Who knows me best?

1. How many brothers and sisters do i have?

2 brothers and 4 sisters 4 brothers and 2 sisters 3 brothers and 3 sisters 5 brothers and 1 sister

2. How many kids do i have?

One Two Three Four

3. What kind of car do i drive?

Grand am Sunfire Impaula S10

4. What color car do i have?

Black Silver White Red

5. Where do i work?

C-Store Casino IGA Quick Stop

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Who knows me best? </h1>
      <img src="https://www.flufo.com/i/q/283108654.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>How many brothers and sisters do i have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3159]" value="A" /> 2 brothers and 4 sisters</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3159]" value="B" /> 4 brothers and 2 sisters</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3159]" value="C" /> 3 brothers and 3 sisters</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3159]" value="D" /> 5 brothers and 1 sister</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>How many kids do i have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3160]" value="A" /> One</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3160]" value="B" /> Two</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3160]" value="C" /> Three</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3160]" value="D" /> Four</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What kind of car do i drive?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3161]" value="A" /> Grand am</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3161]" value="B" /> Sunfire</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3161]" value="C" /> Impaula</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3161]" value="D" /> S10</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What color car do i have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3162]" value="A" /> Black</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3162]" value="B" /> Silver</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3162]" value="C" /> White</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3162]" value="D" /> Red</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>Where do i work?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3163]" value="A" /> C-Store</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3163]" value="B" /> Casino</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3163]" value="C" /> IGA</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3163]" value="D" /> Quick Stop</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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