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Charm CBT
1.
what document?
Blue
Red
Green
Yellow
2.
How many?
12
4
8
5
3.
where?
Here
There
B
e
4.
Who?
Me
you
ZHim
ef
Your name
E-mail address
powered by:
flufo.com
HTML Code
<form method="post" action="https://www.flufo.com/Ikram Adnani/2646/charm-cbt"> <div style="width: 100%;"> <h1 style="color: #376e93;">Charm CBT </h1> <br /> <div style="padding: 5px 0;">1. <strong>what document?</strong> </div> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20722]" value="A" /> Blue</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20722]" value="B" /> Red</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20722]" value="C" /> Green</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20722]" value="D" /> Yellow</label> <br /> <div style="padding: 5px 0;">2. <strong>How many?</strong> </div> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20723]" value="A" /> 12</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20723]" value="B" /> 4</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20723]" value="C" /> 8</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20723]" value="D" /> 5</label> <br /> <div style="padding: 5px 0;">3. <strong>where?</strong> </div> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20724]" value="A" /> Here</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20724]" value="B" /> There</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20724]" value="C" /> B</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20724]" value="D" /> e</label> <br /> <div style="padding: 5px 0;">4. <strong>Who?</strong> </div> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20725]" value="A" /> Me</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20725]" value="B" /> you</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20725]" value="C" /> ZHim</label> <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[20725]" value="D" /> ef</label> <br /> <div><label for="userName">Your name</label> <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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