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Jacobs Joyful Journeys
<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Full name"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <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" label="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="select" required="true" label="Gender" name="select-1772933575275" className="form-control"> <option label="Male" value="male">Male</option> <option label="Female" value="female">Female</option> <option label="Prefer Not to Say" value="prefer-not-to-say">Prefer Not to Say</option> </field> <field type="text" label="Primary Traveler Country of Citizenship" name="primary-traveler-country-of-citizenship" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of Birth (mm/dd/yr)" name="date-1772933705166" className="form-control"/> <field type="text" label="If you have sailed with Disney Cruise Line before, please provide your Castaway Club Number.&nbsp;" name="if-you-have-sailed-with-disney-cruise-line-before-please-provide-your-castaway-club-number-" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Number of Travelers in your Stateroom&nbsp;" name="number-of-travelers-in-your-stateroom-"> <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> </field> <field type="header" subtype="h2" label="2nd Traveler Information"/> <field type="text" label="Full Name (first, middle, last as on travel documents)" name="full-name-first-middle-last" subtype="text" className="form-control"/> <field type="date" label="2nd Traveler Date of Birth (mm/dd/yr)" name="date-1772934131096" className="form-control"/> <field type="radio-group" label="2nd Traveler Gender" name="2nd-traveler-gender"> <option label="Male" value="male">Male</option> <option label="Female" value="female">Female</option> </field> <field type="text" label="2nd Traveler Address, City, State, and Zip" name="2nd-traveler-address-city-state-and-zip" subtype="text" className="form-control"/> <field type="text" label="2nd Traveler Phone Number" name="2nd-traveler-phone-number" subtype="text" className="form-control"/> <field type="text" label="2nd Traveler Country of Citizenship" name="text-1772936296337" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="3rd Traveler Information"/> <field type="text" label="3rd Traveler Full Name (first, middle, last as on travel documents)" name="text-1775076697209" subtype="text" className="form-control"/> <field type="date" label="3rd Traveler Date of Birth (mm/dd/yr)" name="date-1775076914756" className="form-control"/> <field type="radio-group" label="3rd Traveler Gender" name="radio-group-1775076737778"> <option label="Male" value="male">Male</option> <option label="Female" value="female">Female</option> </field> <field type="text" label="3rd Traveler Address, City, State, and Zip" name="text-1775076773775" subtype="text" className="form-control"/> <field type="text" label="3rd Traveler Phone Number" name="text-1775076807316" subtype="text" className="form-control"/> <field type="text" label="3rd Traveler Country of Citizenship" name="text-1775076866025" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Additional Travelers"/> <field type="text" label="Please provide the gender, name, date of birth, country of citizenship of all additional travelers." name="please-provide-the-gender-name-date-of-birth-country-of-citizenship-of-any-additional-travelers" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Details"/> <field type="radio-group" label="What is most important to you when finding a package that works for you?" name="what-is-most-important-to-you-when-finding-a-package-that-works-for-you"> <option label="Full Luxury. "Cost doesn't matter"" value="full-luxury-cost-doesnt-matter">Full Luxury. "Cost doesn't matter"</option> <option label="Overall Experience. "I do not mind paying a little more to maximize my experience"" value="overall-experience-i-do-not-mind-paying-a-little-more-to-maximize-my-experience">Overall Experience. "I do not mind paying a little more to maximize my experience"</option> <option label="The price/budget is the most important factor. "I have a strict budget or cap on what I am willing to spend"" value="the-pricebudget-is-the-most-important-factor-i-have-a-strict-budget-or-cap-on-what-i-am-willing-to-spend">The price/budget is the most important factor. "I have a strict budget or cap on what I am willing to spend"</option> </field> <field type="radio-group" label="Please select your preferred budget rage. Jacobs Joyful Journey will do our best to find an option within your budget. Please keep in mind the number of travelers in your party and the number of days you wish to visit the park to identify a reasonable package.