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<div align="center" style="font-family: Tahoma, Verdana, Arial, Helvetica, sans-serif; font-size: 10pt;"><form action="http://quizzes.blogquiz.net/fun-quizzes/LiveJournal-Memes/What-disease-are-you-livejournal-meme-quiz_aWQ9NzIzNQ.html" method="post" name="quiz7235"><table border="1" cellspacing="0" cellpadding="0"><tr><td><table style="font-family: Tahoma, Verdana, Arial, Helvetica, sans-serif; font-size: 10pt;" border="0" cellspacing="0" cellpadding="3"><tr bgcolor="#003366"><td colspan="2" align="center" valign="middle"><div align="center" style="color: #FFFFFF; font-weight: bold;"><a href="http://quizzes.blogquiz.net/fun-quizzes/LiveJournal-Memes/What-disease-are-you-livejournal-meme-quiz_aWQ9NzIzNQ.html" style="color: #FFFFFF; text-decoration: none;">What disease are you?</a></div></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">LiveJournal Username</td><td align="left" valign="middle"><input type="textbox" name="ljusername" value="" size="20" maxlength="64"></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">Favorite Band</td><td align="left" valign="middle"><select name="input:0"><option value="0" selected>Nickelback</option><option value="1" >Snow Patrol</option><option value="2" >Massive Attack</option><option value="3" >The Killers</option><option value="4" >Hoobastank</option><option value="5" >Josh Groban</option><option value="6" >The Who</option><option value="7" >The Police</option></select></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">Favorite Movie </td><td align="left" valign="middle"><select name="input:1"><option value="0" selected>Lord of the Rings</option><option value="1" >Harry Potter</option><option value="2" >National Treasure</option><option value="3" >Disturbia</option><option value="4" >Happy Feet</option><option value="5" >Star Wars</option><option value="6" >Stargate</option><option value="7" >Star Trek</option><option value="8" >The War of the Worlds</option><option value="9" >E.T.</option><option value="10" >Jurrasic Park</option></select></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">Favorite TV Show</td><td align="left" valign="middle"><select name="input:2"><option value="0" selected>House</option><option value="1" >Bones</option><option value="2" >Jake 2.0</option><option value="3" >Doctor Who</option><option value="4" >Torchwood</option><option value="5" >Ghostwhisperer</option><option value="6" >Numb3rs</option><option value="7" >Mythbusters</option><option value="8" >Special Unit 2</option><option value="9" >Stargate SG-1</option><option value="10" >Stargate Atlantis</option><option value="11" >Star Trek (any series)</option><option value="12" >CSI (any series)</option></select></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">Favorite Book</td><td align="left" valign="middle"><select name="input:3"><option value="0" selected>Lord of the Rings by JRR Tolkien</option><option value="1" >The Touch by F. Paul Wilson</option><option value="2" >Star Trek (any)</option><option value="3" >Stargate SG-1 (any)</option><option value="4" >Stargate Atlantis (any)</option><option value="5" >Star Wars (any)</option><option value="6" >Doctor Who (any)</option><option value="7" >Harry Potter</option><option value="8" >Warriors (any)</option></select></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">Favorite Soda</td><td align="left" valign="middle"><select name="input:4"><option value="0" selected>Pepsi</option><option value="1" >Diet Coke</option><option value="2" >Sprite</option><option value="3" >Mountain Dew</option><option value="4" >Fanta</option><option value="5" >Sierra Mist</option><option value="6" >A&W Root Beer</option><option value="7" >Seven-Up</option></select></td></tr><tr bgcolor="#6699CC"><td align="left" valign="middle" style="color: #FFFFFF;">Favorite Color</td><td align="left" valign="middle"><select name="input:5"><option value="0" selected>Blue</option><option value="1" >Purple</option><option value="2" >Red</option><option value="3" >White</option><option value="4" >Black</option><option value="5" >Yellow</option><option value="6" >Orange</option></select></td></tr><tr bgcolor="#003366" height="5"><td colspan="2"></td></tr><tr bgcolor="#003366"><td colspan="2" align="center" valign="middle"><div align="center"><input type="submit" name="submit" value="Fill in your answers and click here!" style="font-size: 9pt;"></div></td></tr><tr bgcolor="#003366"><td colspan="2" align="center" valign="middle"><div style="color: #FFFFFF;" align="center">This <a href="http://www.blogquiz.net/" style="color: #FFFFFF;">Fun Quiz</a> created by <a href="http://www.blogquiz.net/users/illegal_autopsy" style="color: #FFFFFF;">Kyla</a> at <strong>BlogQuiz.Net</strong><img src="http://70.84.102.91/x/blogquiz.net-blog/25" border="0" width="1" height="1"></div></td></tr></table></td></tr></table><a href="http://weightlosstips.tv/">Weight Loss Tips and Diet Advice</a> from WeightLossTips.TV</form><br></div>
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