Family History

1. Where does your family come from?

Nuevo Laredo Monterrey Mexico City, other Mexican city San Antonio, Dallas

2. What is your last name?

Marrufo Maganalles Campos Other last name within our family

3. Do you have photos of family members?

Yes No

4. Do you know me, Armando Marrufo?

Yes No

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/Armando/150/family-history">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Family History </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>Where does your family come from?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[964]" value="A" /> Nuevo Laredo</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[964]" value="B" /> Monterrey</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[964]" value="C" /> Mexico City, other Mexican city</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[964]" value="D" /> San Antonio, Dallas</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What is your last name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[965]" value="A" /> Marrufo</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[965]" value="B" /> Maganalles</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[965]" value="C" /> Campos</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[965]" value="D" /> Other last name within our family</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Do you have photos of family members?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[966]" value="A" /> Yes</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[966]" value="B" /> No</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>Do you know me, Armando Marrufo?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[967]" value="A" /> Yes</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[967]" value="B" /> No</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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