How Well Do You Know ME?

1. I Was Born Where?

Honolulu, Hawaii Cheyenne, Wyoming Melbourne, Flordia Military Brat Everywhere!

2. My Son's Name is?

Xavier Carreras Xavier Roderick Carreras Xavier Thomas Xavier Joseph Roderick Carreras

3. How Many Tattoos do I Have?

Five Three Zero One

4. When Did Me & David first start Dating?

June 16, 2005 June 14, 2007 April 13, 2006 Sept. 3, 2005

5. What is My Favorite Color?

Orange Blue Baby Blue Red

6. How Many Times have I Moved in the Past Year?

None Two Three Five

7. What is My Tattoo Of?

A Cross My son's Footprints My Boyfriend's Name My Son's Handprints

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">How Well Do You Know ME? </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>I Was Born Where?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1692]" value="A" /> Honolulu, Hawaii</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1692]" value="B" /> Cheyenne, Wyoming</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1692]" value="C" /> Melbourne, Flordia</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1692]" value="D" /> Military Brat Everywhere!</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>My Son&#039;s Name is?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1693]" value="A" /> Xavier Carreras</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1693]" value="B" /> Xavier Roderick Carreras</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1693]" value="C" /> Xavier Thomas</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1693]" value="D" /> Xavier Joseph Roderick Carreras</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>How Many Tattoos do I Have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1694]" value="A" /> Five</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1694]" value="B" /> Three</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1694]" value="C" /> Zero</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1694]" value="D" /> One</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>When Did Me &amp; David first start Dating?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1695]" value="A" /> June 16, 2005</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1695]" value="B" /> June 14, 2007</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1695]" value="C" /> April 13, 2006</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1695]" value="D" /> Sept. 3, 2005</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>What is My Favorite Color?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1696]" value="A" /> Orange</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1696]" value="B" /> Blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1696]" value="C" /> Baby Blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1696]" value="D" /> Red</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>How Many Times have I Moved in the Past Year?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1697]" value="A" /> None</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1697]" value="B" /> Two</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1697]" value="C" /> Three</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1697]" value="D" /> Five</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>What is My Tattoo Of?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1698]" value="A" /> A Cross</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1698]" value="B" /> My son&#039;s Footprints</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1698]" value="C" /> My Boyfriend&#039;s Name</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[1698]" value="D" /> My Son&#039;s Handprints</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>
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