Share your information with Amanda Basurto

Amanda Basurto

Free To Dream Travel LLC

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" required="true" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Walt Disney World  Universal  etc." name="destination" subtype="text" className="form-control"/>&#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" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many adults and how many children? How old will the children be day of travel?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="When is the last time you visited this destination?" name="when-is-the-last-time-you-visited-this-destination">&#13;
			<option label="Never" value="never">Never</option>&#13;
			<option label="Within the last 2 years" value="within-the-last-2-years">Within the last 2 years</option>&#13;
			<option label="2-5 years ago" value="25-years-ago">2-5 years ago</option>&#13;
			<option label="5-10 years ago" value="510-years-ago">5-10 years ago</option>&#13;
			<option label="Over 10 years ago" value="over-10-years-ago">Over 10 years ago</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers (not including air fare and other transportation)?" 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="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have a resort preference?" name="do-you-have-a-resort-preference" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Please include any additional information that will help build a vacation package that is right for you." 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="header" subtype="h3" label="Walt Disney World Only (for Disneyland and Aulani just fill out above information.)"/>&#13;
		<field type="text" label="How many park days are you looking for?&amp;nbsp;" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Which parks would you like to visit?" name="which-parks-would-you-like-to-visit">&#13;
			<option label="Magic Kingdom" value="magic-kingdom">Magic Kingdom</option>&#13;
			<option label="Hollywood Studios" value="hollywood-studios">Hollywood Studios</option>&#13;
			<option label="Epcot" value="epcot">Epcot</option>&#13;
			<option label="Animal Kingdom" value="animal-kingdom">Animal Kingdom</option>&#13;
			<option label="I'm not sure yet" value="im-not-sure-yet">I'm not sure yet</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you interested in adding the Disney Dining Plan to your vacation package?" name="are-you-interested-in-adding-the-disney-dining-plan-to-your-vacation-package">&#13;
			<option label="Yes, the Disney Dining Plan" value="yes-the-disney-dining-plan">Yes, the Disney Dining Plan</option>&#13;
			<option label="Yes, the Disney Quick Service Dining Plan" value="yes-the-disney-quick-service-dining-plan">Yes, the Disney Quick Service Dining Plan</option>&#13;
			<option label="Yes, but I am unsure of which one and would like more information." value="yes-but-i-am-unsure-of-which-one-and-would-like-more-information">Yes, but I am unsure of which one and would like more information.</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Disney requires a $200 deposit. The balance of your trip is due in full 30 days before you arrive. Are you able to make the $200 deposit at the time of booking?" name="disney-requires-a-200-deposit-the-balance-of-your-trip-is-due-in-full-30-days-before-you-arrive-are-you-able-to-make-the-200-deposit-at-the-time-of-booking">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="text-1765803270664" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you need help booking sit down service dining reservations?" name="text-1765803318551" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Disney Cruises Only"/>&#13;
		<field type="checkbox-group" label="Which Disney Cruise Line ship are you interested in?" name="which-disney-cruise-line-ship-are-you-interested-in">&#13;
			<option label="Disney Wish" value="disney-wish">Disney Wish</option>&#13;
			<option label="Disney Dream" value="disney-dream">Disney Dream</option>&#13;
			<option label="Disney Fantsasy" value="disney-fantsasy">Disney Fantsasy</option>&#13;
			<option label="Disney Magic" value="disney-magic">Disney Magic</option>&#13;
			<option label="Disney Wonder" value="disney-wonder">Disney Wonder</option>&#13;
			<option label="Disney Destiny" value="disney-destiny">Disney Destiny</option>&#13;
			<option label="Disney Treasure" value="disney-treasure">Disney Treasure</option>&#13;
			<option label="Not sure yet, please help me choose" value="not-sure-yet-please-help-me-choose">Not sure yet, please help me choose</option>&#13;
		</field>&#13;
		<field type="radio-group" label="How many nights are you looking to cruise for?" name="radio-group-1767115239793">&#13;
			<option label="3 nights" value="3-nights">3 nights</option>&#13;
			<option label="4 nights" value="4-nights">4 nights</option>&#13;
			<option label="5 nights" value="5-nights">5 nights</option>&#13;
			<option label="7 nights" value="7-nights">7 nights</option>&#13;
			<option label="Not sure yet" value="not-sure-yet">Not sure yet</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What type of Stateroom are you interested in?" name="what-type-of-stateroom-are-you-interested-in">&#13;
			<option label="Inside Stateroom" value="inside-stateroom">Inside Stateroom</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Oceanview with Verandah" value="oceanview-with-verandah">Oceanview with Verandah</option>&#13;
			<option label="Concierge Level" value="concierge-level">Concierge Level</option>&#13;
			<option label="Not sure, please recommend" value="not-sure-please-recommend">Not sure, please recommend</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Would you like assistance with any of the following?" name="would-you-like-assistance-with-any-of-the-following">&#13;
			<option label="Pre-cruise hotel" value="precruise-hotel">Pre-cruise hotel</option>&#13;
			<option label="Post-cruise hotel" value="postcruise-hotel">Post-cruise hotel</option>&#13;
			<option label="Adding on to the trip before or after" value="adding-on-to-the-trip-before-or-after">Adding on to the trip before or after</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Have you ever sailed with Disney Cruise Line before?" name="have-you-ever-sailed-with-disney-cruise-line-before">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Universal Destinations"/>&#13;
		<field type="radio-group" label="Are you interested in Universal Orlando or Universal Studios Hollywood?" name="are-you-interested-in-universal-orlando-or-universal-studios-hollywood">&#13;
			<option label="Universal Orlando (Florida)" value="universal-orlando-florida">Universal Orlando (Florida)</option>&#13;
			<option label="Universal Studios Hollywood (California)" value="universal-studios-hollywood-california">Universal Studios Hollywood (California)</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="If choosing Universal Orlando which of the four parks would you like to visit?" name="if-choosing-universal-orlando-which-of-the-four-parks-would-you-like-to-visit">&#13;
			<option label="Universal Studios Orlando" value="universal-studios-orlando">Universal Studios Orlando</option>&#13;
			<option label="Universal Islands of Adventure" value="universal-islands-of-adventure">Universal Islands of Adventure</option>&#13;
			<option label="Universal Epic Universe" value="universal-epic-universe">Universal Epic Universe</option>&#13;
			<option label="Volcano Bay Water Park" value="volcano-bay-water-park">Volcano Bay Water Park</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you interested in staying ON SITE to receive complimentary transportation to and from the parks, early admission, and possibly FREE Universal Unlimited Express Passes for two of the parks (only available staying at certain resorts.)" name="radio-group-1767114062745">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have a Universal Resort in mind?" name="how-did-you-hear-about-my-services" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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