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Melissa Gandy
Melissa Mouse Travels
<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&nbsp;" name="preferred-name-" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="I prefer to be contacted by:&nbsp;" name="i-prefer-to-be-contacted-by-"> <option label="Phone Call" value="phone-call">Phone Call</option> <option label="Email" value="email">Email</option> <option label="Text" value="text">Text</option> <option label="Any of the above is fine" value="any-of-the-above-is-fine">Any of the above is fine</option> </field> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="select" required="true" label="Preferred Month of Travel" name="preferred-month-of-travel" multiple="multiple" className="form-control"> <option label="January" value="january">January</option> <option label="February" value="february">February</option> <option label="March" value="march">March</option> <option label="April" value="april">April</option> <option label="May" value="may">May</option> <option label="June" value="june">June</option> <option label="July" value="july">July</option> <option label="August" value="august">August</option> <option label="September" value="september">September</option> <option label="October" value="october">October</option> <option label="November" value="november">November</option> <option label="December" value="december">December</option> </field> <field type="select" required="true" label="YEAR of travel" name="year-of-travel" className="form-control"> <option label="2026" value="2026">2026</option> <option label="2027" value="2027">2027</option> </field> <field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="Exact dates of travel - if you know them." name="exact-dates-of-travel-if-you-know-them" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Where are you in the planning stages?" name="where-are-you-in-the-planning-stages"> <option label="Just browsing!" value="just-browsing">Just browsing!</option> <option label="Pretty good idea, but need help with some details." value="pretty-good-idea-but-need-help-with-some-details">Pretty good idea, but need help with some details.</option> <option label="Pretty good idea of what I want & when!" value="pretty-good-idea-of-what-i-want-when">Pretty good idea of what I want & when!</option> <option label="I have my deposit & am ready to book!" value="i-have-my-deposit-am-ready-to-book">I have my deposit & am ready to book!</option> </field> <field type="text" required="true" label="How many Adults" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="How many Children (Under 18)" name="text-1768252856268" subtype="text" className="form-control"/> <field type="text" required="true" label="Please list names &amp; ages of any children under 18 - this helps us with more accurate quoting. (If no children - type "none")&nbsp;" name="text-1768857760803" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for all travelers? (NOT including flights)&nbsp;" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$3,000 to $4,500" value="3000-to-4500">$3,000 to $4,500</option> <option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-to-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-to-10000">$8,500 to $10,000</option> <option label="$10,000 to $15000" value="10000-to-15000">$10,000 to $15000</option> <option label="$15,000-$20,000" value="1500020000">$15,000-$20,000</option> <option label="$20k +" value="20k-">$20k +</option> </field> <field type="checkbox-group" required="true" label="Hotel Preference&nbsp;" description="Check all that apply." name="vibe-preference" other="true"> <option label="Onsite Budget/Value Resort (All Star Resorts/ Pop / Art of Animation) " value="onsite-budgetvalue-resort-all-star-resorts-pop-art-of-animation-">Onsite Budget/Value Resort (All Star Resorts/ Pop / Art of Animation) </option> <option label="Onsite Moderate Resort - (Port Orleans/ Caribbean Beach Resort)" value="onsite-moderate-resort-port-orleans-caribbean-beach-resort">Onsite Moderate Resort - (Port Orleans/ Caribbean Beach Resort)</option> <option label="Onsite Deluxe Resort " value="onsite-deluxe-resort-">Onsite Deluxe Resort </option> <option label="Offsite Resort that can still be packaged with my tickets" value="offsite-resort-that-can-still-be-packaged-with-my-tickets">Offsite Resort that can still be packaged with my tickets</option> <option label="Offsite / Vacation Home " value="offsite-vacation-home-">Offsite / Vacation Home </option> </field> <field type="checkbox-group" required="true" label="What parks are you wanting to visit?" name="preferred-cruise-line"> <option label="Magic Kingdom (Castle/ Nostalgia/ Many rides for little ones)" value="magic-kingdom-castle-nostalgia-many-rides-for-little-ones">Magic Kingdom (Castle/ Nostalgia/ Many rides for little ones)</option> <option label="EPCOT ( Frozen/ Nemo/ Aquarium/ Countries) " value="epcot-frozen-nemo-aquarium-countries-">EPCOT ( Frozen/ Nemo/ Aquarium/ Countries) </option> <option label="Hollywood Studios (Star Wars/ Toystory/ Tower of Terror) " value="hollywood-studios-star-wars-toystory-tower-of-terror-">Hollywood Studios (Star Wars/ Toystory/ Tower of Terror) </option> <option label="Animal Kingdom (Everest/Animal Encounters/ Avatar/Lion King & Nemo Shows) " value="animal-kingdom-everestanimal-encounters-avatarlion-king-nemo-shows-">Animal Kingdom (Everest/Animal Encounters/ Avatar/Lion King & Nemo Shows) </option> <option label="A Water Park (Blizzard Beach or Typhoon Lagoon) " value="a-water-park-blizzard-beach-or-typhoon-lagoon-">A Water Park (Blizzard Beach or Typhoon Lagoon) </option> </field> <field type="radio-group" required="true" label="How many days are you wanting in the parks? (Please note less than 3 days may incur a Travel Agent Fee).