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<input type="hidden" name="required_vars" id="required_vars" value="name,email,field-8095136dbf43904,field-db78a15f20b6289" />
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<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td colspan="2" valign="top">
<strong><p>Please answer 100% truthfully and do not play with the answers.</p></strong>
</td>
</tr><tr>
<td valign="top">
<strong>UserName(Instagram or Wattpad):</strong>
</td>
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<input type="text" name="name" id="name" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>How did you find this blog?</strong>
</td>
<td valign="top">
<input type="radio" name="field-fc92342af9fe8d9" id="field-fc92342af9fe8d9_0" value="Instagram(ScallisonsAnchor)" /> Instagram(ScallisonsAnchor)<br/>
<input type="radio" name="field-fc92342af9fe8d9" id="field-fc92342af9fe8d9_1" value="Wattpad (ChyaneColeman)" /> Wattpad (ChyaneColeman)<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>Email Address:</strong>
</td>
<td valign="top">
<input type="text" name="email" id="email" size="40" value="" />
</td>
</tr>
<tr>
<td colspan="2" valign="top">
<strong><p>You email is required to receive the invitation to join the blog, also I will send weekly updates from the email.</p></strong>
</td>
</tr><tr>
<td valign="top">
<strong>What would you contribute to the blog?</strong>
</td>
<td valign="top">
<input type="text" name="field-ac8b539d856b21f" id="field-ac8b539d856b21f" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>How long have you been watching teenwolf?</strong>
</td>
<td valign="top">
<input type="text" name="field-4ab897aeda9781c" id="field-4ab897aeda9781c" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>How much do you know about teenwolf?</strong>
</td>
<td valign="top">
<select name="field-8095136dbf43904" id="field-8095136dbf43904">
<option value="EVERYTHING">EVERYTHING</option>
<option value="Season 4">Season 4</option>
<option value="A little">A little</option>
<option value="I just started">I just started</option>
<option value="nothing">nothing</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Otp?</strong>
</td>
<td valign="top">
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_0" value="Scallison" /> Scallison<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_1" value="Stydia" /> Stydia<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_2" value="Stalia" /> Stalia<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_3" value="Sterek" /> Sterek<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_4" value="Scira" /> Scira<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_5" value="Allisaac" /> Allisaac<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_6" value="Sciles" /> Sciles<br/>
<input type="checkbox" name="field-aec7e7158e60eb5[]" id="field-aec7e7158e60eb5_7" value="What's an OTP?" /> What's an OTP?<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>How many times would you post a week?</strong>
</td>
<td valign="top">
<input type="radio" name="field-db78a15f20b6289" id="field-db78a15f20b6289_0" value="-5" /> -5<br/>
<input type="radio" name="field-db78a15f20b6289" id="field-db78a15f20b6289_1" value="6" /> 6<br/>
<input type="radio" name="field-db78a15f20b6289" id="field-db78a15f20b6289_2" value="7" /> 7<br/>
<input type="radio" name="field-db78a15f20b6289" id="field-db78a15f20b6289_3" value="8+" /> 8+<br/>
</td>
</tr>
<tr>
<td colspan="2" align="center">
<input type="submit" value=" Submit Form " />
</td>
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