What do you think about me?

1. What is my favorite color?

black lime green blue gold

2. What is my favorite animal?

donkey rat pig dog

3. Whats my favorite number?

23 14 12 78

4. What are my initials?

CAA CRF CRA SHT

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">What do you think about me? </h1>
      <img src="https://www.flufo.com/i/q/756121434.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What is my favorite color?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1150]" value="A" /> black</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1150]" value="B" /> lime green</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1150]" value="C" /> blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1150]" value="D" /> gold</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What is my favorite animal?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1151]" value="A" /> donkey</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1151]" value="B" /> rat</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1151]" value="C" /> pig</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1151]" value="D" /> dog</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Whats my favorite number?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1152]" value="A" /> 23</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1152]" value="B" /> 14</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1152]" value="C" /> 12</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1152]" value="D" /> 78</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What are my initials?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1153]" value="A" /> CAA</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1153]" value="B" /> CRF</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1153]" value="C" /> CRA</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1153]" value="D" /> SHT</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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