gistfile1.html

<form id="playform">

  <fieldset>
    <legend>Contact Info:</legend>
    Name: <input type="text" size="30" /><br />
    Email: <input type="text" size="30" /><br />
    Date of birth: <input type="text" size="10" />
  </fieldset>

  <fieldset>
    <legend>Computer Preferences:</legend>
    OS type: <input type="radio" name="osx" /> OSX &mdash; <input type="radio" name="Win" /> Windows &mdash; <input type="radio" name="unix" /> Unix<br/>
    Computer name: <input type="text" size="30" /><br />
    Computer type: <input type="radio" name="laptop" /> Laptop &mdash; <input type="radio" name="Desktop" /> Desktop
  </fieldset>

  <fieldset>
    <legend>Clothing Style:</legend>
    $ spent per month: <input type="text" size="10" /><br />
    Self-evaluation: <input type="radio" name="grungy" /> Grungy &mdash; <input type="radio" name="nerdy" /> Nerdy &mdash; <input type="radio" name="refined" /> Refined<br/>
  </fieldset>

  <fieldset>
    <legend>Dining Options:</legend>
    Chicken or Fish? <input type="radio" name="chix" /> Chicken &mdash; <input type="radio" name="Fish" /> Fish<br/>
  </fieldset>

	<input type="submit" value="submit my information">
	
</form>