Me COnOceS BiEn?

1. Cual es mi nombre completo?

Magalí Denise Burman Magalí Burman Denise Burman Denise Magalí Burman

2. Cuando cuplo?

19 de Octubre 21 de Febrero 28 de Febrero 14 de Julio

3. Como se llama mi perra?

Coockie Joe Sashi Sam

4. Donde naci?

Costa Rica Argentina Paraguay U.S.A

5. Como se llaman mis papas?

Marcelo y Silvia Julia y Pedro Susana y Mario Alejandro y Andrea

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/Magui/1721/me-conoces-bien">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Me COnOceS BiEn? </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>Cual es mi nombre completo?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13651]" value="A" /> Magalí  Denise  Burman</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13651]" value="B" /> Magalí Burman</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13651]" value="C" /> Denise Burman</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13651]" value="D" /> Denise Magalí Burman</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>Cuando cuplo?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13652]" value="A" /> 19 de Octubre</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13652]" value="B" /> 21 de Febrero</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13652]" value="C" /> 28 de Febrero</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13652]" value="D" /> 14 de Julio</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Como se llama mi perra?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13653]" value="A" /> Coockie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13653]" value="B" /> Joe</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13653]" value="C" /> Sashi</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13653]" value="D" /> Sam</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>Donde naci?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13654]" value="A" /> Costa Rica</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13654]" value="B" /> Argentina</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13654]" value="C" /> Paraguay</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13654]" value="D" /> U.S.A</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>Como se llaman mis papas?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13655]" value="A" /> Marcelo y Silvia</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13655]" value="B" /> Julia y Pedro</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13655]" value="C" /> Susana y Mario</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13655]" value="D" /> Alejandro y Andrea</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>

Select all

Send this HTML code to friends & family

Your e-mail address

Friend e-mail addresses
1.
OR - add more friends

Latest quizzes

Start a quick quiz:

Our friends

Home Contact us

Developed by Armia Systems, Inc