ME ME ME!!!

1. My Favorite Instrument

Drums Bass Piano/Keyboard Vocal (voice)

2. I want to be a...

Rockstar!!! Radio D.J. American Idiot Studio Musician

3. My favorite game is

Texas Hold 'em Poker The Game of Life Guitar Hero 3 Halo 1,2,3

4. My favorite band...

Badly Drawn Boy Rush Nickelback Linkin Park

5. Television Show???

Heros The Office Smallville Chuck

6. Favorite Athelete = X X=?

Andrew Jones Jonny Damon Chipper Jones Deon Branch

7. And My favorite song is???

Without a Kiss - Badly Drawn Boy Set Fire to the Third Bar (w/ Martha Wainwright) - Snow Patrol Crashed - Daughtry

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/Gilbert/839/me-me-me">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">ME ME ME!!! </h1>
      <img src="https://www.flufo.com/i/q/497659793.jpg" alt="" border="0" align="right" />   
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>My Favorite Instrument</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6611]" value="A" /> Drums</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6611]" value="B" /> Bass</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6611]" value="C" /> Piano/Keyboard</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6611]" value="D" /> Vocal (voice)</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>I want to be a...</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6612]" value="A" /> Rockstar!!!</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6612]" value="B" /> Radio D.J.</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6612]" value="C" /> American Idiot</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6612]" value="D" /> Studio Musician</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>My favorite game is</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6613]" value="A" /> Texas Hold &#039;em Poker</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6613]" value="B" /> The Game of Life</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6613]" value="C" /> Guitar Hero 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6613]" value="D" /> Halo 1,2,3</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>My favorite band...</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6614]" value="A" /> Badly Drawn Boy</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6614]" value="B" /> Rush</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6614]" value="C" /> Nickelback</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6614]" value="D" /> Linkin Park</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>Television Show???</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6615]" value="A" /> Heros</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6615]" value="B" /> The Office</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6615]" value="C" /> Smallville</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6615]" value="D" /> Chuck</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>Favorite Athelete = X      X=?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6616]" value="A" /> Andrew Jones</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6616]" value="B" /> Jonny Damon</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6616]" value="C" /> Chipper Jones</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6616]" value="D" /> Deon Branch</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>And My favorite song is???</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6617]" value="A" /> Without a Kiss - Badly Drawn Boy</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6617]" value="B" /> Set Fire to the Third Bar (w/ Martha Wainwright) - Snow Patrol</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[6617]" value="C" /> Crashed - Daughtry</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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