<form action='http://www.kwiz.biz/simplesurveys/do-survey.php' method='post' target='_new'><table border=1 bordercolor=#efefef cellspacing=0><tr><td valign=top align=right>What is your name?</td><td align=left>Chalk Fulla Moxy (AKA Moxy)<input type='hidden' name='question1' value='What+is+your+name%3F'><input type='hidden' name='type1' value='1'></td></tr><tr><td valign=top align=right>What other nicknames do you have?</td><td align=left>Moo Bear, Mox, Miss Mox, Moxer, bogger<input type='hidden' name='question2' value='What+other+nicknames+do+you+have%3F'><input type='hidden' name='type2' value='1'></td></tr><tr><td valign=top align=right>What breed are you?</td><td align=left>American Bulldog<input type='hidden' name='question3' value='What+breed+are+you%3F'><input type='hidden' name='type3' value='1'></td></tr><tr><td valign=top align=right>Where were you born?</td><td align=left>MN<input type='hidden' name='question4' value='Where+were+you+born%3F'><input type='hidden' name='type4' value='1'></td></tr><tr><td valign=top align=right>Where do you live now?</td><td align=left>MN<input type='hidden' name='question5' value='Where+do+you+live+now%3F'><input type='hidden' name='type5' value='1'></td></tr><tr><td valign=top align=right>What is your favorite toy?</td><td align=left>Thats Tough Everything is considered Mine, and I love it all..But I have to say my Favorite is either a Kong or an Orange Juice Container<input type='hidden' name='question6' value='What+is+your+favorite+toy%3F'><input type='hidden' name='type6' value='1'></td></tr><tr><td valign=top align=right>What is your favorite store?</td><td align=left>Petco, I get so excited I loose my Breath and my Face turns red!<input type='hidden' name='question7' value='What+is+your+favorite+store%3F'><input type='hidden' name='type7' value='1'></td></tr><tr><td valign=top align=right>How many toys do you have?</td><td align=left>More Than I can Count on all my paws, How many toys have I destroyed is more than what I have. <input type='hidden' name='question8' value='How+many+toys+do+you+have%3F'><input type='hidden' name='type8' value='1'></td></tr><tr><td valign=top align=right>What brand of food do you eat?</td><td align=left>My mom feeds me a Raw / B.A.R.F diet because I have allergies, and demodex mites and it is so much better for my skin. I love love love my food it is so good and dad gets mad becuase he says I eat better than he does! <input type='hidden' name='question9' value='What+brand+of+food+do+you+eat%3F'><input type='hidden' name='type9' value='1'></td></tr><tr><td valign=top align=right>Wet or dry food?</td><td align=left>R.A.W/B.A.R.F wet food<input type='hidden' name='question10' value='Wet+or+dry+food%3F'><input type='hidden' name='type10' value='1'></td></tr><tr><td valign=top align=right>What is your favorite color?</td><td align=left>Red for Toys and Black for Collars. <input type='hidden' name='question11' value='What+is+your+favorite+color%3F'><input type='hidden' name='type11' value='1'></td></tr><tr><td valign=top align=right>Are you bad when nobody's looking?</td><td align=left>YEP!!! I like to eat the stuffing from Pillows, Chase the cat ( I OWN THE UPSTAIRS CAT DON"T FORGET THAT), Clean the dishes and the counter and steal the neighbor girls mittens!<input type='hidden' name='question12' value='Are+you+bad+when+nobody%5C%27s+looking%3F'><input type='hidden' name='type12' value='1'></td></tr><tr><td valign=top align=right>Are you friendly?</td><td align=left>Too Friendly!! I jump up and give the Petsmart cashier kisses when we go!! She thinks I am cute!! I also flirt with the Vet Techs and other dogs!!<input type='hidden' name='question13' value='Are+you+friendly%3F'><input type='hidden' name='type13' value='1'></td></tr><tr><td valign=top align=right>Are you overweight?</td><td align=left>Nope I am getting bigger than what they say I was supposed to be, but I am fit!<input type='hidden' name='question14' value='Are+you+overweight%3F'><input type='hidden' name='type14' value='1'></td></tr><tr><td valign=top align=right>Do you eat people food?</td><td align=left>Yep, I get Turkey Dogs for training, and peanut butter and cheese in my kongs and if i am good i get some of the food before it is seasoned!!<input type='hidden' name='question15' value='Do+you+eat+people+food%3F'><input type='hidden' name='type15' value='1'></td></tr><tr><td valign=top align=right>Do you eat bugs?</td><td align=left>I don't know yet! But I am sure I will like them!<input type='hidden' name='question16' value='Do+you+eat+bugs%3F'><input type='hidden' name='type16' value='1'></td></tr><tr><td valign=top align=right>Do you live with other animals?</td><td align=left>Yep, I let a Black Cat live with me<input type='hidden' name='question17' value='Do+you+live+with+other+animals%3F'><input type='hidden' name='type17' value='1'></td></tr><tr><td valign=top align=right>Do you like to exercise?</td><td align=left>Yeah I love the off leash park, but don't quite do well on leash yet, we are working on that. I like to play in my yard so much that its hard to get me to come in. <input type='hidden' name='question18' value='Do+you+like+to+exercise%3F'><input type='hidden' name='type18' value='1'></td></tr><tr><td valign=top align=right>Do you like car rides?