&nbsp;" name="please-select-your-preferred-budget-rage-jacobs-joyful-journey-will-do-our-best-to-find-an-option-within-your-budget-please-keep-in-mind-the-number-of-travelers-in-your-party-and-the-number-of-days-you-wish-to-visit-the-park-to-identify-a-reasonable-package-"> <option label="$2000.00 - $4000.00" value="200000-400000">$2000.00 - $4000.00</option> <option label="$4001.00 - $6000.00" value="400100-600000">$4001.00 - $6000.00</option> <option label="$6001.00 - $8000.00" value="600100-800000">$6001.00 - $8000.00</option> <option label="$8001.00 - $10000.00" value="800100-1000000">$8001.00 - $10000.00</option> <option label="Budget is not a concern " value="budget-is-not-a-concern-">Budget is not a concern </option> </field> <field type="radio-group" required="true" label="Primary Stateroom Preference" name="primary-stateroom-preference"> <option label="Standard Inside Stateroom (169 sq ft)" value="standard-inside-stateroom-169-sq-ft">Standard Inside Stateroom (169 sq ft)</option> <option label="Deluxe Inside Stateroom (204 sq ft)" value="deluxe-inside-stateroom-204-sq-ft">Deluxe Inside Stateroom (204 sq ft)</option> <option label="Deluxe Oceanview Stateroom (204 sq ft)" value="deluxe-oceanview-stateroom-204-sq-ft">Deluxe Oceanview Stateroom (204 sq ft)</option> <option label="Deluxe Oceanview Stateroom - Guaranteed (204 sq ft)" value="deluxe-oceanview-stateroom-guaranteed-204-sq-ft">Deluxe Oceanview Stateroom - Guaranteed (204 sq ft)</option> <option label="Deluxe Family Oceanview Stateroom (241 sq ft)" value="deluxe-family-oceanview-stateroom-241-sq-ft">Deluxe Family Oceanview Stateroom (241 sq ft)</option> <option label="Deluxe Oceanview Stateroom with Verandah (246 sq ft)" value="deluxe-oceanview-stateroom-with-verandah-246-sq-ft">Deluxe Oceanview Stateroom with Verandah (246 sq ft)</option> <option label="Deluxe Family Oceanview Stateroom with Verandah (299 sq ft)" value="deluxe-family-oceanview-stateroom-with-verandah-299-sq-ft">Deluxe Family Oceanview Stateroom with Verandah (299 sq ft)</option> <option label="Concierge Family Oceanview Stateroom with Verandah (306 sq ft)" value="concierge-family-oceanview-stateroom-with-verandah-306-sq-ft">Concierge Family Oceanview Stateroom with Verandah (306 sq ft)</option> <option label="Concierge 1 Bedroom Suite with Verandah (592 sq ft)" value="concierge-1-bedroom-suite-with-verandah-592-sq-ft">Concierge 1 Bedroom Suite with Verandah (592 sq ft)</option> <option label="Concierge Royal Suite with Verandah (1781 sq ft)" value="concierge-royal-suite-with-verandah-1781-sq-ft">Concierge Royal Suite with Verandah (1781 sq ft)</option> <option label="No Preference " value="no-preference-">No Preference </option> </field> <field type="radio-group" required="true" label="Secondary Stateroom Preference" name="radio-group-1775077704600"> <option label="Standard Inside Stateroom (169 sq ft)" value="standard-inside-stateroom-169-sq-ft">Standard Inside Stateroom (169 sq ft)</option> <option label="Deluxe Inside Stateroom (204 sq ft)" value="deluxe-inside-stateroom-204-sq-ft">Deluxe Inside Stateroom (204 sq ft)</option> <option label="Deluxe Oceanview Stateroom (204 sq ft)" value="deluxe-oceanview-stateroom-204-sq-ft">Deluxe Oceanview Stateroom (204 sq ft)</option> <option label="Deluxe Oceanview Stateroom - Guaranteed (204 sq ft)" value="deluxe-oceanview-stateroom-guaranteed-204-sq-ft">Deluxe Oceanview Stateroom - Guaranteed (204 sq ft)</option> <option label="Deluxe Family Oceanview Stateroom (241 sq ft)" value="deluxe-family-oceanview-stateroom-241-sq-ft">Deluxe Family Oceanview Stateroom (241 sq ft)</option> <option label="Deluxe Oceanview Stateroom with Verandah (246 sq ft)" value="deluxe-oceanview-stateroom-with-verandah-246-sq-ft">Deluxe Oceanview Stateroom with Verandah (246 sq ft)</option> <option label="Deluxe Family Oceanview Stateroom with Verandah (299 sq