DO YOU KNOW ME?

1. WHERE AM I FROM

LAS VEGAS MIA 305 LA NY

2. WHO IS MY HEART

SARA NOELLE` NICHOLE

3. WHAT ARE MY FAVORITE COLORS

GREEN AND BLUE RED AND BLACK BLACK AND BLUE DOSENT MATTER

4. AM I IN LOVE

YES NO MAYBE

5. MY FAVORITE ALCOHOL

WINE BEER CROWN ON THE ROCKS PATRON

6. MY FAVORITE FOOTBALL TEAM

DOLPHINS 49ERS JETS COWBOYS

7. HAVE I BEEN ON TV

YES NO

8. WHAT COLOR ARE MY EYES

GREEN BLUE CHANGE FROM GREEN TO BLUE BROWN

9. DO I WANT KIDS

YES NO

10. WHEN IS MY BIRTH DAY

4-21-84 6-17-84 1-25-78 11-4-81

Your name

E-mail address

HTML Code

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  <div style="width: 100%;">    
  <h1 style="color: #376e93;">DO YOU KNOW ME? </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>WHERE AM I FROM</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4915]" value="A" /> LAS VEGAS</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4915]" value="B" /> MIA 305</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4915]" value="C" /> LA</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4915]" value="D" /> NY</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>WHO IS MY HEART</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4916]" value="A" /> SARA</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4916]" value="B" /> NOELLE`</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4916]" value="C" /> NICHOLE</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>WHAT ARE MY FAVORITE COLORS</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4917]" value="A" /> GREEN AND BLUE</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4917]" value="B" /> RED AND BLACK</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4917]" value="C" /> BLACK AND BLUE</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4917]" value="D" /> DOSENT MATTER</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>AM I IN LOVE</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4918]" value="A" /> YES</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4918]" value="B" /> NO</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4918]" value="C" /> MAYBE</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>MY FAVORITE ALCOHOL</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4919]" value="A" /> WINE</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4919]" value="B" /> BEER</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4919]" value="C" /> CROWN ON THE ROCKS</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4919]" value="D" /> PATRON</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>MY FAVORITE FOOTBALL TEAM</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4920]" value="A" /> DOLPHINS</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4920]" value="B" /> 49ERS</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4920]" value="C" /> JETS</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4920]" value="D" /> COWBOYS</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>HAVE I BEEN ON TV</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4921]" value="A" /> YES</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4921]" value="B" /> NO</label>
      <br />        
      <div style="padding: 5px 0;">8.
      <strong>WHAT COLOR ARE MY EYES</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4922]" value="A" /> GREEN</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4922]" value="B" /> BLUE</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4922]" value="C" /> CHANGE FROM GREEN TO BLUE</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4922]" value="D" /> BROWN</label>
      <br />        
      <div style="padding: 5px 0;">9.
      <strong>DO I WANT KIDS</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4923]" value="A" /> YES</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4923]" value="B" /> NO</label>
      <br />        
      <div style="padding: 5px 0;">10.
      <strong>WHEN IS MY BIRTH DAY</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4924]" value="A" /> 4-21-84</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4924]" value="B" /> 6-17-84</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4924]" value="C" /> 1-25-78</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[4924]" value="D" /> 11-4-81</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;" />     
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    	<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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