Share your information with Renee Edwards

Renee Edwards

The Travel Chick

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Walt Disney World Intake&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Please fill out an intake form for each family or room to be booked."/>&#13;
		<field type="date" required="true" label="Date Field" name="date-1777756831915" className="form-control"/>&#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="radio-group" required="true" label="Prefered Method of Contact" name="prefered-method-of-contact" other="true">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Any" value="any">Any</option>&#13;
		</field>&#13;
		<field type="date" required="true" 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"/>&#13;
		<field type="date" required="true" 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"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="If your dates are flexible~what other dates would you concider?" name="if-your-dates-are-flexiblewhat-other-dates-would-you-concider" rows="4" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers over the age of 18?&amp;nbsp;" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Will you be traveling with children?" description="Under the age of 18." name="will-you-be-traveling-with-children" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="If you are traveling with children, please list their names and ages at the time of travel." name="if-you-are-traveling-with-children-please-list-their-names-and-ages-at-the-time-of-travel" rows="5" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What parks do you want to visit?" name="what-parks-do-you-want-to-visit" other="true">&#13;
			<option label="Magic Kingdom" value="magic-kingdom">Magic Kingdom</option>&#13;
			<option label="Epcot" value="epcot">Epcot</option>&#13;
			<option label="Hollywood Studios" value="hollywood-studios">Hollywood Studios</option>&#13;
			<option label="Animal Kingdom" value="animal-kingdom">Animal Kingdom</option>&#13;
			<option label="All of the Above" value="all-of-the-above">All of the Above</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you want to go to the Water Parks?" description="Disney&#39;s Typhoon Lagoon and Disney&#39;s Blizzard Beach" name="do-you-want-to-go-to-the-water-parks" other="true">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers in this room?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Value Resorts " value="value-resorts-">Value Resorts </option>&#13;
			<option label="Moderate Resorts" value="moderate-resorts">Moderate Resorts</option>&#13;
			<option label="Deluxe Resorts" value="deluxe-resorts">Deluxe Resorts</option>&#13;
			<option label="Deluxe Villa " value="deluxe-villa-">Deluxe Villa </option>&#13;
			<option label="WDW Good Neighbor Hotel" value="wdw-good-neighbor-hotel">WDW Good Neighbor Hotel</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Are you interested in any of the festivals or events that Disney offers?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Christmas events" value="christmas-events">Christmas events</option>&#13;
			<option label="Mickey's Not So Scary Halloween Party" value="mickeys-not-so-scary-halloween-party">Mickey's Not So Scary Halloween Party</option>&#13;
			<option label="Flower and Garden Festival" value="flower-and-garden-festival">Flower and Garden Festival</option>&#13;
			<option label="Run Disney or Marathons" value="run-disney-or-marathons">Run Disney or Marathons</option>&#13;
			<option label="International Food and Wine Festival" value="international-food-and-wine-festival">International Food and Wine Festival</option>&#13;
			<option label="Any " value="any-">Any </option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you have any Disney Affiliations?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Disney Annual Passholder" value="disney-annual-passholder">Disney Annual Passholder</option>&#13;
			<option label="Disney Visa Card Holder" value="disney-visa-card-holder">Disney Visa Card Holder</option>&#13;
			<option label="Disney + Subscriber" value="disney-subscriber">Disney + Subscriber</option>&#13;
			<option label="DVC Owner" value="dvc-owner">DVC Owner</option>&#13;
			<option label="DCL Castaway Club" value="dcl-castaway-club">DCL Castaway Club</option>&#13;
			<option label="Florida Resident" value="florida-resident">Florida Resident</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="text" required="true" label="If you were refered to me, please list their name and contact info.&amp;nbsp;" description="If you were not refered to me- put NA" name="if-you-were-refered-to-me-please-list-their-name-and-contact-info-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="I understand that complimentary quotes are for reference only and are subject to change. No courtesy holds will be made unless specifically requested by the client." name="i-understand-that-complimentary-quotes-are-for-reference-only-and-are-subject-to-change-no-courtesy-holds-will-be-made-unless-specifically-requested-by-the-client">&#13;
			<option label="I understand and agree" value="i-understand-and-agree">I understand and agree</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>