HTML Code

<form method="post" action="https://www.flufo.com/samantha/1415/all-me">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">all me </h1>
      <img src="https://www.flufo.com/i/q/155035741.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>whats my name</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11245]" value="A" /> samantha</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11245]" value="B" /> brittney</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11245]" value="C" /> meme</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11245]" value="D" /> kiana</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>wat month and day was i born</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11246]" value="A" /> 10/11</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11246]" value="B" /> 12/18</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11246]" value="C" /> 11/12</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11246]" value="D" /> 12/10</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>how many sisters and brothers do i have total</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11247]" value="A" /> 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11247]" value="B" /> 34</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11247]" value="C" /> 23</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11247]" value="D" /> 6</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>who my fav titi</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11248]" value="A" /> jessie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11248]" value="B" /> martha</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11248]" value="C" /> mitha</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11248]" value="D" /> candy</label>
      <br />     
      <div><label for="userName">Your name</label>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
      <input type="text" name="userName" id="userName" value="" style="width: 300px;" />     
    </div><br />
    <div>
      <label for="userEmail">E-mail address</label>
      <input type="text" name="userEmail" id="userEmail" value="" style="width: 300px;" />     
    </div><br />
    	<input type="submit" name="submit" value="Ready" /> <span style="margin-left: 200px;">powered by: <a href="http://www.flufo.com" target="_blank">flufo.com</a></span>
  </div>
</form>

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