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Dallas Godbold

Travelmation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Traveler Info"/>&#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 type="text" label="Preferred name" name="preferred-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="textarea" required="true" label="All Traveler Info" placeholder="Please provide full names &amp;amp; birthdates for all travelers. " name="all-traveler-info" className="form-control"/>&#13;
		<field type="date" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="date" label="Return Date" name="return-date" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Disney Info"/>&#13;
		<field type="select" label="How soon are you looking to book?&amp;nbsp;" name="how-soon-are-you-looking-to-book-" className="form-control">&#13;
			<option label="Today " value="today-" selected="selected">Today </option>&#13;
			<option label="Within the next 7-10 days" value="within-the-next-710-days">Within the next 7-10 days</option>&#13;
			<option label="In a few months" value="in-a-few-months">In a few months</option>&#13;
			<option label="Just Considering Options" value="just-considering-options">Just Considering Options</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Hotel Category Preference" name="hotel-category-preference">&#13;
			<option label="Value (-$175-$250 per night)" value="value-175250-per-night">Value (-$175-$250 per night)</option>&#13;
			<option label="Moderate (over $250 per night)" value="moderate-over-250-per-night">Moderate (over $250 per night)</option>&#13;
			<option label="Deluxe (over $400 per night)" value="deluxe-over-400-per-night">Deluxe (over $400 per night)</option>&#13;
			<option label="Off property" value="off-property">Off property</option>&#13;
		</field>&#13;
		<field type="select" label="Ticket Options" name="ticket-options" className="form-control">&#13;
			<option label="Base Ticket" value="base-ticket" selected="selected">Base Ticket</option>&#13;
			<option label="Park Hopper" value="park-hopper">Park Hopper</option>&#13;
			<option label="Park Hopper Plus (includes water parks)" value="park-hopper-plus-includes-water-parks">Park Hopper Plus (includes water parks)</option>&#13;
			<option label="I would like more information" value="i-would-like-more-information">I would like more information</option>&#13;
		</field>&#13;
		<field type="text" label="How many days would like tickets to the park?" placeholder="Ex: 3 park days" name="how-many-days-would-like-tickets-to-the-park" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Which parks would you like to visit?" name="which-parks-would-you-like-to-visit">&#13;
			<option label="Magic Kingdom" value="magic-kingdom" selected="selected">Magic Kingdom</option>&#13;
			<option label="Hollywood Studios" value="hollywood-studios">Hollywood Studios</option>&#13;
			<option label="EPCOT" value="epcot">EPCOT</option>&#13;
			<option label="Animal Kingdom" value="animal-kingdom">Animal Kingdom</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like to add on one of the Dining Plans?" name="would-you-like-to-add-on-one-of-the-dining-plans">&#13;
			<option label="Yes, the Disney Quick-Service dining plan " value="yes-the-disney-quickservice-dining-plan-">Yes, the Disney Quick-Service dining plan </option>&#13;
			<option label="Yes, the Disney Dining Plan (includes Quick Service &amp; Table Service)" value="yes-the-disney-dining-plan-includes-quick-service-table-service">Yes, the Disney Dining Plan (includes Quick Service &amp; Table Service)</option>&#13;
			<option label="I need more information" value="i-need-more-information">I need more information</option>&#13;
			<option label="No thank you! " value="no-thank-you-">No thank you! </option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Preferred Budget" name="preferred-budget">&#13;
			<option label="Under $3,000" value="under-3000">Under $3,000</option>&#13;
			<option label="$3,000 - $5,000" value="3000-5000">$3,000 - $5,000</option>&#13;
			<option label="$5,000 - $7,000" value="5000-7000">$5,000 - $7,000</option>&#13;
			<option label="$7,000 - $9,000" value="7000-9000">$7,000 - $9,000</option>&#13;
			<option label="$10,000 +" value="10000-">$10,000 +</option>&#13;
		</field>&#13;
		<field type="textarea" label="Any further information you would like me to know!" name="textarea-1704573107485" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>