Share your information with Melissa Caracciolo

Melissa Caracciolo

Sharpe Travel Agency

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Vacation Quote Request Form"/>&#13;
		<field type="paragraph" subtype="p" label="My name is Melissa and I can&#39;t wait to help you plan your family&#39;s dream vacation! Before we can start making magic, let&#39;s get some important details covered."/>&#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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred Method of Contact" name="preferred-method-of-contact" className="field-hidden">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Text Message" value="text-message">Text Message</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Where are you interested in traveling ?" description="Select a max of two options from the menu" name="destination">&#13;
			<option label="Disney World" value="disney-world">Disney World</option>&#13;
			<option label="Disneyland" value="disneyland">Disneyland</option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="Disney's Aulani in Hawaii" value="disneys-aulani-in-hawaii">Disney's Aulani in Hawaii</option>&#13;
			<option label="Adventures by Disney" value="adventures-by-disney">Adventures by Disney</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="date" label="Arrival Date" name="arrival-date" className="form-control"/>&#13;
		<field type="date" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="select" label="How many adults in your total party?&amp;nbsp;" name="how-many-adults-" className="form-control">&#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="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
			<option label="10" value="10">10</option>&#13;
			<option label="More than 10" value="more-than-10">More than 10</option>&#13;
		</field>&#13;
		<field type="select" label="How many children in your total party?&amp;nbsp;" name="how-many-children" className="form-control">&#13;
			<option label="0" value="0">0</option>&#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="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
			<option label="10" value="10">10</option>&#13;
			<option label="More than 10" value="more-than-10">More than 10</option>&#13;
		</field>&#13;
		<field type="textarea" label="If there are children in your group, what will their ages be at time of travel?&amp;nbsp;" name="textarea-1728493246297" rows="5" className="form-control"/>&#13;
		<field type="checkbox-group" label="What is your preferred budget range?" name="checkbox-group-1765412662924">&#13;
			<option label="$1,500 - $2,500" value="1500-2500">$1,500 - $2,500</option>&#13;
			<option label="$2,500 - $4,500" value="2500-4500">$2,500 - $4,500</option>&#13;
			<option label="$4,500 - $6,000" value="4500-6000">$4,500 - $6,000</option>&#13;
			<option label="$6,000 - $7,500" value="6000-7500">$6,000 - $7,500</option>&#13;
			<option label="$7,500 - $10,000" value="7500-10000">$7,500 - $10,000</option>&#13;
			<option label="$10,000 or above" value="10000-or-above">$10,000 or above</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What best describes your hotel preference?" name="checkbox-group-1765413034798">&#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="Villa Style" value="villa-style">Villa Style</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="If you are traveling to a theme park, how many park days are you planning for?" name="checkbox-group-1772328224010">&#13;
			<option label="2-3" value="2-3">2-3</option>&#13;
			<option label="3-4" value="3-4">3-4</option>&#13;
			<option label="4-5" value="4-5">4-5</option>&#13;
			<option label="5 or more" value="5-or-more">5 or more</option>&#13;
		</field>&#13;
		<field type="select" label="If you are traveling to a theme park, how many park days are you planning for?" name="select-1765413856792" className="form-control field-hidden">&#13;
			<option label="2-3" value="2-3">2-3</option>&#13;
			<option label="3-4" value="3-4">3-4</option>&#13;
			<option label="5-6" value="5-6">5-6</option>&#13;
			<option label="5 or more" value="5-or-more">5 or more</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything else you&#39;re hoping for?&amp;nbsp; (i.e. dream hotels,&amp;nbsp; any celebrations, special activities, etc.)" placeholder="Example: It is our honeymoon  we love to hike  we are foodies  etc." name="please-list-any-other-important-details-to-consider" rows="5" className="form-control"/>&#13;
		<field type="checkbox-group" label="How did you hear about me?" name="checkbox-group-1765413404346">&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="TikTok" value="tiktok">TikTok</option>&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>