Demonstration of a Web Form

<HTML>

<HEAD>

<TITLE>Online Pitch Quiz</TITLE>

</HEAD>

<BODY>

<FORM ACTION = "http://www.neiu.edu/~jalucas/cgi/form.cgi" METHOD = "POST">

<INPUT TYPE = "hidden" NAME = "mailto" VALUE = "J-Lucas@neiu.edu">

<INPUT TYPE = "hidden" NAME = "html_response"

VALUE = "Thanks for submitting your Online Pitch Quiz.">

<INPUT TYPE = "hidden" NAME = "email_subject"

VALUE = "Online Pitch Quiz">

<INPUT TYPE = "hidden" NAME = "variable_order"

VALUE = "name|email|lines|spaces">

<INPUT TYPE = "hidden" NAME = "required_variables"

VALUE = "name|email">

<INPUT TYPE = "hidden" NAME = "url_of_this_form"

VALUE = "http://www.neiu.edu/~jalucas/cgi/quiz.html">

<INPUT TYPE = "hidden" NAME = "response_title" VALUE = "Thank You">

<INPUT TYPE = "hidden" NAME = "return_link_name"

VALUE = "UMULTI FORM DEMONSTRATION">

<INPUT TYPE = "hidden" NAME = "return_link_url"

VALUE = "http://www.neiu.edu/~itc/sig/umultiformdemo.html">

<INPUT TYPE = "hidden" NAME = "database_name" VALUE =

"http://www.neiu.edu/~jalucas/cgi/data/data.pitch">

<INPUT TYPE = "hidden" NAME = "database_delimiter" VALUE = ",">

<H2>Online Pitch Quiz</H2>

<BR> <B>Name:</B>

<INPUT TYPE = "text" NAME = "name" SIZE = "35" MAXLENGTH = "35">

<BR><B>Email:</B>

<INPUT TYPE = "text" NAME = "email" SIZE = "35" MAXLENGTH = "35">

<BR> <B>Question 1:</B>

<BR> How many lines are there in a staff?

<OL>

<LI>4<INPUT TYPE = "radio" NAME = "lines" VALUE="4">

<LI>5<INPUT TYPE = "radio" NAME = "lines" VALUE="5">

<LI>other<INPUT TYPE= "radio" NAME = "lines" VALUE="other">

</OL>

<B>Question 2:</B>

<BR>How many spaces in a staff?

<OL>

<LI>4<INPUT TYPE = "radio" NAME = "spaces" VALUE="4">

<LI>5<INPUT TYPE = "radio" NAME = "spaces" VALUE="5">

<LI>other<INPUT TYPE= "radio" NAME = "spaces" VALUE="other">

</OL>

<CENTER>

<INPUT TYPE = "submit" VALUE = "SUBMIT QUIZ">

</CENTER>

</FORM>

</BODY>

</HTML>