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<html>

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    <form id='main' method='post' action='http://httpbin.org/post'>
    <fieldset class="question-fieldset twocolinputs">
                  <h2>
                     Question #81: 
                  </h2>
                  <div class="answer-single">
                     <input id="2-a" name="MX3A" type="checkbox" class="checkbox-button-input" value="true">
                     <label class="answer-label" for="2-a">
                     Email
                     </label>
                  </div>
                  <div class="answer-single">
                     <input id="2-b" name="MX3B" type="checkbox" class="checkbox-button-input" value="true">
                     <label class="answer-label" for="2-b">
                     SMS
                     </label>
                  </div>
                  <div class="answer-single">
                     <input id="2-c" name="MX3C" type="checkbox" class="checkbox-button-input" value="true">
                     <label class="answer-label" for="2-c">
                     Llamada
                     </label>
                     <input type='submit'>
                  </div>
               </fieldset>
               </form>
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</html>
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