All about Mary

1. What is my maiden name?

Jones Hazelet Fleck Johnson

2. What is my middle name?

Jane Lilliana Elizabeth Angelica

3. What year and month was I born?

May 1982 May 1881 March 1982 March 1981

4. What year did I graduate high school?

1999 2000 2001 I never did

5. How many surgeries have I had?

2 4 6 8

6. What was my last job before becoming a full time mom?

Round Table pizza preschool teacher Target office assistant

7. My kids were born in what town?

Lodi Stockton Sacramento Jackson

8. Where do I currently live?

Lodi Elk Grove Camanche Jackson

9. How many pets live in my house?

1 2 3 4

10. What show would I rather watch?

CSI Oprah Steve Wilkos Desperate Housewives

11. What grade will my oldest child start this year?

pre-k kindergarden 1st 2nd

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">All about Mary </h1>
      <img src="https://www.flufo.com/i/q/736688669.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What is my maiden name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3677]" value="A" /> Jones</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3677]" value="B" /> Hazelet</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3677]" value="C" /> Fleck</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3677]" value="D" /> Johnson</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What is my middle name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3678]" value="A" /> Jane</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3678]" value="B" /> Lilliana</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3678]" value="C" /> Elizabeth</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3678]" value="D" /> Angelica</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What year and month was I born?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3679]" value="A" /> May 1982</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3679]" value="B" /> May 1881</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3679]" value="C" /> March 1982</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3679]" value="D" /> March 1981</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What year did I graduate high school?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3680]" value="A" /> 1999</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3680]" value="B" /> 2000</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3680]" value="C" /> 2001</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3680]" value="D" /> I never did</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>How many surgeries have I had?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3681]" value="A" /> 2</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3681]" value="B" /> 4</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3681]" value="C" /> 6</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3681]" value="D" /> 8</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>What was my last job before becoming a full time mom?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3682]" value="A" /> Round Table pizza</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3682]" value="B" /> preschool teacher</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3682]" value="C" /> Target</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3682]" value="D" /> office assistant</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>My kids were born in what town?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3683]" value="A" /> Lodi</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3683]" value="B" /> Stockton</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3683]" value="C" /> Sacramento</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3683]" value="D" /> Jackson</label>
      <br />        
      <div style="padding: 5px 0;">8.
      <strong>Where do I currently live?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3684]" value="A" /> Lodi</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3684]" value="B" /> Elk Grove</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3684]" value="C" /> Camanche</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3684]" value="D" /> Jackson</label>
      <br />        
      <div style="padding: 5px 0;">9.
      <strong>How many pets live in my house?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3685]" value="A" /> 1</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3685]" value="B" /> 2</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3685]" value="C" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3685]" value="D" /> 4</label>
      <br />        
      <div style="padding: 5px 0;">10.
      <strong>What show would I rather watch?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3686]" value="A" /> CSI</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3686]" value="B" /> Oprah</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3686]" value="C" /> Steve Wilkos</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3686]" value="D" /> Desperate Housewives</label>
      <br />        
      <div style="padding: 5px 0;">11.
      <strong>What grade will my oldest child start this year?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3687]" value="A" /> pre-k</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3687]" value="B" /> kindergarden</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3687]" value="C" /> 1st</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[3687]" value="D" /> 2nd</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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