<p>Age</p>

<p><input maxlength="3" name="Age" type="text" value="" /></p>

<p>Gender (male/female)</p>

<p><select name="gender"><option value="male">Male</option><option value="female">Female</option></select></p>

<p>Ethnicity (choose)</p>

<p><select name="Ethnicity"></select></p>

<p>Place of living</p>

<p><select name="Location"></select></p>

<p>Height</p>

<p><input name="height" type="text" /></p>

<p>Weight</p>

<p><input name="weight" type="text" /></p>

<p>Own rated attractiveness</p>

<p><input name="Rating" type="text" /></p>

<p><input name="submit" type="button" value="submit" /></p>