This is me...

1. Cual es mi concentracion de estudios?

Comunicacion Audiovisual Relaciones Publicas y Publicidad Promocion y Publicidad Periodismo

2. Cuantos hermanos(as) tengo?

4 3 2 1

3. En algun momento, tuve mi pelo de todos estos colores, excepto:

Rojo Burgundy (vino) Rubio Negro

4. En high school, estudie en:

San Jose Notre Dame La Vocacional Cristo de los Milagros

5. Cual es mi 2do nombre?

Marie Giselle Jeanette Paola

6. Me casaria sin pensarlo con____ y si fuera hombre, con _____:

Daddy Yankee; Beyonce Johnny Depp; Jessica Alba Colin Farrel; Britney Spears Daddy Yankee; Eva Mendes

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">This is me... </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>Cual es mi concentracion de estudios?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13232]" value="A" /> Comunicacion Audiovisual</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13232]" value="B" /> Relaciones Publicas y Publicidad</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13232]" value="C" /> Promocion y Publicidad</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13232]" value="D" /> Periodismo</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>Cuantos hermanos(as) tengo?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13233]" value="A" /> 4</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13233]" value="B" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13233]" value="C" /> 2</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13233]" value="D" /> 1</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>En algun momento, tuve mi pelo de todos estos colores, excepto:</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13234]" value="A" /> Rojo</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13234]" value="B" /> Burgundy (vino)</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13234]" value="C" /> Rubio</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13234]" value="D" /> Negro</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>En high school, estudie en:</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13235]" value="A" /> San Jose</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13235]" value="B" /> Notre Dame</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13235]" value="C" /> La Vocacional</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13235]" value="D" /> Cristo de los Milagros</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>Cual es mi 2do nombre?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13236]" value="A" /> Marie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13236]" value="B" /> Giselle</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13236]" value="C" /> Jeanette</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13236]" value="D" /> Paola</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>Me casaria sin pensarlo con____ y si fuera hombre, con _____:</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13237]" value="A" /> Daddy Yankee; Beyonce</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13237]" value="B" /> Johnny Depp; Jessica Alba</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13237]" value="C" /> Colin Farrel; Britney Spears</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13237]" value="D" /> Daddy Yankee; Eva Mendes</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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