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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=device-width, initial scale=1.0" />
<link rel="stylesheet" href="styles.css" />
<title>Is Your Government Legitimate?</title>
</head>
<body>
<h1 id="title">Is Your Government Legitimate?</h1>
<p id="description">
Do you exist under a repressive state regime? Is your community under
occupation by the pigs? Is your government complicit in genocide? Complete
this survey to determine whether it's time to overthrow the state and / or
renounce your citizenship.
</p>
<form id="survey-form">
<fieldset id="personal-details">
<label for="name" id="name-label"
>Name:
<input
id="name"
name="name"
type="text"
placeholder="Joe Blogs"
required
/></label>
<label for="email" id="email-label"
>Email:
<input
id="email"
name="name"
type="email"
placeholder="[email protected]"
required
/></label>
<label for="number" id="number-label"
>Age:
<input
id="number"
name="age"
type="number"
min="13"
max="120"
placeholder="35"
required
/></label>
<label for="country" id="country-label"
>Country:
<input
id="country"
name="country"
type="text"
placeholder="UK"
required
/></label>
</fieldset>
<fieldset id="freedoms">
<legend>Select the Basic Freedoms You Possess</legend>
<label for="speech"
><input
id="speech"
class="inline"
name="speech"
value="speech"
type="radio"
/>
Freedom of Speech</label
>
<label for="expression"
><input
id="expression"
class="inline"
name="expression"
value="expression"
type="radio"
/>
Freedom of Expression</label
>
<label for="protest-dissent"
><input
id="protest-dissent"
class="inline"
name="protest-dissent"
value="protest-dissent"
type="radio"
/>
Freedom to Dissent / Protest</label
>
<label for="assembly"
><input
id="assembly"
class="inline"
name="assembly"
value="assembly"
type="radio"
/>
Freedom of Association / Assembly</label
>
<label for="bodily-autonomy"
><input
id="bodily-autonomy"
class="inline"
name="bodily-autonomy"
value="bodily-autonomy"
type="radio"
/>
Bodily Autonomy</label
>
<label for="privacy"
><input
id="privacy"
class="inline"
name="privacy"
value="privacy"
type="radio"
/>
Privacy</label
>
<label for="no-freedoms"
><input
id="no-freedoms"
class="inline"
name="no-freedoms"
value="no-freedoms"
type="radio"
/>
None of the above</label
>
</fieldset>
<fieldset id="power">
<legend>Who Holds Power in Your Country?</legend>
<label for="dropdown"
><select id="dropdown" name="power-holder">
<option value="">--Please choose an option--</option>
<option value="usa">The United States Empire</option>
<option value="monarchy">Unelected Hereditary Head of State</option>
<option value="political-party">Corrupt Chumocracy</option>
<option value="police-state">Police</option>
<option value="democracy">The People aka Democracy</option>
</select></label
>
</fieldset>
<fieldset id="lunch">
<legend>Who is Entitled to a Free Lunch in Your Country?</legend>
<label for="politicians"
><input
id="politicians"
class="inline"
type="radio"
name="free-lunch"
value="politicians"
checked
/>
Politicians</label
>
<label for="children"
><input
id="children"
class="inline"
value="children"
type="radio"
name="free-lunch"
/>
Children</label
>
</fieldset>
<fieldset id="violations">
<legend>Check Your Basic Human Rights Violations</legend>
<label for="love"
><input id="love" value="love" type="checkbox" /> Is the State
isolating you from the man that you want, thereby preventing you from
having a family and massively increasing your risk of suicide?</label
><label for="suicide"
><input id="suicide" value="suicide" type="checkbox" /> Is the State
isolating you from your childhood friends, therby massively increasing
your risk of suicide?</label
><label for="work"
><input id="work" value="work" type="checkbox" /> Is the State
blocking you from work that you enjoy, with people whos company you
enjoy, resulting in huge loss of earnings?</label
><label for="surveil"
><input id="surveil" value="surveil" type="checkbox" /> Does the State
surveil you and then circulate intimate details of your menstrual
cycle with sexual predators?</label
><label for="naked"
><input id="naked" value="naked" type="checkbox" /> Does the State
livestream video of you while on Zoom, in a state of undress, in your
bed, to your colleagues without your knowledge much less
consent?</label
><label for="neuroimage"
><input id="neuroimage" value="neuroimage" type="checkbox" /> Does the
State neuroimage you and then circulate that intimate data to your
colleagues, thereby putting you at risk of violence and making you
feel unsafe to even have thoughts?</label
>
<label for="pester"
><input id="pester" value="pester" type="checkbox" /> Does the State
relentlessly pester and harass you with CHIS (Covert Human
Intelligence Sources) to coerce you into allowing abusive relatives -
whom you have taken out Court Orders against - back into your
life?</label
>
</fieldset>
<fieldset id="additional">
<label for="comments"
>Provide any additional comments:
<textarea
id="comments"
name="comments"
rows="3"
cols="30"
placeholder="Free Palestine!"
></textarea>
</label>
</fieldset>
<input type="submit" id="submit" />
</form>
</body>
</html>