2#**id**#&lt;b&gt;What is your employment status?&lt;/b&gt;#**label**#type_radio#****#3#**id**#&lt;b&gt;What is your level of education?&lt;/b&gt;#**label**#type_radio#****#4#**id**#&lt;b&gt;In which industry do you work?&lt;/b&gt;#**label**#type_own_select#****#5#**id**#&lt;b&gt;What is the annual revenue of your company?&lt;/b&gt;#**label**#type_radio#****#6#**id**#Word Verification:#**label**#type_captcha#****#7#**id**#type_submit_reset_7#**label**#type_submit_reset#****#