How well do you know me?

1. When is my birthday?

2-26-93 3-17-91 5-28-93 12-28-92

2. What is my dogs name?

Pookah Spookie I dont have a dog Foofie

3. When did i make this quiz???

Saturday Monday Friday OMG!!!!!!!

4. What is my Middle name???

Juan? John??? Josh???? Mr. Brown Guy?????

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/XD~iaz/305/how-well-do-you-know-me">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">How well do you know me? </h1>
      <img src="https://www.flufo.com/i/q/715060177.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>When is my birthday?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2113]" value="A" /> 2-26-93</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2113]" value="B" /> 3-17-91</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2113]" value="C" /> 5-28-93</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2113]" value="D" /> 12-28-92</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What is my dogs name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2114]" value="A" /> Pookah</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2114]" value="B" /> Spookie</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2114]" value="C" /> I dont have a dog</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2114]" value="D" /> Foofie</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>When did i make this quiz???</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2115]" value="A" /> Saturday</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2115]" value="B" /> Monday</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2115]" value="C" /> Friday</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2115]" value="D" /> OMG!!!!!!!</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What is my Middle name???</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2116]" value="A" /> Juan?</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2116]" value="B" /> John???</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2116]" value="C" /> Josh????</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[2116]" value="D" /> Mr. Brown Guy?????</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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