how well do you know me

1. where was she born?

Sydney Melbourne London Italy

2. what is matilda's middle name

rose grace ann imogen

3. how many pets does she have

1 3 2

4. what are her three fave hobbies?

dance, run, draw cook, shop, travel sow, swim, hang she has none

Your name

E-mail address

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">how well do you know me </h1>
      <img src="https://www.flufo.com/i/q/276015906.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>where was she born?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12018]" value="A" /> Sydney</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12018]" value="B" /> Melbourne</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12018]" value="C" /> London</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12018]" value="D" /> Italy</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>what is matilda&#039;s middle name</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12019]" value="A" /> rose</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12019]" value="B" /> grace</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12019]" value="C" /> ann</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12019]" value="D" /> imogen</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>how many pets does she have</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12020]" value="A" /> 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12020]" value="B" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12020]" value="D" /> 2</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>what are her three fave hobbies?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12021]" value="A" /> dance, run, draw</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12021]" value="B" /> cook, shop, travel</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12021]" value="C" /> sow, swim, hang</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12021]" value="D" /> she has none</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;" />     
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    <div>
      <label for="userEmail">E-mail address</label>
      <input type="text" name="userEmail" id="userEmail" value="" style="width: 300px;" />     
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    	<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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</form>

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