Share your information with Renee Edwards

Renee Edwards

The Travel Chick

<html>
  <body>
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	<fields>&#13;
		<field type="date" label="Date Field" name="date-1775781815139" className="form-control"/>&#13;
		<field type="header" subtype="h1" 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="header" subtype="h1" label="Address and Contact Information"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" 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="Travel Dates"/>&#13;
		<field type="text" required="true" label="What are your prefered travel dates?" name="text-1775782323748" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are your dates flexible? If so, what is the travel date range?" name="text-1775782638973" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="People Traveling"/>&#13;
		<field type="textarea" label="Please provide the names and ages of all individuals traveling. If you require more than one room, please specify which individuals will be staying in each room." name="textarea-1775782968820" value="Please provide the names and ages of all individuals traveling. If you require more than one room  please specify which individuals will be staying in each room." className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Resort and Accomodations"/>&#13;
		<field type="select" required="true" label="What Resort Category do you prefer?&amp;nbsp;" name="select-1775782021064" className="form-control">&#13;
			<option label="Signature Collection ($$$$)" value="signature-collection-">Signature Collection ($$$$)</option>&#13;
			<option label="Prime Value ($$$)" value="prime-value-">Prime Value ($$$)</option>&#13;
			<option label="Value Inns and Suites ($$)" value="value-inns-and-suites-">Value Inns and Suites ($$)</option>&#13;
			<option label="Off Property" value="off-property">Off Property</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you have a prefered hotel? Is so, list.&amp;nbsp;" name="text-1775782957315" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you need an accessible room? If so, list whether it is mobility, hearing, or visual." name="text-1775784034894" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please list your preference on bedding configuration." description="King  2 queen  etc" name="text-1775784300728" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please list any other needs/wants for your accomodations.&amp;nbsp;" description="Garden view  pool view  lower level, etc" name="text-1775784391159" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Theme Parks"/>&#13;
		<field type="radio-group" required="true" label="What parks do you want to visit?" name="radio-group-1775784940816" other="true">&#13;
			<option label="Universal Islands of Adventure" value="universal-islands-of-adventure">Universal Islands of Adventure</option>&#13;
			<option label="Universal Studios" value="universal-studios">Universal Studios</option>&#13;
			<option label="Epic Universe" value="epic-universe">Epic Universe</option>&#13;
			<option label="Volcano Bay (Water Park)" value="volcano-bay-water-park">Volcano Bay (Water Park)</option>&#13;
			<option label="All" value="all">All</option>&#13;
			<option label="All Except Water Park" value="all-except-water-park">All Except Water Park</option>&#13;
			<option label="Only The Water Park" value="only-the-water-park">Only The Water Park</option>&#13;
			<option label="" value=""/>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you want Park to Park Tickets?&amp;nbsp;" description="Do you want to ride the Hogwarts ™ Express?  The Park-to-Park ticket is required to take the train between the Wizarding World of Harry Potter™ - Hogsmeade™ and the Wizarding World of Harry Potter™ - Diagon Alley™. The experience is different each way!" name="text-1775784897123" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you want the Express Pass?" description="Express  Pass allows you to bypass the regular standby line at most participating rides and attractions  helping you experience more in less time. This can dramatically change the pace of your day  especially during busy seasons." name="text-1775785686834" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What are your must see or do in the parks?" name="text-1775785570027" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Are you interested in any of the special events or VIP tours?&amp;nbsp;" description="Halloween Horror Nights  Mardi Gras  Concert Series, etc" name="textarea-1775785666521" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Budget"/>&#13;
		<field type="text" label="What is your budget for your Universal Studios trip?&amp;nbsp;" name="text-1775786130336" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Anything else?" description="If there is any other information to share please do so here." name="textarea-1775786210348" className="form-control"/>&#13;
	</fields>&#13;
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  </body>
</html>