Share your information with Tina Ruiz

Tina Ruiz

Believe Vacations

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="CLIENT INFORMATION"/>&#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="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="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" required="true" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="ABOUT YOUR TRIP"/>&#13;
		<field type="checkbox-group" required="true" label="What vacation type are you looking to plan?" name="what-vacation-type-are-you-looking-to-plan" other="true">&#13;
			<option label="Disneyland (California)" value="disneyland-california">Disneyland (California)</option>&#13;
			<option label="Walt Disney World (Orlando)" value="walt-disney-world-orlando">Walt Disney World (Orlando)</option>&#13;
			<option label="Disney's Aulani Resort in Hawaii " value="disneys-aulani-resort-in-hawaii-">Disney's Aulani Resort in Hawaii </option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="Adventures by Disney (Worldwide)" value="adventures-by-disney-worldwide">Adventures by Disney (Worldwide)</option>&#13;
			<option label="Universal Orlando (Florida)" value="universal-orlando-florida">Universal Orlando (Florida)</option>&#13;
			<option label="Universal Hollywood (California)" value="universal-hollywood-california">Universal Hollywood (California)</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes - I am flexible based on availability" value="yes-i-am-flexible-based-on-availability">Yes - I am flexible based on availability</option>&#13;
			<option label="No - I have specific dates that I must maintain" value="no-i-have-specific-dates-that-i-must-maintain">No - I have specific dates that I must maintain</option>&#13;
		</field>&#13;
		<field type="textarea" label="Will you be celebrating anything during this trip? If so, what is the celebration and what date would you like to celebrate?" name="will-you-be-celebrating-anything-during-this-trip-if-so-what-is-the-celebration-and-what-date-would-you-like-to-celebrate" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adults will be traveling?" name="how-many-adults-will-be-traveling" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Names of adults traveling?" name="how-many-children-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many children (if applicable)?" name="text-1753743424152" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Please list names and ages of all children (age at time of travel):" name="please-list-the-ages-of-all-children-at-time-of-travel" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers? This just gives me a general starting point and can always be changed later." name="what-is-your-budget-for-all-travelers-this-just-gives-me-a-general-starting-point-and-can-always-be-changed-later">&#13;
			<option label="$3,000 - $5,000" value="3000-5000">$3,000 - $5,000</option>&#13;
			<option label="$5,000 - $7,500" value="5000-7500">$5,000 - $7,500</option>&#13;
			<option label="$7,500 - $10,000" value="7500-10000">$7,500 - $10,000</option>&#13;
			<option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option>&#13;
			<option label="$15,000+" value="15000">$15,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What are you wanting to book?" name="what-travel-components-would-you-like-us-to-assist-you-with-check-all-that-apply" other="true">&#13;
			<option label="Hotel &amp; Theme park tickets" value="hotel-theme-park-tickets">Hotel &amp; Theme park tickets</option>&#13;
			<option label="Hotel Only " value="hotel-only-">Hotel Only </option>&#13;
			<option label="Theme Park Tickets " value="theme-park-tickets-">Theme Park Tickets </option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Transportation to/from Airport" value="transportation-tofrom-airport">Transportation to/from Airport</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What kind of hotel are you looking for?" name="what-is-your-preferred-accommodation-please-note-that-certain-disney-options-are-only-available-to-those-in-deluxe-onproperty-accommodations" other="true">&#13;
			<option label="Disney Resort" value="disney-resort">Disney Resort</option>&#13;
			<option label="Disney Owned" value="disney-owned">Disney Owned</option>&#13;
			<option label="Good Neighbor Hotel" value="good-neighbor-hotel">Good Neighbor Hotel</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What hotel options are you interested in? Check all that apply." name="radio-group-1753507301382" other="true">&#13;
			<option label="Deluxe Resorts" value="deluxe-resorts">Deluxe Resorts</option>&#13;
			<option label="Moderate Resorts" value="moderate-resorts">Moderate Resorts</option>&#13;
			<option label="Value Resort" value="value-resort">Value Resort</option>&#13;
			<option label="Monorail  Access (Deluxe)" value="monorail-access-deluxe">Monorail  Access (Deluxe)</option>&#13;
			<option label="Skyliner Access" value="skyliner-access">Skyliner Access</option>&#13;
			<option label="Close Proximity to a Park" value="close-proximity-to-a-park">Close Proximity to a Park</option>&#13;
			<option label="Character Dining at Hotel" value="character-dining-at-hotel">Character Dining at Hotel</option>&#13;
		</field>&#13;
		<field type="radio-group" label="How many park tickets day?" name="radio-group-1757301150038" other="true">&#13;
			<option label="1 park day" value="1-park-day">1 park day</option>&#13;
			<option label="2 park days" value="2-park-days">2 park days</option>&#13;
			<option label="3 park days" value="3-park-days">3 park days</option>&#13;
			<option label="4 park days" value="4-park-days">4 park days</option>&#13;
			<option label="5 park days" value="5-park-days">5 park days</option>&#13;
			<option label="6 park days" value="6-park-days">6 park days</option>&#13;
			<option label="7 park days" value="7-park-days">7 park days</option>&#13;
			<option label="8 park days" value="8-park-days">8 park days</option>&#13;
			<option label="9 park days" value="9-park-days">9 park days</option>&#13;
			<option label="10 park days" value="10-park-days">10 park days</option>&#13;
			<option label="N/A" value="na">N/A</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What experiences are you looking for? Check all that apply." name="what-experiences-are-you-looking-for-check-all-that-apply" other="true">&#13;
			<option label="Lightning Lanes" value="lightning-lanes">Lightning Lanes</option>&#13;
			<option label="Park Hopper Passes" value="park-hopper-passes">Park Hopper Passes</option>&#13;
			<option label="MagicBands" value="magicbands">MagicBands</option>&#13;
			<option label="Character Dining" value="character-dining">Character Dining</option>&#13;
			<option label="Dining Reservations" value="dining-reservations">Dining Reservations</option>&#13;
			<option label="Memory Maker" value="memory-maker">Memory Maker</option>&#13;
			<option label="Bibbidi Bobbidi Boutique" value="bibbidi-bobbidi-boutique">Bibbidi Bobbidi Boutique</option>&#13;
			<option label="Droids or Lightsaber Building" value="droids-or-lightsaber-building">Droids or Lightsaber Building</option>&#13;
			<option label="Not sure" value="not-sure">Not sure</option>&#13;
			<option label="No thanks" value="no-thanks">No thanks</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Have you been to this location before?" name="have-you-been-to-this-location-before">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Is there anything else I need to know or questions you may have?" name="what-else-would-you-like-me-to-know-about-your-ideal-vacation" className="form-control"/>&#13;
		<field type="textarea" label="Who can I thank for referring you to me?" name="who-can-i-thank-for-referring-you-to-me" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="FINE PRINT"/>&#13;
		<field type="checkbox-group" required="true" label="Please note that prices can change until a booking deposit is paid. After booking if any special offers are announced and can be applied to your trip I will adjust price if applicable." name="please-note-that-some-of-our-proposals-come-from-suppliers-who-provide-bundled-rates-without-breaking-down-individual-components-this-practice-protects-our-valued-partners-who-may-have-confidential-contracted-rates-from-local-vendors-and-creates-a-seamless-and-holistic-approach-to-your-travel-plans-do-you-agree-and-understand-that-your-proposal-will-come-as-one-packaged-rate-and-itemized-pricing-will-not-be-available">&#13;
			<option label="Yes, I understand and agree." value="yes-i-understand-and-agree">Yes, I understand and agree.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
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