Share your information with Jessica Carvalho

Jessica Carvalho

Journey-with-Jess

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="About You"/>&#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" label="Preferred name" name="preferred-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" required="true" label="What is your preferred method of communication?" name="what-is-your-preferred-method-of-communication">&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="FB Messenger" value="fb-messenger">FB Messenger</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="checkbox-group" required="true" label="What kind of Disney experience are you looking for?" name="what-kind-of-disney-experience-are-you-looking-for">&#13;
			<option label="Family vacation with kids" value="family-vacation-with-kids">Family vacation with kids</option>&#13;
			<option label="Adult vacation no kids" value="adult-vacation-no-kids">Adult vacation no kids</option>&#13;
		</field>&#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="radio-group" required="true" label="How many people are traveling on this trip?" name="how-many-people-are-traveling-on-this-trip" other="true">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Ages of all travelers (used for discounts and child pricing if applicable)" name="ages-of-all-travelers-used-for-discounts-and-child-pricing-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="How long would you like to go for?&amp;nbsp;" name="how-long-would-you-like-to-go-for-" other="true">&#13;
			<option label="Weekend Getaway (Friday-Sunday)" value="weekend-getaway-fridaysunday">Weekend Getaway (Friday-Sunday)</option>&#13;
			<option label="3-5 days" value="35-days">3-5 days</option>&#13;
			<option label="7 days" value="7-days">7 days</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What type of lodging are you looking for?" name="hotel-preference" other="true">&#13;
			<option label="On Property" value="on-property">On Property</option>&#13;
			<option label="Off Property with shuttle option" value="off-property-with-shuttle-option">Off Property with shuttle option</option>&#13;
			<option label="Off property  (use rental car or ride sharing service)" value="off-property-use-rental-car-or-ride-sharing-service">Off property  (use rental car or ride sharing service)</option>&#13;
		</field>&#13;
		<field type="radio-group" label="For On Property Stays" description="Please complete this ONLY if you want to stay on property" name="for-on-property-stays">&#13;
			<option label="Value Resort Hotels" value="value-resort-hotels">Value Resort Hotels</option>&#13;
			<option label="Moderate Resort Hotels" value="moderate-resort-hotels">Moderate Resort Hotels</option>&#13;
			<option label="Deluxe Resort Hotels" value="deluxe-resort-hotels">Deluxe Resort Hotels</option>&#13;
			<option label="Deluxe Villas" value="deluxe-villas">Deluxe Villas</option>&#13;
		</field>&#13;
		<field type="radio-group" label="For Off Property Stays" description="Please complete this ONLY if you want to stay off property" name="for-off-property-stays">&#13;
			<option label="Value Hotels" value="value-hotels">Value Hotels</option>&#13;
			<option label="Moderate Hotels" value="moderate-hotels">Moderate Hotels</option>&#13;
			<option label="Luxury Hotels" value="luxury-hotels">Luxury Hotels</option>&#13;
			<option label="Rentals (AirBNB/VRBO)" value="rentals-airbnbvrbo">Rentals (AirBNB/VRBO)</option>&#13;
		</field>&#13;
		<field type="text" label="RENTAL CAR :&amp;nbsp; what size/style would you like? As much detail as possible please." placeholder="Only if you want to stay off property and rent a car" name="rental-car-what-sizestyle-would-you-like-as-much-detail-as-possible-please" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Would you like to add a meal plan to your stay? (if on property only)" name="would-you-like-to-add-a-meal-plan-to-your-stay-if-on-property-only">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like to add Memory Maker" description="This is the photo package" name="would-you-like-to-add-memory-maker">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Unsure, I would like pricing" value="unsure-i-would-like-pricing">Unsure, I would like pricing</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you want Disney parks tickets for this trip?&amp;nbsp; &amp;nbsp;If Yes, please choose the amount of days below." name="do-you-want-disney-parks-tickets-for-this-trip-if-yes-please-choose-the-amount-of-days-below">&#13;
			<option label="Day Passes (1 park a day)" value="day-passes-1-park-a-day">Day Passes (1 park a day)</option>&#13;
			<option label="Hopper Passes (bounce from park to park throughout the day) " value="hopper-passes-bounce-from-park-to-park-throughout-the-day-">Hopper Passes (bounce from park to park throughout the day) </option>&#13;
			<option label="Hopper Plus Passes (bounce amongst the parks and water/sports parks)" value="hopper-plus-passes-bounce-amongst-the-parks-and-watersports-parks">Hopper Plus Passes (bounce amongst the parks and water/sports parks)</option>&#13;
			<option label="Water Park and Sport Passes (added to the day passes, no ability to &quot;hop&quot; from park to park on the same day)" value="water-park-and-sport-passes-added-to-the-day-passes-no-ability-to-hop-from-park-to-park-on-the-same-day">Water Park and Sport Passes (added to the day passes, no ability to "hop" from park to park on the same day)</option>&#13;
		</field>&#13;
		<field type="radio-group" label="How many days would you like park passes for?" name="how-many-days-would-you-like-park-passes-for" other="true">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
		</field>&#13;
		<field type="text" label="Are there any other parks you would like to visit during your stay in Florida?&amp;nbsp;" placeholder="ex. Seaworld  Busch Gardens  Universal Studios etc" name="are-there-any-other-parks-you-would-like-to-visit-during-your-stay-in-florida-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" 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="All of my quotes include trip protection, you can choose to opt out and sign a waiver.&amp;nbsp;" name="all-of-my-quotes-include-trip-protection-you-can-choose-to-opt-out-and-sign-a-waiver-">&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you need financing options?" name="do-you-need-financing-options">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you need airfare for this trip?" name="do-you-need-airfare-for-this-trip">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" placeholder="ex. Boston" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="When do you plan on booking your travel?" name="when-do-you-plan-on-booking-your-travel">&#13;
			<option label="Within a week (deposit due at time of booking min of $200)" value="within-a-week-deposit-due-at-time-of-booking-min-of-200">Within a week (deposit due at time of booking min of $200)</option>&#13;
			<option label="Within a month" value="within-a-month">Within a month</option>&#13;
			<option label="Not sure yet " value="not-sure-yet-">Not sure yet </option>&#13;
		</field>&#13;
		<field type="text" label="What else should I know about you, your travel needs or anything else that was not asked here? i.e if you&#39;ve been here before and what things you have done or want to do here." name="what-else-should-i-know-about-you-your-travel-needs-or-anything-else-that-was-not-asked-here-ie-if-youve-been-here-before-and-what-things-you-have-done-or-want-to-do-here" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" 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>