Share your information with Kelly Urban

Kelly Urban

TravelMation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Disney &amp;amp; Universal Quote Request"/>&#13;
		<field type="paragraph" subtype="p" label="Please fill out this form so we can start planning your dream vacation!"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Lead Guest First Name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Lead Guest Last Name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-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="header" subtype="h1" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Details"/>&#13;
		<field type="checkbox-group" required="true" label="Where do you want to go?" name="where-do-you-want-to-go">&#13;
			<option label="Walt Disney World (Florida)" value="walt-disney-world-florida">Walt Disney World (Florida)</option>&#13;
			<option label="Universal Orlando" value="universal-orlando">Universal Orlando</option>&#13;
			<option label="Disneyland LA" value="disneyland-la">Disneyland LA</option>&#13;
			<option label="Universal Hollywood" value="universal-hollywood">Universal Hollywood</option>&#13;
			<option label="Both Disney World &amp; Universal (Florida)" value="both-disney-world-universal-florida">Both Disney World &amp; Universal (Florida)</option>&#13;
			<option label="Both Disneyland &amp; Universal (LA)" value="both-disneyland-universal-la">Both Disneyland &amp; Universal (LA)</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Desired Departure Date" description="This just gives me a general idea of when you like to go; it can be changed later." name="where-would-you-like-to-go" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Return Date" 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" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Will you be traveling with other adults? Please list their names below. (Example: Susie Jones)&amp;nbsp;" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Will you be traveling with children? Please list their names and birthdates below. (Example: Susie Jones 1/3/2018)&amp;nbsp;" name="will-you-be-traveling-with-children-please-list-their-names-and-birthdates-below-example-susie-jones-132018-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Will you be celebrating any special occasions?" name="text-1736988255295" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Have you visited here before? If so, when?&amp;nbsp;" name="text-1736988301254" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Accommodations"/>&#13;
		<field type="checkbox-group" required="true" label="What Best Describes Your Hotel Preference?" name="which-of-the-following-universal-resort-tiers-are-you-interested-in">&#13;
			<option label="Value" value="value">Value</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Deluxe" value="deluxe">Deluxe</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have a specific Hotels that you are interested in?" name="what-best-describes-your-hotel-preference" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Room Preference:&amp;nbsp;" name="checkbox-group-1736988374243">&#13;
			<option label="Standard" value="standard">Standard</option>&#13;
			<option label="View Room" value="view-room">View Room</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Tickets and Experiences"/>&#13;
		<field type="text" required="true" label="How many days would you like tickets for? ( If requesting for both Disney &amp;amp; Universal if possible, please list how many days for each!)" name="is-there-anything-nonuniversal-youd-like-to-do-or-see-while-youre-on-your-trip-examples-spa-golf-other-amusement-parks-etc" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What type of tickets are you interested in?&amp;nbsp;" name="will-you-need-the-following-">&#13;
			<option label="Single Park Per Day" value="single-park-per-day">Single Park Per Day</option>&#13;
			<option label="Park-to-park (visit multiple parks in one day)" value="parktopark-visit-multiple-parks-in-one-day">Park-to-park (visit multiple parks in one day)</option>&#13;
			<option label="Express Passes or lightening Lanes" value="express-passes-or-lightening-lanes">Express Passes or lightening Lanes</option>&#13;
			<option label="VIP Tour" value="vip-tour">VIP Tour</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are there specific rides or attractions you are excited about?&amp;nbsp;" name="text-1736988646237" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are you interested in Dining Plans?" name="are-you-interested-in-dining-plans">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do any of the following apply to your travel party?" name="do-any-of-the-following-apply-to-your-travel-party">&#13;
			<option label="An active or retired member of the miliary" value="an-active-or-retired-member-of-the-miliary">An active or retired member of the miliary</option>&#13;
			<option label="A Florida resident" value="a-florida-resident">A Florida resident</option>&#13;
			<option label="A disability or special needs" value="a-disability-or-special-needs">A disability or special needs</option>&#13;
			<option label="A  Disney or Universal Annual Passholder" value="a-disney-or-universal-annual-passholder">A  Disney or Universal Annual Passholder</option>&#13;
			<option label="Other-please call me" value="otherplease-call-me">Other-please call me</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Transportation"/>&#13;
		<field type="text" label="Do you need assistance with flights? If so, what is your departure airport?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Information"/>&#13;
		<field type="radio-group" required="true" label="What is your Dream Vacation Budget" 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="checkbox-group" required="true" label="Vibe Preferences" name="vibe-preferences">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest &amp; Relaxation" value="rest-relaxation">Rest &amp; Relaxation</option>&#13;
			<option label="Family Friendly" value="family-friendly">Family Friendly</option>&#13;
			<option label="Food &amp; Wine" value="food-wine">Food &amp; Wine</option>&#13;
			<option label="Multi-generational" value="multigenerational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How soon are you looking to book?" name="how-soon-are-you-looking-to-book" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are you currently working with another travel agent?" name="are-you-currently-working-with-another-travel-agent" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Is there anything else I need to know about your vacation needs?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>