• a (pin) number (a password)
• a date
• a radio dial button
• a select menu (pull down)
• check boxes
• Validation (extra point)

In this feedback form you'd like to check who your audience is and how they like your site, so ask appropriate questions.

First name:
Last name:

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Sex: Male Female

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You are a student :
You are a instructor:
You are 18 years or older:

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Select a company: Volvo Saab Fiat Audi Porsche (for a chance to win a vehicle by submitting this form)

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Birthdate Date:

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UserName:
password: