<form action='/survey/checkout' method='post' enctype="multipart/form-data"> <div> <label>Pronouns</label> <select name='gender' required> <option value='female'>She/Her</option> <option value='male'>He/Him</option> <option value='neutral'>They/Them</option> <option value='prefer not to say'>Prefer Not To Say</option> </select> </div> <div> <label>How have you been during the pandemic?</label> <select name='feel??!?' required> <option value='happy'>&#128512;</option> <option value='sad'>&#128557;</option> <option value='confound'>&#128534;</option> <option value='slepy'>&#128564;</option> </select> </div> <div> <label>How comfortable are you going out in public?</label> <input type='number' name='num' placeholder='1 - 10' min='1' max='10' required> </div> <div> <label>During the pandemic, which days of the week have you been regularly exercising?</label> </div> <div> <input type='checkbox' name='mon' value='Yes'> <input type='checkbox' name='tue' value='Yes'> <input type='checkbox' name='wed' value='Yes'> <input type='checkbox' name='thu' value='Yes'> <input type='checkbox' name='fri' value='Yes'> <input type='checkbox' name='sat' value='Yes'> <input type='checkbox' name='sun' value='Yes'> </div> <div> <label>MO TU W TH FR ST SU</label> </div> <div> <label>Birthday</label> <input name='bday' type='date' required> </div> <div> <label>TV show you binged?</label> <input type="text" name="show" list="shows" required> <datalist id="shows"> <option>The Office</option> <option>Family Guy</option> <option>The Simpsons</option> <option>The Super Mario Brothers Super Show</option> <option>Youtube</option> <option>Breaking Bad</option> <option>The Good Place</option> </datalist> </div> <div> <input type='submit' value='Submit Survey'> <input type='hidden' value = 'console.clear()'> </div> <div> <img src="https://bit.ly/fcc-relaxing-cat" alt="cat"> </div> <div> <label>Enjoy this cat :)</label> </div> </form>