How well do you know me?

1. What is my middle name?

Marie Nicole Anna Bob

2. How many siblings do I have?

7 5 8 9

3. Where was I born?

NYC Houston Albuquerque Camden

4. Who am I currently living with?

Dad Mom Dad and mom uncle

5. Where do I want to go to college?

USc OSU Berkeley Harvard

6. How many dogs do I currently have?

9 3 2

7. What holiday have I NEVER celebrated before?

Indpendence day new years halloween christmas

8. Where do I plan on going this summer?

Paris Moscow Rome Puerto Rico

9. What is the name of my Myspace brother?

Antonio Pedro Gabriel Andres

10. What is my alternative career choice?

Pediatrician Social worker cop dentist

11. What am I afraid of?

bugs rejection old creepy guys heights

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/jade/1699/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[13470]" value="A" /> Marie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13470]" value="B" /> Nicole</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13470]" value="C" /> Anna</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13470]" value="D" /> Bob</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>How many siblings do I have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13471]" value="A" /> 7</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13471]" value="B" /> 5</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13471]" value="C" /> 8</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13471]" value="D" /> 9</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Where was I born?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13472]" value="A" /> NYC</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13472]" value="B" /> Houston</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13472]" value="C" /> Albuquerque</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13472]" value="D" /> Camden</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>Who am I currently living with?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13473]" value="A" /> Dad</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13473]" value="B" /> Mom</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13473]" value="C" /> Dad and mom</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13473]" value="D" /> uncle</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>Where do I want to go to college?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13474]" value="A" /> USc</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13474]" value="B" /> OSU</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13474]" value="C" /> Berkeley</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13474]" value="D" /> Harvard</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>How many dogs do I currently have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13475]" value="A" /> 9</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13475]" value="B" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13475]" value="D" /> 2</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>What holiday have I NEVER celebrated before?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13476]" value="A" /> Indpendence day</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13476]" value="B" /> new years</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13476]" value="C" /> halloween</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13476]" value="D" /> christmas</label>
      <br />        
      <div style="padding: 5px 0;">8.
      <strong>Where do I plan on going this summer?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13477]" value="A" /> Paris</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13477]" value="B" /> Moscow</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13477]" value="C" /> Rome</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13477]" value="D" /> Puerto Rico</label>
      <br />        
      <div style="padding: 5px 0;">9.
      <strong>What is the name of my Myspace brother?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13478]" value="A" /> Antonio</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13478]" value="B" /> Pedro</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13478]" value="C" /> Gabriel</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13478]" value="D" /> Andres</label>
      <br />        
      <div style="padding: 5px 0;">10.
      <strong>What is my alternative career choice?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13479]" value="A" /> Pediatrician</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13479]" value="B" /> Social worker</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13479]" value="C" /> cop</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13479]" value="D" /> dentist</label>
      <br />        
      <div style="padding: 5px 0;">11.
      <strong>What am I afraid of?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13480]" value="A" /> bugs</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13480]" value="B" /> rejection</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13480]" value="C" /> old creepy guys</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13480]" value="D" /> heights</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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