This is a form:
What is your name?
What is your quest?
My web site is:
Amazing
Awesome
The Best
Cool
Super
[ feel free to select multiples ;) ]
What is your favorite color?
Green
Blue
Red
Yellow
Black
Purple
Other
Do you like cheese?
Yes
No
Pie is:
Yummy
Delicious
Appetizing
Scrumptious