<html> <body> <form-template> <fields> <field type="paragraph" subtype="blockquote" label="Disneyland Questionnaire"/> <field type="header" subtype="h2" label="Full name"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" label="Preferred Contact Method" inline="true" name="preferred-contact-method"> <option label="Phone" value="phone">Phone</option> <option label="Email" value="email">Email</option> <option label="Either" value="either">Either</option> </field> <field type="checkbox-group" required="true" label="Would you like to be added to our email list to receive travel offers &amp; news?" name="would-you-like-to-be-added-to-our-email-list-to-receive-travel-offers-news"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h2" label="Travel Details &amp; Budget"/> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="checkbox-group" label="What would you like to include in your booking?" name="what-would-you-like-to-include-in-your-booking" other="true"> <option label="Air" value="air">Air</option> <option label="Airport Transfers" value="airport-transfers">Airport Transfers</option> <option label="Hotel" value="hotel">Hotel</option> <option label="Disneyland Park Tickets" value="disneyland-park-tickets">Disneyland Park Tickets</option> </field> <field type="radio-group" label="What is your budget for all travelers in total?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option> <option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="select" label="How Many Adults in Your Party (Ages 18+)?" name="how-many-adults-in-your-party-ages-18" className="form-control"> <option label="0" value="0">0</option> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7+" value="7">7+</option> </field> <field type="select" label="How Many Children in Your Party (Ages 3-17)?" name="how-many-children-in-your-party-ages-317" className="form-control"> <option label="0" value="0">0</option> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7+" value="7">7+</option> </field> <field type="select" label="How Many Toddlers/Infants in Your Party (Under Age 3)?" name="how-many-toddlersinfants-in-your-party-under-age-3" className="form-control"> <option label="0" value="0">0</option> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7+" value="7">7+</option> </field> <field type="text" label="Does anyone in your party have specific needs that we should be aware of while planning?" name="does-anyone-in-your-party-have-specific-needs-that-we-should-be-aware-of-while-planning" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Hotel/Resort Information"/> <field type="text" label="How many hotel rooms will you require?" name="how-many-rooms-will-you-require" subtype="text" className="form-control"/> <field type="checkbox-group" label="Which hotel(s) are you interested in? Please check all that apply." name="which-hotels-are-you-interested-in-please-check-all-that-apply"> <option label="Disneyland Hotel" value="disneyland-hotel">Disneyland Hotel</option> <option label="The Villas at Disneyland Hotel" value="the-villas-at-disneyland-hotel">The Villas at Disneyland Hotel</option> <option label="Pixar Place Hotel" value="pixar-place-hotel">Pixar Place Hotel</option> <option label="Disney's Grand Californian Hotel & Spa" value="disneys-grand-californian-hotel-spa">Disney's Grand Californian Hotel & Spa</option> <option label="A Good Neighbor Hotel (off property)" value="a-good-neighbor-hotel-off-property">A Good Neighbor Hotel (off property)</option> </field> <field type="text" label="Do you have a particular hotel/resort in mind?" name="do-you-have-a-particular-hotelresort-in-mind" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Disneyland Park Information"/> <field type="text" label="How many days of park tickets are you looking for?" name="how-many-days-of-park-tickets-are-you-looking-for" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are you interested in any Disneyland Park add ons? Check all that apply." name="are-you-interested-in-any-wdw-park-add-ons-check-all-that-apply"> <option label="Park Hopper (visit both parks per day)" value="park-hopper-visit-both-parks-per-day">Park Hopper (visit both parks per day)</option> <option label="Private/VIP Tours" value="privatevip-tours">Private/VIP Tours</option> <option label="Genie +" value="genie-">Genie +</option> <option label="Disney After Hour Events (if applicable during your trip dates)" value="disney-after-hour-events-if-applicable-during-your-trip-dates">Disney After Hour Events (if applicable during your trip dates)</option> </field> <field type="checkbox-group" label="Are you affiliated with any of the following groups?" name="are-you-affiliated-with-any-of-the-following-groups"> <option label="Disneyland Annual Pass" value="disneyland-annual-pass">Disneyland Annual Pass</option> <option label="United States Armed Forces" value="united-states-armed-forces">United States Armed Forces</option> <option label="Southern California Resident" value="southern-california-resident">Southern California Resident</option> <option label="Disney Rewards Visa Cardholder" value="disney-rewards-visa-cardholder">Disney Rewards Visa Cardholder</option> </field> <field type="checkbox-group" label="Would you like to add on any other Theme Parks in California?" name="what-locations-would-you-like-to-visit-check-all-that-apply"> <option label="Universal Hollywood Studios" value="universal-hollywood-studios">Universal Hollywood Studios</option> <option label="Legoland" value="legoland">Legoland</option> <option label="Knott's Berry Farm" value="knotts-berry-farm">Knott's Berry Farm</option> <option label="Seaworld" value="seaworld">Seaworld</option> </field> <field type="checkbox-group" label="How many times, if any have you've been to Disneyland California?" name="how-many-times-if-any-have-youve-been-to-walt-disney-world"> <option label="This is my first time" value="this-is-my-first-time">This is my first time</option> <option label="A few times" value="a-few-times">A few times</option> <option label="Numerous times" value="numerous-times">Numerous times</option> </field> <field type="header" subtype="h1" label="Flight Information. If not applicable, please skip."/> <field type="text" label="Preferred Airline, if applicable." description="Please list your preferred airline and we can look to see if there are flights that meet your needs." name="preferred-airline-if-applicable" subtype="text" className="form-control"/> <field type="select" label="Flight Fare/Class Preference" description="We will find the best fit for you that is still within your budget." name="flight-fareclass-preference" className="form-control"> <option label="Standard/Economy" value="standardeconomy">Standard/Economy</option> <option label="Business Class" value="business-class">Business Class</option> <option label="First Class" value="first-class">First Class</option> </field> <field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/> <field type="checkbox-group" label="Traveling for a special occasion?" name="traveling-for-a-special-occasion"> <option label="Birthday" value="birthday">Birthday</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Bachelor/Bachelorette Party" value="bachelorbachelorette-party">Bachelor/Bachelorette Party</option> <option label="Anniversay" value="anniversay">Anniversay</option> <option label="Destination Wedding" value="destination-wedding">Destination Wedding</option> <option label="Family Reunion" value="family-reunion">Family Reunion</option> <option label="Company Incentive/Reward Travel" value="company-incentivereward-travel">Company Incentive/Reward Travel</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" label="Any other details you would like me to know about your trip?" name="notes" className="form-control"/> </fields> </form-template> </body> </html>
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