Who Knows Me Best

1. What is my Middle Name?

Eugene Cheney Preston Alan

2. How long have I known my wife?

9 years 6 years 3 years 7 years

3. How many times have I been to combat?

1 2 3 4

4. In what month was my son, Preston, born?

January February December April

5. I was discharged from the military for what reason?

Right Hip Disability Left Hip Disability Right Knee Disability Left Knee Disability

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E-mail address

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Who Knows Me Best </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[1168]" value="A" /> Eugene</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1168]" value="B" /> Cheney</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1168]" value="C" /> Preston</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1168]" value="D" /> Alan</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>How long have I known my wife?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1169]" value="A" /> 9 years</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1169]" value="B" /> 6 years</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1169]" value="C" /> 3 years</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1169]" value="D" /> 7 years</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>How many times have I been to combat?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1170]" value="A" /> 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1170]" value="B" /> 2</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1170]" value="C" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1170]" value="D" /> 4</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>In what month was my son, Preston, born?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1171]" value="A" /> January</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1171]" value="B" /> February</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1171]" value="C" /> December</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1171]" value="D" /> April</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>I was discharged from the military for what reason?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1172]" value="A" /> Right Hip Disability</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1172]" value="B" /> Left Hip Disability</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1172]" value="C" /> Right Knee Disability</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1172]" value="D" /> Left Knee Disability</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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