How well do you know me?

1. What state did I move to?

Maryland Kansas Virginia West Virginia

2. What is my dog's name?

Princess Deity Fluffy Precious

3. What is the name of the drag group I associate with?

Topeka Drags Dancing Flamingo's Funky Town Follies Crazy Bitches

4. How old am I?

25 27 29 31

5. What is my Fiance's name?

Jenn Gina Dana Jessica

6. How many tat's do I have?

50 1 10 30

7. What is my favorite kind of music?

Rock Rap Country All of the above

8. What is my favorite color?

Blue Pink Purple Green

Your name

E-mail address

HTML Code

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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/962722168.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What state did I move to?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12438]" value="A" /> Maryland</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12438]" value="B" /> Kansas</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12438]" value="C" /> Virginia</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12438]" value="D" /> West Virginia</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What is my dog&#039;s name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12439]" value="A" /> Princess</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12439]" value="B" /> Deity</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12439]" value="C" /> Fluffy</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12439]" value="D" /> Precious</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What is the name of the drag group I associate with?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12440]" value="A" /> Topeka Drags</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12440]" value="B" /> Dancing Flamingo&#039;s</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12440]" value="C" /> Funky Town Follies</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12440]" value="D" /> Crazy Bitches</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>How old am I?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12441]" value="A" /> 25</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12441]" value="B" /> 27</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12441]" value="C" /> 29</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12441]" value="D" /> 31</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>What is my Fiance&#039;s name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12442]" value="A" /> Jenn</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12442]" value="B" /> Gina</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12442]" value="C" /> Dana</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12442]" value="D" /> Jessica</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>How many tat&#039;s do I have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12443]" value="A" /> 50</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12443]" value="B" /> 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12443]" value="C" /> 10</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12443]" value="D" /> 30</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>What is my favorite kind of music?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12444]" value="A" /> Rock</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12444]" value="B" /> Rap</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12444]" value="C" /> Country</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12444]" value="D" /> All of the above</label>
      <br />        
      <div style="padding: 5px 0;">8.
      <strong>What is my favorite color?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12445]" value="A" /> Blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12445]" value="B" /> Pink</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12445]" value="C" /> Purple</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[12445]" value="D" /> Green</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;" />     
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