Share your information with Rachel Pruitt

Rachel Pruitt

Simply Magical Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Client Information"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" 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="date" 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" 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="radio-group" required="true" label="Where are you wanting to travel?" name="where-are-you-wanting-to-travel">&#13;
			<option label="Walt Disney World in Orlando, FL" value="walt-disney-world-in-orlando-fl">Walt Disney World in Orlando, FL</option>&#13;
			<option label="Disneyland in Southern California" value="disneyland-in-southern-california">Disneyland in Southern California</option>&#13;
			<option label="Aulani in Hawaii" value="aulani-in-hawaii">Aulani in Hawaii</option>&#13;
			<option label="International Disney Theme Park" value="international-disney-theme-park">International Disney Theme Park</option>&#13;
		</field>&#13;
		<field type="select" label="How will you be traveling ?&amp;nbsp;" name="how-will-you-be-traveling-to-disney" className="form-control">&#13;
			<option label="Driving" value="driving">Driving</option>&#13;
			<option label="Flying" value="flying">Flying</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do any of these apply to you?" name="do-any-of-these-apply-to-you">&#13;
			<option label="Disney Annual Passholder" value="disney-annual-passholder">Disney Annual Passholder</option>&#13;
			<option label="Disney Visa Cardholder" value="disney-visa-cardholder">Disney Visa Cardholder</option>&#13;
			<option label="Active or Retired Military" value="active-or-retired-military">Active or Retired Military</option>&#13;
			<option label="Disney+ Subscriber" value="disney-subscriber">Disney+ Subscriber</option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#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="radio-group" label="What best describes your resort preference?" name="hotel-preference" other="true">&#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;
			<option label="Not sure" value="not-sure">Not sure</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="When it comes to resort preference, what is most important to you?" name="when-it-comes-to-resort-preference-what-is-most-important-to-you">&#13;
			<option label="Convenience to the parks" value="convenience-to-the-parks">Convenience to the parks</option>&#13;
			<option label="Budget " value="budget-">Budget </option>&#13;
			<option label="Theming" value="theming">Theming</option>&#13;
			<option label="Transportation " value="transportation-">Transportation </option>&#13;
			<option label="An all inclusive experience" value="an-all-inclusive-experience">An all inclusive experience</option>&#13;
		</field>&#13;
		<field type="textarea" label="Do you have a resort preference?" name="do-you-have-a-resort-preference" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Number of Adults&amp;nbsp;" name="number-of-adults-" className="form-control"/>&#13;
		<field type="textarea" label="Number of Children/ Age at time of travel" name="number-of-children-age-at-time-of-travel" className="form-control"/>&#13;
		<field type="textarea" label="If you would like more than one room please indicate how you would like guests to be divided." name="textarea-1630980468785" className="form-control"/>&#13;
		<field type="textarea" label="First/ Last Name of everyone in your party" name="first-last-name-of-everyone-in-your-party" className="form-control"/>&#13;
		<field type="textarea" label="Children&#39;s Favorite Characters" name="childrens-favorite-characters" className="form-control"/>&#13;
		<field type="radio-group" label="How many park days are you thinking?" name="how-many-park-days-are-you-thinking">&#13;
			<option label="0" value="0">0</option>&#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="More than 5" value="more-than-5">More than 5</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="What type of ticket sounds good?" name="what-type-of-ticket-sounds-good" className="form-control">&#13;
			<option label="Base Ticket- One park per day" value="base-ticket-one-park-per-day">Base Ticket- One park per day</option>&#13;
			<option label="Park Hopper- Multiple parks per day" value="park-hopper-multiple-parks-per-day">Park Hopper- Multiple parks per day</option>&#13;
			<option label="Park Hopper Plus- Multuple parks and water parks" value="park-hopper-plus-multuple-parks-and-water-parks">Park Hopper Plus- Multuple parks and water parks</option>&#13;
			<option label="Not sure- talk me through this!" value="not-sure-talk-me-through-this">Not sure- talk me through this!</option>&#13;
			<option label="Not applicable" value="not-applicable">Not applicable</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Interested in the dining plan if traveling to Walt Disney World?" name="interested-in-the-dining-plan-if-traveling-to-walt-disney-world">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No thanks" value="no-thanks">No thanks</option>&#13;
			<option label="Maybe- i'd like more information" value="maybe-id-like-more-information">Maybe- i'd like more information</option>&#13;
		</field>&#13;
		<field type="select" label="Celebrating Something?" name="celebrating-someething" multiple="multiple" className="form-control">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="First Visit" value="first-visit">First Visit</option>&#13;
			<option label="Personal Triumph" value="personal-triumph">Personal Triumph</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#13;
		<field type="select" label="Do you prefer to call or text?" name="do-you-prefer-to-call-or-text" className="form-control">&#13;
			<option label="call" value="call">call</option>&#13;
			<option label="text" value="text">text</option>&#13;
		</field>&#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>