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Petition and Survey Test
Email Address
*
[CONFIRM] Can we add your name to our petition?
Yes, add my name!
Submit
Do you agree this is a yes/no question?
Yes
No
What checkboxes are important to you?
Checkbox 1
Checkbox 2
Checkbox 3
Next
What radio buttons are important to you?
Radio 1
Radio 2
Radio 3
Do you want to donate?
Yes, I'll donate $5!
Yes, I'll donate $10!
Yes, I'll donate $25!
No, thanks.
Will you share this page?
Yes, I sure will!
No, thanks
