Madz Rox

1. Whats my middle name?

Anna Nicole Frances Clay

2. Whats my fav song?

Bleeding Love 1 2 step like a boy get up

3. Whats my crushes name?

Brandon Craig Luke Alec

4. What do I want to name my baby girl when she is born?

Adalyn Ashlyn Abby Ashlee

Your name

E-mail address

HTML Code

<form method="post" action="https://www.flufo.com/Madz/892/madz-rox">
  <div style="width: 100%;">    
  <h1 style="color: #376e93;">Madz Rox </h1>
         
    <br />        
      <div style="padding: 5px 0;">1.
      <strong>Whats my middle name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7144]" value="A" /> Anna</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7144]" value="B" /> Nicole</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7144]" value="C" /> Frances</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7144]" value="D" /> Clay</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>Whats my fav song?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7145]" value="A" /> Bleeding Love</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7145]" value="B" /> 1 2 step</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7145]" value="C" /> like a boy</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7145]" value="D" /> get up</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>Whats my crushes name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7146]" value="A" /> Brandon</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7146]" value="B" /> Craig</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7146]" value="C" /> Luke</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7146]" value="D" /> Alec</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What do I want to name my baby girl when she is born?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7147]" value="A" /> Adalyn</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7147]" value="B" /> Ashlyn</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7147]" value="C" /> Abby</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7147]" value="D" /> Ashlee</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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