what do you think about me?

1. on a scale 1-10 what am i?

4 5 10 8

2. am i some one that you would like to be around a lot?

yes no hell no mabey

3. do you think iam mean or nice?

mean nice evil okay

4. what color are my eyes?

brown hazel blue green

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>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>on a scale 1-10 what am i?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1154]" value="A" /> 4</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1154]" value="B" /> 5</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1154]" value="C" /> 10</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1154]" value="D" /> 8</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>am i some one that you would like to be around a lot?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1155]" value="A" /> yes</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1155]" value="B" /> no</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1155]" value="C" /> hell no</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1155]" value="D" /> mabey</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>do you think iam mean or nice?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1156]" value="A" /> mean</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1156]" value="B" /> nice</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1156]" value="C" /> evil</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1156]" value="D" /> okay</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>what color are my eyes?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1157]" value="A" /> brown</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1157]" value="B" /> hazel</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1157]" value="C" /> blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1157]" value="D" /> green</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>
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