Royal Pacific Resort - Signature</option>&#13;
			<option label="Loews Sapphire Falls Resort - Signature" value="loews-sapphire-falls-resort-signature">Loews Sapphire Falls Resort - Signature</option>&#13;
			<option label="Universal Helios Grand Hotel _Closest to Epic Universe" value="universal-helios-grand-hotel-closest-to-epic-universe">Universal Helios Grand Hotel _Closest to Epic Universe</option>&#13;
			<option label="Universal Aventura Hotel - Prime Value" value="universal-aventura-hotel-prime-value">Universal Aventura Hotel - Prime Value</option>&#13;
			<option label="Universal Stella Nova Resort - Prime Value" value="universal-stella-nova-resort-prime-value">Universal Stella Nova Resort - Prime Value</option>&#13;
			<option label="Universal Terra Luna Resort - Prime Value" value="universal-terra-luna-resort-prime-value">Universal Terra Luna Resort - Prime Value</option>&#13;
			<option label="Universal Cabana Bay Beach Resort - Value Inns and Suites" value="universal-cabana-bay-beach-resort-value-inns-and-suites">Universal Cabana Bay Beach Resort - Value Inns and Suites</option>&#13;
			<option label="Universal Endless Summer Resort - Dockside Inn and Suites - Value Inns &amp; Suites" value="universal-endless-summer-resort-dockside-inn-and-suites-value-inns-suites">Universal Endless Summer Resort - Dockside Inn and Suites - Value Inns &amp; Suites</option>&#13;
			<option label="Universal Endless Summer Resort - Surfside Inn  &amp; Suites - Value Inns &amp; Suites" value="universal-endless-summer-resort-surfside-inn-suites-value-inns-suites">Universal Endless Summer Resort - Surfside Inn  &amp; Suites - Value Inns &amp; Suites</option>&#13;
			<option label="Off Property" value="off-property">Off Property</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="DISNEYLAND&amp;nbsp; &amp;nbsp;VACATION&amp;nbsp; &amp;nbsp;OPTIONS" name="disneyland-vacation-options" className="field-hidden">&#13;
			<option label="Room Only" value="room-only">Room Only</option>&#13;
			<option label="Park Tickets Only" value="park-tickets-only">Park Tickets Only</option>&#13;
			<option label="Disneyland package - Room &amp; Tickets" value="disneyland-package-room-tickets">Disneyland package - Room &amp; Tickets</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many cabins are needed?" name="text-1770763484072" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you have a preferred ship?&amp;nbsp;" name="text-1770762887024" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="header" subtype="h1" label="Universal Hollywood Accommodations" className="field-hidden"/>&#13;
		<field type="text" required="true" label="Hotel Preference?&amp;nbsp;" description="Hollywood does not have their own hotels  so if you know of a particular chain to use  enter it here or type UNDECIDED" name="hotel-preference-" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="radio-group" required="true" label="Universal Orlando&amp;nbsp; Park Options" inline="true" name="universal-orlando-park-options">&#13;
			<option label="Single park per day" value="single-park-per-day">Single park per day</option>&#13;
			<option label="Multi park per day" value="multi-park-per-day">Multi park per day</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you need an accessible cabin?&amp;nbsp;" name="text-1770763521603" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="checkbox-group" required="true" label="Do you need transfers to/ from airport to / from pier ?" inline="true" name="dates-flexible" className="field-hidden">&#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="Do you know which resort you would like to stay?&amp;nbsp;" description="Value  Moderate  Deluxe or Good Neighbor (offsite)" name="text-1774116820321" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="text" required="true" label="Universal Hollywood - Single day or Multi day ticket" description="Multi day ticket is a 2 day ticket unless you inform me you want to add another day" name="text-1774117810097" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="radio-group" required="true" label="Type of Vacation" name="type-of-vacation" other="true">&#13;
			<option label="Solo" value="solo">Solo</option>&#13;
			<option label="Family Vacation" value="family-vacation">Family Vacation</option>&#13;
			<option label="Girls Trip" value="girls-trip">Girls Trip</option>&#13;
			<option label="Guys Trip" value="guys-trip">Guys Trip</option>&#13;
		</field>&#13;
		<field type="text" label="Any special occassion?&amp;nbsp;" name="text-1770762233928" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="PRICE RANGE FOR ALL TRAVELERS" description="Give me your best estimate so I make a proper quote" name="text-1774118588955" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="PAYMENT OPTIONS" name="radio-group-1774118763058" other="true">&#13;
			<option label="Book now - Pay in full" value="book-now-pay-in-full">Book now - Pay in full</option>&#13;
			<option label="Deposit now - make installments" value="deposit-now-make-installments">Deposit now - make installments</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Possible Discounts" name="possible-discounts" other="true">&#13;
			<option label="Annual Passholder" value="annual-passholder">Annual Passholder</option>&#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="Military - Active Duty or Retired US  Military ID Required" value="military-active-duty-or-retired-us-military-id-required">Military - Active Duty or Retired US  Military ID Required</option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="WDW&amp;nbsp; VACATION&amp;nbsp; OPTIONS" inline="true" name="wdw-vacation-options" other="true" className="field-hidden">&#13;
			<option label="Room Only" value="room-only">Room Only</option>&#13;
			<option label="Park Tickets Only" value="park-tickets-only">Park Tickets Only</option>&#13;
			<option label="Room and Tickets" value="room-and-tickets">Room and Tickets</option>&#13;
			<option label="" value=""/>&#13;
		</field>&#13;
		<field type="text" required="true" label="THEME PARK TICKETS - How many needed and for how many days" description="If you need child tickets  I need to know age" name="text-1774117437018" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="checkbox-group" required="true" label="Are you interested in Memory Maker?&amp;nbsp;" description="This is photo package you can purchase in advance - it includes character meet &amp;amp; greets" inline="true" name="checkbox-group-1774117611365" other="true" className="field-hidden">&#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="checkbox-group" required="true" label="Are you interested in the Dining Plan?&amp;nbsp;" description="Quck Service/ Table Service/ Character Dining" inline="true" name="checkbox-group-1774118354293" other="true" className="field-hidden">&#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="checkbox-group" required="true" label="Do you want Park Hopper&amp;nbsp; ticket Option?&amp;nbsp;" inline="true" name="checkbox-group-1774118121228" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you want Water Park Option added to ticket?&amp;nbsp;" description="This may be provided free on your check in date - Depends on promo" inline="true" name="checkbox-group-1774117895697" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you want Lightning Lane added to ticket?&amp;nbsp;" inline="true" name="checkbox-group-1774117672314" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Preferred Dining Time" inline="true" name="have-you-cruised-with-disney-before-" className="field-hidden">&#13;
			<option label="5:45 pm" value="545-pm">5:45 pm</option>&#13;
			<option label="8:00 pm" value="800-pm">8:00 pm</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you want travel insurance?&amp;nbsp;" inline="true" name="checkbox-group-1770763112323">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#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="paragraph" subtype="p" label="Please understand, this isn&#39;t a final price—it&#39;s a personalized trip consultation. Your answers to the questions will guide me in crafting the perfect vacation for you. You also acknowledge that all quoted prices are subject to change until deposits are secured for your booking. Expect a response to your Disney inquiry within 24-48 hours- I am committed to making your travel dreams magical! Thank you for allowing me to assist you.... Julie at Magic Suitcase Getaways"/>&#13;
	</fields>&#13;
</form-template>
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