Nowhere near new, and not my own work, but I like it...

[nhs_boy]

Comments

[shuripentu]

And the sad thing is, you probably could code something like this easily enough to duplicate most of the gothy angsty crap that gets posted round the intorweb. :)

[bazzalisk]

The Other section should be checkboxes, not radio-buttons! :)

[nhs_boy]

Heh...

But that would just imply that it was possible to _not_ check them! :-)