Share your information with Cassie Laegen

Cassie Laegen

CCT Travel and Vacation Planning

<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 type="text" required="true" 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="checkbox-group" label="Preferred contact method?" name="where-would-you-like-to-go">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Call" value="call">Call</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Other" value="Other">Other</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Where would you like to go?" name="checkbox-group-1749673521251">&#13;
			<option label="Walt Disney World (Florida)" value="walt-disney-world-florida">Walt Disney World (Florida)</option>&#13;
			<option label="Disneyland (California)" value="disneyland-california">Disneyland (California)</option>&#13;
			<option label="Universal Studios" value="universal-studios">Universal Studios</option>&#13;
			<option label="Dollywood" value="dollywood">Dollywood</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="text" label="Dates of Travel" description="Please narrow down your travel dates as much as possible. If you have a specific week in mind but are flexible on the exact days  feel free to note that in the box. If you&#39;re open to traveling anytime within a certain month (or months), just let me know that too!" name="dates-of-travel" subtype="text" 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>