Do You Know Me?

1. What is my favorite color?

Red Black Blue Pink

2. What is my favorite type of food?

Mexican Italian Chinese Thai

3. What is my little sisters name?

Maria Jessica Monica Maricela

4. What is my boyfriends name?

Mario Mark Raul You don't have one!

5. How many brothers and sisters do I have?

4 3 6 5

6. What color are my eyes?

Black Blue Hazel Brown

7. Where do I work?

Hotel Law Firm Burger King You don't have a job!

8. Do I have any kids?

Yes No

9. What is my momma's name?

Esther Maria Rosa Guadalupe

10. What is my dad's name?

Pedro Vicente Ramon Juan

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>What is my favorite color?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7598]" value="A" /> Red</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7598]" value="B" /> Black</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7598]" value="C" /> Blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7598]" value="D" /> Pink</label>
      <br />        
      <div style="padding: 5px 0;">2.
      <strong>What is my favorite type of food?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7599]" value="A" /> Mexican</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7599]" value="B" /> Italian</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7599]" value="C" /> Chinese</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7599]" value="D" /> Thai</label>
      <br />        
      <div style="padding: 5px 0;">3.
      <strong>What is my little sisters name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7600]" value="A" /> Maria</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7600]" value="B" /> Jessica</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7600]" value="C" /> Monica</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7600]" value="D" /> Maricela</label>
      <br />        
      <div style="padding: 5px 0;">4.
      <strong>What is my boyfriends name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7601]" value="A" /> Mario</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7601]" value="B" /> Mark</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7601]" value="C" /> Raul</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7601]" value="D" /> You don&#039;t have one!</label>
      <br />        
      <div style="padding: 5px 0;">5.
      <strong>How many brothers and sisters do I have?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7602]" value="A" /> 4</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7602]" value="B" /> 3</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7602]" value="C" /> 6</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7602]" value="D" /> 5</label>
      <br />        
      <div style="padding: 5px 0;">6.
      <strong>What color are my eyes?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7603]" value="A" /> Black</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7603]" value="B" /> Blue</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7603]" value="C" /> Hazel</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7603]" value="D" /> Brown</label>
      <br />        
      <div style="padding: 5px 0;">7.
      <strong>Where do I work?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7604]" value="A" /> Hotel</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7604]" value="B" /> Law Firm</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7604]" value="C" /> Burger King</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7604]" value="D" /> You don&#039;t have a job!</label>
      <br />        
      <div style="padding: 5px 0;">8.
      <strong>Do I have any kids?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7605]" value="A" /> Yes</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7605]" value="B" /> No</label>
      <br />        
      <div style="padding: 5px 0;">9.
      <strong>What is my momma&#039;s name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7606]" value="A" /> Esther</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7606]" value="B" /> Maria</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7606]" value="C" /> Rosa</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7606]" value="D" /> Guadalupe</label>
      <br />        
      <div style="padding: 5px 0;">10.
      <strong>What is my dad&#039;s name?</strong>  
    </div>
                <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7607]" value="A" /> Pedro</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7607]" value="B" /> Vicente</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7607]" value="C" /> Ramon</label>
                  <label style="display: block; margin: 3px 0;"><input type="radio" name="correctAnswer[7607]" value="D" /> Juan</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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