How well do you know me?

1. What is my middle name?

Jean Hannah Marie Lynn

2. How old am I going to be on my birthday?

12 10 11 13

3. What is my dogs name?

Stinkers Squeakers Princess I don't know

4. How many brothers do I have?

1 3 4 2

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/Gabrielle/1429/how-well-do-you-know-me">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">How well do you know me? </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What is my middle name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11359]" value="A" /> Jean</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11359]" value="B" /> Hannah</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11359]" value="C" /> Marie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11359]" value="D" /> Lynn</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>How old am I going to be on my birthday?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11360]" value="A" /> 12</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11360]" value="B" /> 10</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11360]" value="C" /> 11</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11360]" value="D" /> 13</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What is my dogs name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11361]" value="A" /> Stinkers</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11361]" value="B" /> Squeakers</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11361]" value="C" /> Princess</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11361]" value="D" /> I don&#039;t know</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>How many brothers do I have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11362]" value="A" /> 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11362]" value="B" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11362]" value="C" /> 4</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[11362]" value="D" /> 2</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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