Knowledgement

1. How Many Times Have I Been To Mexico

UNO TWO Three Four Or More

2. What Is My Favorite Subject

S.S. English Reading Math

3. Who is My Ancestor

Micheal Jordan Jessica Simpson Elvis Presley Mike Brown

4. What Is My Favorite Number

4 11 12 53

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Knowledgement </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>How Many Times Have I Been To Mexico</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8375]" value="A" /> UNO</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8375]" value="B" /> TWO</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8375]" value="C" /> Three</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8375]" value="D" /> Four Or More</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What Is My Favorite Subject</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8376]" value="A" /> S.S.</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8376]" value="B" /> English</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8376]" value="C" /> Reading</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8376]" value="D" /> Math</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Who is My Ancestor</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8377]" value="A" /> Micheal Jordan</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8377]" value="B" /> Jessica Simpson</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8377]" value="C" /> Elvis Presley</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8377]" value="D" /> Mike Brown</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What Is My Favorite Number</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8378]" value="A" /> 4</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8378]" value="B" /> 11</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8378]" value="C" /> 12</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[8378]" value="D" /> 53</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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