Share your information with Emily Solel

Emily Solel

Walt Dreams Are Made Of

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Trip Interest Form"/>&#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 required="true"  type="text" 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="checkbox-group" required="true" label="Where would you like to go?" name="where-would-you-like-to-go">&#13;
			<option label="Walt Disney World" value="walt-disney-world">Walt Disney World</option>&#13;
			<option label="Disneyland" value="disneyland">Disneyland</option>&#13;
			<option label="Universal Studios" value="universal-studios">Universal Studios</option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="All Inclusive" value="all-inclusive">All Inclusive</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Other" value="Other">Other</option>&#13;
		</field>&#13;
		<field type="date" label="When would you like to check in?" name="when-would-you-like-to-check-in" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Do you have a Budget in Mind?" name="do-you-have-a-budget-in-mind">&#13;
			<option label="$1,500 - $4,500" value="1500-4500">$1,500 - $4,500</option>&#13;
			<option label="$4,500-$6,500" value="45006500">$4,500-$6,500</option>&#13;
			<option label="$6,500 - $8,500" value="6500-8500">$6,500 - $8,500</option>&#13;
			<option label="$8,500+" value="8500">$8,500+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What Stage of Planning Are you?" name="what-stage-of-planning-are-you">&#13;
			<option label="I am ready to book a trip and put down a deposit!" value="i-am-ready-to-book-a-trip-and-put-down-a-deposit">I am ready to book a trip and put down a deposit!</option>&#13;
			<option label="I have already started researching and want to book a trip within the next 30 days!" value="i-have-already-started-researching-and-want-to-book-a-trip-within-the-next-30-days">I have already started researching and want to book a trip within the next 30 days!</option>&#13;
			<option label="I am early on in the planning process and want to get pricing and ideas to begin budgeting." value="i-am-early-on-in-the-planning-process-and-want-to-get-pricing-and-ideas-to-begin-budgeting">I am early on in the planning process and want to get pricing and ideas to begin budgeting.</option>&#13;
			<option label="I am already booked and very overwhelmed!" value="i-am-already-booked-and-very-overwhelmed">I am already booked and very overwhelmed!</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know? (Celebrations, mobility concerns, food allergies, etc.) ?" name="what-else-would-you-like-me-to-know-celebrations-mobility-concerns-food-allergies-etc-" className="form-control"/>&#13;
		<field type="text" label="Where you referred by anyone? If so we want to thank them!" name="where-you-referred-by-anyone-if-so-we-want-to-thank-them" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>