Share your information with Lindsay Meyer

Lindsay Meyer

Travelmation LLC

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	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" 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" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Please provide full legal name(s) - to match passport - for each adult (over 18) in your travel party."/>&#13;
		<field type="textarea" required="true" label="Text Area" name="textarea-1668563504045" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Please provide full legal name(s) - to match passport, along with date of birth, for each child in your travel party. If there are only adults in your travel party, please type N/A."/>&#13;
		<field type="textarea" required="true" label="Text Area" name="textarea-1668563592852" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Preferred Travel Dates"/>&#13;
		<field type="text" required="true" label="Please provide either a specific date window OR month that you would like to travel." name="please-provide-either-a-specific-date-window-or-month-that-you-would-like-to-travel" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Budget"/>&#13;
		<field type="checkbox-group" required="true" label="What is the budget for this trip?" name="what-is-the-budget-for-this-trip">&#13;
			<option label="$2,000-3,000" value="20003000">$2,000-3,000</option>&#13;
			<option label="$3,000-5,000" value="30005000">$3,000-5,000</option>&#13;
			<option label="$5,000-7,000" value="50007000">$5,000-7,000</option>&#13;
			<option label="$7,000-10,000" value="700010000">$7,000-10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
			<option label="Budget is flexible" value="budget-is-flexible">Budget is flexible</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Disney Cruise Specific Details"/>&#13;
		<field type="checkbox-group" label="Is this your first Disney Cruise?" name="is-this-your-first-trip-to-disney">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do you have a preference for stateroom type/category?" name="would-you-like-to-add-memorymaker-disneys-photo-service-offered-throughout-the-parks-rides-and-resorts">&#13;
			<option label="Inside" value="inside">Inside</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Verandah" value="verandah">Verandah</option>&#13;
			<option label="Concierge" value="concierge">Concierge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="If you have cruised with Disney before, which ships have you sailed?"/>&#13;
		<field type="textarea" label="Text Area" name="textarea-1668564019181" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Would you like early or late dining for your sailing?"/>&#13;
		<field type="text" label="Text Field" name="text-1668564120523" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Any other specific details that you would like to share that would assist in the planning of this trip?"/>&#13;
		<field type="textarea" label="Text Area" name="textarea-1669208996473" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Referrals from family and friends are one of the best parts of this business... please let me know how you heard about my planning services with Travelmation.&amp;nbsp;"/>&#13;
		<field type="textarea" label="Text Area" name="textarea-1731342148517" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>