Think ur my friend, huh?!

1. What is my passion/career?

Management Art Modeling Dog walking

2. Do I have any children?

Yes, 2. Nope and never will Yes, 1 Kinda, do kittens count?

3. What issue do I battle everyday, successfully.

The Mailman Anorexia Bulimia Tacos

4. When Is my birthday?

Dec. 26th January 2nd December 24th December 12th

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Think ur my friend, huh?! </h1>
      <img src="https://www.flufo.com/i/q/48785446.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What is my passion/career?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3092]" value="A" /> Management</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3092]" value="B" /> Art</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3092]" value="C" /> Modeling</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3092]" value="D" /> Dog walking</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>Do I have any children?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3093]" value="A" /> Yes, 2.</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3093]" value="B" /> Nope and never will</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3093]" value="C" /> Yes, 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3093]" value="D" /> Kinda, do kittens count?</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What issue do I battle everyday, successfully.</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3094]" value="A" /> The Mailman</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3094]" value="B" /> Anorexia</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3094]" value="C" /> Bulimia</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3094]" value="D" /> Tacos</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>When Is my birthday?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3095]" value="A" /> Dec. 26th</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3095]" value="B" /> January 2nd</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3095]" value="C" /> December 24th</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3095]" value="D" /> December 12th</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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