Do you really know me?

1. What is my favorite stores?

Hollister and express Forever 21 Pacsun Hot topic Clairs Zumeiz and Macy's

2. If i had a milion dollars what would i buy??

A mall A really big house A zoo A nose job

3. Who is my favorite color or pattern

Bright oarnge black sparkles neon green pink neon sparkles

4. I really care about what people say about me?

sometimes kinda YESS NO

5. What is my deepest darkest fear??

Dying the dark puking Germs

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Do you really know me? </h1>
      <img src="https://www.flufo.com/i/q/486632536.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What is my favorite stores?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13665]" value="A" /> Hollister and express</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13665]" value="B" /> Forever 21 Pacsun</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13665]" value="C" /> Hot topic Clairs</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13665]" value="D" /> Zumeiz and Macy&#039;s</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>If i had a milion dollars what would i buy??</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13666]" value="A" /> A mall</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13666]" value="B" /> A really big house</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13666]" value="C" /> A zoo</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13666]" value="D" /> A nose job</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Who is my favorite color or pattern</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13667]" value="A" /> Bright oarnge</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13667]" value="B" /> black sparkles</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13667]" value="C" /> neon green</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13667]" value="D" /> pink neon sparkles</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>I really care about what people say about me?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13668]" value="A" /> sometimes</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13668]" value="B" /> kinda</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13668]" value="C" /> YESS</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13668]" value="D" /> NO</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>What is my deepest darkest fear??</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13669]" value="A" /> Dying</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13669]" value="B" /> the dark</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13669]" value="C" /> puking</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[13669]" value="D" /> Germs</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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    	<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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