Share your information with Sophia Butcher

Sophia Butcher

Moms at Sea Travel, a Dream Vacations Franchise

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Details"/>&#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" label="Would you like a phone call?" name="radio-group-1785175073257">&#13;
			<option label="Yes! As soon as possible! I'm ready to cruise!" value="yes-as-soon-as-possible-im-ready-to-cruise">Yes! As soon as possible! I'm ready to cruise!</option>&#13;
			<option label="Yes, but I'd like to schedule it." value="yes-but-id-like-to-schedule-it">Yes, but I'd like to schedule it.</option>&#13;
			<option label="Not right now." value="not-right-now">Not right now.</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like me to send you a text when I&#39;ve responded via email?" description="Emails are often lost in spam folders. To ensure you receive my response  please select  yes if you&#39;d like a text message to accompany my email." name="radio-group-1785175151430">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Trip Details"/>&#13;
		<field type="checkbox-group" required="true" label="Which cruise line or travel experience are you interested in?" description="If you&#39;re not sure, feel free to select a few options!" name="checkbox-group-1785178963153">&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Royal Caribbean Cruise Line" value="royal-caribbean-cruise-line">Royal Caribbean Cruise Line</option>&#13;
			<option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option>&#13;
			<option label="Celebrity Cruise Line" value="celebrity-cruise-line">Celebrity Cruise Line</option>&#13;
			<option label="River Cruise" value="river-cruise">River Cruise</option>&#13;
			<option label="Exotic Destinations" value="exotic-destinations">Exotic Destinations</option>&#13;
			<option label="Adventures By Disney" value="adventures-by-disney">Adventures By Disney</option>&#13;
			<option label="Quick Bahamas/Caribbean Getaway" value="quick-bahamascaribbean-getaway">Quick Bahamas/Caribbean Getaway</option>&#13;
			<option label="Land-Based Vacation" value="landbased-vacation">Land-Based Vacation</option>&#13;
			<option label="Adults Only" value="adults-only">Adults Only</option>&#13;
			<option label="Family Friendly" value="family-friendly">Family Friendly</option>&#13;
			<option label="Theme Parks" value="theme-parks">Theme Parks</option>&#13;
		</field>&#13;
		<field type="textarea" label="Tell me more!" placeholder="Please tell me more about this trip! Please include any important dates, or must haves." name="textarea-1785177876314" rows="3" className="form-control"/>&#13;
		<field type="text" required="true" label="Where would you like to travel to?" description="If you&#39;re not sure  feel free to list a couple of options!" placeholder="ex: Bahamas  Caribbean, Europe" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Cruise Information"/>&#13;
		<field type="text" label="What port would you like to depart from?" description="If you&#39;re not sure  feel free to list a couple of options!" placeholder="ex: Port Canaveral  Miami, Barcelona" name="text-1785175473405" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What ship or ship class would you like to sail?" description="If you&#39;re not sure  feel free to list a couple of options!" placeholder="ex: Icon Class" name="text-1785175958583" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What type of cabin are you interested in?" name="checkbox-group-1785179615127">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Oceanview (just a window)" value="oceanview-just-a-window">Oceanview (just a window)</option>&#13;
			<option label="Oceanview Balcony" value="oceanview-balcony">Oceanview Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Multiple Cabins" value="multiple-cabins">Multiple Cabins</option>&#13;
			<option label="Cabin that holds 5+ guests" value="cabin-that-holds-5-guests">Cabin that holds 5+ guests</option>&#13;
			<option label="Accessible Cabin" value="accessible-cabin">Accessible Cabin</option>&#13;
			<option label="Best Value Cabin" value="best-value-cabin">Best Value Cabin</option>&#13;
		</field>&#13;
		<field type="text" label="How many total guests?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many guests 12 and under?" name="text-1785173504632" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="When would you like to travel?" description="Please feel free to enter a certain date or date range for your trip." placeholder="ex: Christmas break 2026  or December 26, 2026-January 2, 2027" name="text-1785176330823" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="My dates are flexible" name="radio-group-1785173996366">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="State of Residency" placeholder="ex: Florida  Georgia, or New York" name="text-1785175471690" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Eligible Discounts" description="Often times discounts may be provided to certain groups." name="checkbox-group-1785179816274">&#13;
			<option label="Military" value="military">Military</option>&#13;
			<option label="Senior 55+" value="senior-55">Senior 55+</option>&#13;
			<option label="EMT/First Responder" value="emtfirst-responder">EMT/First Responder</option>&#13;
			<option label="Law Enforcement" value="law-enforcement">Law Enforcement</option>&#13;
			<option label="I currently receive Casino Offers" value="i-currently-receive-casino-offers">I currently receive Casino Offers</option>&#13;
		</field>&#13;
		<field type="radio-group" label="I am looking to apply a casino offer to this sailing." name="radio-group-1785176870096" other="true" className="field-hidden">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1785176824013" rule="eyJ3aGVuRmllbGQiOiJjaGVja2JveC1ncm91cC0xNzg1MTc5ODE2Mjc0Iiwid2hlbkNvbmRpdGlvbiI6ImNvbnRhaW5zIiwid2hlblZhbHVlIjoiY2FzaW5vIiwidGhlbkFjdGlvbiI6InNob3ciLCJ0aGVuRmllbGRzIjpbInJhZGlvLWdyb3VwLTE3ODUxNzY4NzAwOTYiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJyYWRpby1ncm91cC0xNzg1MTc2ODcwMDk2IiwibGFiZWwiOiJJIGFtIGxvb2tpbmcgdG8gYXBwbHkgYSBjYXNpbm8gb2ZmZXIgdG8gdGhpcyBzYWlsaW5nLiJ9XX0="/>&#13;
		<field type="text" label="Did you see any special offers or trips being advertised? Please let me know which one you were interested in." name="text-1785178793376" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Add me to your email list! I&#39;d like to stay up to date on special offers, updates, promotions, and vacation specials." inline="true" name="checkbox-group-1785180716937">&#13;
			<option label="Yes!" value="yes" selected="selected">Yes!</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>