ft)" value="deluxe-family-oceanview-stateroom-with-verandah-299-sq-ft">Deluxe Family Oceanview Stateroom with Verandah (299 sq ft)</option> <option label="Concierge Family Oceanview Stateroom with Verandah (306 sq ft)" value="concierge-family-oceanview-stateroom-with-verandah-306-sq-ft">Concierge Family Oceanview Stateroom with Verandah (306 sq ft)</option> <option label="Concierge 1 Bedroom Suite with Verandah (592 sq ft)" value="concierge-1-bedroom-suite-with-verandah-592-sq-ft">Concierge 1 Bedroom Suite with Verandah (592 sq ft)</option> <option label="Concierge Royal Suite with Verandah (1781 sq ft)" value="concierge-royal-suite-with-verandah-1781-sq-ft">Concierge Royal Suite with Verandah (1781 sq ft)</option> <option label="No Preference " value="no-preference-">No Preference </option> </field> <field type="radio-group" required="true" label="Final Stateroom Preference" name="radio-group-1775077727566"> <option label="Standard Inside Stateroom (169 sq ft)" value="standard-inside-stateroom-169-sq-ft">Standard Inside Stateroom (169 sq ft)</option> <option label="Deluxe Inside Stateroom (204 sq ft)" value="deluxe-inside-stateroom-204-sq-ft">Deluxe Inside Stateroom (204 sq ft)</option> <option label="Deluxe Oceanview Stateroom (204 sq ft)" value="deluxe-oceanview-stateroom-204-sq-ft">Deluxe Oceanview Stateroom (204 sq ft)</option> <option label="Deluxe Oceanview Stateroom - Guaranteed (204 sq ft)" value="deluxe-oceanview-stateroom-guaranteed-204-sq-ft">Deluxe Oceanview Stateroom - Guaranteed (204 sq ft)</option> <option label="Deluxe Family Oceanview Stateroom (241 sq ft)" value="deluxe-family-oceanview-stateroom-241-sq-ft">Deluxe Family Oceanview Stateroom (241 sq ft)</option> <option label="Deluxe Oceanview Stateroom with Verandah (246 sq ft)" value="deluxe-oceanview-stateroom-with-verandah-246-sq-ft">Deluxe Oceanview Stateroom with Verandah (246 sq ft)</option> <option label="Deluxe Family Oceanview Stateroom with Verandah (299 sq ft)" value="deluxe-family-oceanview-stateroom-with-verandah-299-sq-ft">Deluxe Family Oceanview Stateroom with Verandah (299 sq ft)</option> <option label="Concierge Family Oceanview Stateroom with Verandah (306 sq ft)" value="concierge-family-oceanview-stateroom-with-verandah-306-sq-ft">Concierge Family Oceanview Stateroom with Verandah (306 sq ft)</option> <option label="Concierge 1 Bedroom Suite with Verandah (592 sq ft)" value="concierge-1-bedroom-suite-with-verandah-592-sq-ft">Concierge 1 Bedroom Suite with Verandah (592 sq ft)</option> <option label="Concierge Royal Suite with Verandah (1781 sq ft)" value="concierge-royal-suite-with-verandah-1781-sq-ft">Concierge Royal Suite with Verandah (1781 sq ft)</option> <option label="No Preference " value="no-preference-">No Preference </option> </field> <field type="radio-group" label="Preferred Stateroom location&nbsp;" name="radio-group-1772935438953"> <option label="Aft - back of the ship" value="aft-back-of-the-ship">Aft - back of the ship</option> <option label="Midship - Middle of the ship" value="midship-middle-of-the-ship">Midship - Middle of the ship</option> <option label="Forward - Front of the ship" value="forward-front-of-the-ship">Forward - Front of the ship</option> </field> <field type="radio-group" label="Preferred Deck Level&nbsp;" name="preferred-deck-level-"> <option label="Lower Level Deck (1-5)" value="lower-level-deck-15">Lower Level Deck (1-5)</option> <option label="Mid Level Deck (5-10)" value="mid-level-deck-510">Mid Level Deck (5-10)</option> <option label="Higher Level Deck (Deck 10 or higher)" value="higher-level-deck-deck-10-or-higher">Higher Level Deck (Deck 10 or higher)</option> </field> <field type="select" required="true" label="Preferred dining time&nbsp;" name="preferred-dining-time-" className="form-control"> <option label="Late (around 8pm)" value="late-around-8pm">Late (around 8pm)</option> <option label="Early (around 5pm)" value="early-around-5pm">Early (around 5pm)</option> <option label="No Preference " value="no-preference-">No Preference </option> </field> <field type="text" label="Please share any additional important information related to your vacation preferences." name="text-1772935706125" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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