Untitled

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<head>
<style>
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</style>
<title> Question 3 </title> </head> <body> <page>
<table>
	<tr>
		<td><a  href = "http://clipartfreefor.com/cliparts/music-notes-png/cliparti1_music-notes-png_06.jpg">
			<img 	src = "http://clipartfreefor.com/cliparts/music-notes-png/cliparti1_music-notes-png_06.jpg"
    		alt="HTML5 Icon" width="128"
    		align = "CENTER" /></a></td>
    	<th> Music lover's survey </th>
    </tr>
</table><br/>

<form action = "action_page.php" method="get">
	<fieldset class= "fieldset1">
	<legend style = "color:#cc33ff"> <strong> Music Lover's Personal Information </strong> </legend>

	<p>First Name <input type = "text" name = "First name" size = "30" /></p>
	<p>Family Name <input type = "text" name = "Family name" size = "30" /></p>
	<p>Genre: 	<label> <input type = "radio" name = "gender" value = "female"/> Female </label>
 				<label> <input type = "radio" name = "gender" value = "male"/> Male </label></p>
 	<p>What age category are you from? 	 <select name = "age">
 										<option> 0 to 5 </option>
 										<option> 5 to 8 </option>
 										<option> 8 to 13 </option>
 										<option> 13 to 16 </option>
 										<option> 16 to 18 </option>
 										<option> 18 and over </option>
 										</select>
 	</p>
 	<p>Email: <input type="email" name="email"></input></p>
</fieldset><br/>

<fieldset class = "fieldset2">
<legend style = "color:#ff0066"> <strong> Survey Questions </strong> </legend>
	<p>Which type of music do you like? (Choose as many as you like) <br/>
		<label> <input type = "checkbox" name ="Choose[]" value = "Blues"/> Blues </label>
		<label> <input type = "checkbox" name ="Choose[]" value = "Classical music"/> Classical music </label>
		<label> <input type = "checkbox" name ="Choose[]" value = "Electronic music"/> Electronic music </label>
		<label> <input type = "checkbox" name ="Choose[]" value = "Hip Hop/Rap"/> Hip Hop/Rap </label>
		<label> <input type = "checkbox" name ="Choose[]" value = "Pop/Popular music"/> Pop/Popular music </label>
		<label> <input type = "checkbox" name ="Choose[]" value = "Reggae"/> Reggae </label>
		<label> <input type = "checkbox" name ="Choose[]" value = "Other"/> Other </label></p>
	<p>List 3 of your favorite artist/band: <br/>
		<input type = "text" name = "First choice" size = "30" />
		<input type = "text" name = "Second choice" size = "30" />
		<input type = "text" name = "Third choice" size = "30" />
	</p>
	<p> If you were to win two tickets for one of the following concert, which one would you like to attend? <br/>
		<label> <input type = "radio" name = "Concert" value = "Brit Floyd"/> Brit Floyd (March 24, 2016) </label>
		<label> <input type = "radio" name = "Concert" value = "Iron Maiden"/> Iron Maiden (April 1, 2016) </label>
		<label> <input type = "radio" name = "Concert" value = "Janet Jackson"/> Janet Jackson (June 17, 2016) </label>
		<label> <input type = "radio" name = "Concert" value = "Adele"/> Adele (September 30, 2016) </label></p>
</fieldset>

	<br/><p>Thanks for taking the time to fill out the survey!</p>

	<br/><input type = "submit" value = "Submit Form"/>
 	<input type = "reset" value = "Reset Form"/>
 	</form>
 	 </page>
</body></html>