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			<meta name="generator" content="Adobe GoLive">
			<title>Form | Questionnaire</title>
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			<form action="(EmptyReference!)" name="questionaire">
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				<table width="550" border="0" cellspacing="0" cellpadding="8" >
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							<h3><!-- #BeginEditable "Questionnaire" -->&#x8C03;&#x67E5;&#x8868;<!-- #EndEditable --></h3>
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								<p><b>Donec enim. Sed</b> tristique imperdiet diam. Duis enim magna, venenatis sed, accumsan eget, sollicitudin eu, nulla. Praesent venenatis, arcu sed nonummy pellentesque, diam dui volutpat felis, non placerat velit urna ut odio. Curabitur sodales.</p>
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								<b>1.</b> Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Etiam vestibulum posuere velit. Donec at urna. Fusce ultrices facilisis risus. Morbi id nisl in magna lacinia iaculis.

								<p><input type="radio" name="question1" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
									<input type="radio" name="question1" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
									<input type="radio" name="question1" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
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								<b>2.</b> Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Etiam vestibulum posuere velit. Donec at urna. Fusce ultrices facilisis risus. Morbi id nisl in magna lacinia iaculis.

								<p><input type="radio" name="question2" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
									<input type="radio" name="question2" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
									<input type="radio" name="question2" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
								</p>
								<hr noshade size="3">
								<b>3.</b> Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Etiam vestibulum posuere velit. Donec at urna. Fusce ultrices facilisis risus. Morbi id nisl in magna lacinia iaculis.

								<p><input type="radio" name="question3" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
									<input type="radio" name="question3" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
									<input type="radio" name="question3" value="radioValue" border="0"> Lorem ipsum dolor sit amet, consectetuer<br>
								
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								<input type="submit" name="submitButtonName" value="&#x63D0;&#x4EA4;" border="0"><!-- #EndEditable --></td>
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			</form>
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