how much do you know about me?

1. What's my middle name

Lee Lea Fry Channy

2. What town am i from?

Uvalde Leakey portland Kerville

3. What's my fav. soda?

Dr. Pepper Coke Cola Pespi Dr. B

4. What's my phone number?

232-5334 643-7584 776-1743 232-4117

5. What's my fav. Beer?

Miller Light Miller Bud Light Budweiser

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/dalton/543/how-much-do-you-know-about-me">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">how much do you know about me? </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>What&#039;s my middle name</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4109]" value="A" /> Lee</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4109]" value="B" /> Lea</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4109]" value="C" /> Fry</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4109]" value="D" /> Channy</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What town am i from?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4110]" value="A" /> Uvalde</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4110]" value="B" /> Leakey</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4110]" value="C" /> portland</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4110]" value="D" /> Kerville</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What&#039;s my fav. soda?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4111]" value="A" /> Dr. Pepper</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4111]" value="B" /> Coke Cola</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4111]" value="C" /> Pespi</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4111]" value="D" /> Dr. B</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What&#039;s my phone number?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4112]" value="A" /> 232-5334</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4112]" value="B" /> 643-7584</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4112]" value="C" /> 776-1743</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4112]" value="D" /> 232-4117</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>What&#039;s my fav. Beer?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4113]" value="A" /> Miller Light</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4113]" value="B" /> Miller</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4113]" value="C" /> Bud Light</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4113]" value="D" /> Budweiser</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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