Hay's Quiz

1. Who ismy fav jo bro?

Nick Joe Frankie Kevin

2. When am I going to a Jonas Brothers concert?

June 10 July 3 July 17 None of the above

3. what's my fav food?

buttered noodles pizza french fries grilled cheese

4. Who dropped me on my head whenI was little?

Austin My mom My dad My neighbor

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Hay&#039;s Quiz </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>Who ismy fav jo bro?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10978]" value="A" /> Nick</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10978]" value="B" /> Joe</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10978]" value="C" /> Frankie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10978]" value="D" /> Kevin</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>When am I going to a Jonas Brothers concert?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10979]" value="A" /> June 10</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10979]" value="B" /> July 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10979]" value="C" /> July 17</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10979]" value="D" /> None of the above</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>what&#039;s my fav food?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10980]" value="A" /> buttered noodles</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10980]" value="B" /> pizza</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10980]" value="C" /> french fries</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10980]" value="D" /> grilled cheese</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>Who dropped me on my head whenI was little?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10981]" value="A" /> Austin</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10981]" value="B" /> My mom</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10981]" value="C" /> My dad</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[10981]" value="D" /> My neighbor</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>
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