</td><td align=left>NOPE! We try every so many days, and i puke alot! In the last month I have made 3 car rides with out puking or drugs!! WOOOF!! <input type='hidden' name='question19' value='Do+you+like+car+rides%3F'><input type='hidden' name='type19' value='1'></td></tr><tr><td valign=top align=right>Do you get into stuff?</td><td align=left>What don't I get into should be the question!<input type='hidden' name='question20' value='Do+you+get+into+stuff%3F'><input type='hidden' name='type20' value='1'></td></tr><tr><td valign=top align=right>Do you like to swim?</td><td align=left>Not sure yet.. I can't get a bath while swimming right?<input type='hidden' name='question21' value='Do+you+like+to+swim%3F'><input type='hidden' name='type21' value='1'></td></tr><tr><td valign=top align=right>What is your favorite treat?</td><td align=left>Turkey Dogs and Maccaroni Noodles!<input type='hidden' name='question22' value='What+is+your+favorite+treat%3F'><input type='hidden' name='type22' value='1'></td></tr><tr><td valign=top align=right>Do you shed?</td><td align=left>I shoot my fur like a porcupine when I am scared and shed a bit<input type='hidden' name='question23' value='Do+you+shed%3F'><input type='hidden' name='type23' value='1'></td></tr><tr><td valign=top align=right>What's the funniest thing you ever did?</td><td align=left>I was sleeping infront of the space heater, and i noticed a speck of packing foam on the corner of the space heater.. I was scared so I barked at it, everytime I barked it moved forward when i breathed in it moved back..That scared me so i barked more and it moved more...mom thought that was funny!<input type='hidden' name='question24' value='What%5C%27s+the+funniest+thing+you+ever+did%3F'><input type='hidden' name='type24' value='1'></td></tr><tr><td valign=top align=right>What's the bravest thing you ever did?</td><td align=left>I protect my humans from the trashcan every sunday night!!<input type='hidden' name='question25' value='What%5C%27s+the+bravest+thing+you+ever+did%3F'><input type='hidden' name='type25' value='1'></td></tr><tr><td valign=top align=right>Are you neutered?</td><td align=left>I am spayed!<input type='hidden' name='question26' value='Are+you+neutered%3F'><input type='hidden' name='type26' value='1'></td></tr><tr><td valign=top align=right>Are you a social animal?</td><td align=left>I am socially submissive!<input type='hidden' name='question27' value='Are+you+a+social+animal%3F'><input type='hidden' name='type27' value='1'></td></tr><tr><td valign=top align=right>Collar or harness?</td><td align=left>I have a martingale collar & pinch for training, a Bing Collar for tags, and a Harness for the car! <input type='hidden' name='question28' value='Collar+or+harness%3F'><input type='hidden' name='type28' value='1'></td></tr><tr><td valign=top align=right>Retractable or regular leash?</td><td align=left>I have a retractable for playing and a Leash with quick stop handle for daily use!<input type='hidden' name='question29' value='Retractable+or+regular+leash%3F'><input type='hidden' name='type29' value='1'></td></tr><tr><td valign=top align=right>Ceramic, Metal or Plastic bowls?</td><td align=left>Teflon coated SS bowls. I personally detailed the bowl by removing the non skid rubber... Much better<input type='hidden' name='question30' value='Ceramic%2C+Metal+or+Plastic+bowls%3F'><input type='hidden' name='type30' value='1'></td></tr><tr><td valign=top align=right>Do you sleep in a crate?</td><td align=left>I am supposed to, but generally I fall asleep on the couch with Mom and we stay there!<input type='hidden' name='question31' value='Do+you+sleep+in+a+crate%3F'><input type='hidden' name='type31' value='1'></td></tr><tr><td valign=top align=right>Do you have a dog bed?</td><td align=left>I have a Dog bed that says CAT in big letters on it. I call it mine!! The cat seams to think it is hers, so I pick it up and move it to show her it is clearly mine!<input type='hidden' name='question32' value='Do+you+have+a+dog+bed%3F'><input type='hidden' name='type32' value='1'></td></tr><tr><td valign=top align=right>Do you have a doghouse?</td><td align=left>Yep, and I rarely use it!<input type='hidden' name='question33' value='Do+you+have+a+doghouse%3F'><input type='hidden' name='type33' value='1'></td></tr><tr><td valign=top align=right>Do you belong to any dog clubs?</td><td align=left>We are on dogster, and have clubs on Myspace and on this site. <input type='hidden' name='question34' value='Do+you+belong+to+any+dog+clubs%3F'><input type='hidden' name='type34' value='1'></td></tr><tr><td valign=top align=right>How does your owner describe you?</td><td align=left>My Humans say that I will be the Million Dollar baby by the time I am feeling better. I am very outgoing and friendly to humans and dogs and cats. I love to jump and roll snowballs!<input type='hidden' name='question35' value='How+does+your+owner+describe+you%3F'><input type='hidden' name='type35' value='1'></td></tr><tr><td colspan=2 align=center><input type='submit' value='Take This Survey'>
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