&nbsp;" name="how-many-days-are-you-wanting-in-the-parks-please-note-less-than-3-days-may-incur-a-travel-agent-fee-"> <option label="1 Day" value="1-day">1 Day</option> <option label="2 Days" value="2-days">2 Days</option> <option label="3 Days " value="3-days-">3 Days </option> <option label="4 Days" value="4-days">4 Days</option> <option label="5 Days " value="5-days-">5 Days </option> <option label="6 Days " value="6-days-">6 Days </option> <option label="7 Days " value="7-days-">7 Days </option> <option label="8 Days " value="8-days-">8 Days </option> <option label="9 Days or more" value="9-days-or-more">9 Days or more</option> </field> <field type="checkbox-group" required="true" label="Do you qualify for any of the following? (This does NOT guarantee a discount)&nbsp;" name="do-you-qualify-for-any-of-the-following-this-does-not-guarantee-a-discount-"> <option label="Military - Active Duty, 100% Disabled Veterans (with DAVPRM marking), Retired, and Reservists." value="military-active-duty-100-disabled-veterans-with-davprm-marking-retired-and-reservists">Military - Active Duty, 100% Disabled Veterans (with DAVPRM marking), Retired, and Reservists.</option> <option label="Disney Visa Holder" value="disney-visa-holder">Disney Visa Holder</option> <option label="Disney+ Account Owner" value="disney-account-owner">Disney+ Account Owner</option> <option label="Florida Resident" value="florida-resident">Florida Resident</option> <option label="None of the above" value="none-of-the-above">None of the above</option> </field> <field type="checkbox-group" required="true" label="Do you want the park hopper? (Hop from one park to another in the same day?)&nbsp;" description="I don't recommend this for first time visitors." name="activity-preferences"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="I have no idea, please chat with me about this." value="i-have-no-idea-please-chat-with-me-about-this">I have no idea, please chat with me about this.</option> </field> <field type="select" required="true" label="Are you interested in the dining plan?&nbsp;" name="are-you-interested-in-the-dining-plan-" className="form-control"> <option label="Yes, the Quick Service Plan ( No table service meals) " value="yes-the-quick-service-plan-no-table-service-meals-">Yes, the Quick Service Plan ( No table service meals) </option> <option label="Yes the full service plan (Table Service Meals Included) " value="yes-the-full-service-plan-table-service-meals-included-">Yes the full service plan (Table Service Meals Included) </option> <option label="No thank you" value="no-thank-you">No thank you</option> <option label="I'm not sure, can we talk about this?" value="im-not-sure-can-we-talk-about-this">I'm not sure, can we talk about this?</option> </field> <field type="select" required="true" label="Are you interested in the memory maker?" description="This is the digital photo package. Includes ride character and in -park photos - It costs less to add it now than in the parks." name="select-1768857871223" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No thank you" value="no-thank-you">No thank you</option> <option label="I'm not sure yet" value="im-not-sure-yet">I'm not sure yet</option> </field> <field type="text" label="Is there anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your reason for planning this trip?&nbsp;" name="text-1768253058205" subtype="text" className="form-control"/> <field type="text" required="true" label="Are you celebrating anything? (Ex. Yes, Johns 21st birthday)&nbsp;" name="text-1768856798290" subtype="text" className="form-control"/> <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"/> <field type="select" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" className="form-control"> <option label="Referred by a friend" value="referred-by-a-friend">Referred by a friend</option> <option label="Instagram" value="instagram">Instagram</option> <option label="Your Facebook Group" value="your-facebook-group">Your Facebook Group</option> <option label="Email Newsletter" value="email-newsletter">Email Newsletter</option> <option label="Facebook Page" value="facebook-page">Facebook Page</option> <option label="Google " value="google-">Google </option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" required="true" label="By Filling this form out I am recognizing that I am giving Melissa Gandy with Melissa Mouse Travels and/or her employees permission to contact me.&nbsp;" name="checkbox-group-1768856865328"> <option label="Yes, I agree." value="yes-i-agree">Yes, I agree.</option> </field> </fields> </form-template> </body> </html>
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