Reminders for key date

Currently, this form does no validation. You can enter any junk, but I review this. I assume you are intelligent, and not trying to trouble me... After all, this page is for my friends only.
In future, when I automate the link to the web, I plan to add validations. ( That's to keep my idiot-proof friends happy :-) ).
Your Name : (Do not hit return)

Your E-mail: (Do not hit return)

1) Whose birthday/wedding anniversary do you want to record ? : (Do not hit return)

2) What is the type of event you want to record ?
Birthday
Wedding anniversary
None of the above ! interested in this event.

If you chose None of the above, what type of event is it ?

3) What's the date ? Day ( 1 to 31 ) : Month ( 1 to 12 ) :

4) Do you want this to be publicly accessible on the Web ?
Yah, that's ok with me. My friends would like that.
Are you crazy? What would her husband do if he found out ? NO WAY!

5) Would you like an e-mail in advance ?
5 days in advance
1 day in advance
No, just informing you.

6) Is this relevant to any of the following groups ?
A-TOP, IIT-K
C-MID, IIM-C
Hindustan Leavers Ltd. ( HLL )
Apex
No, they won't be interested in this event.

7) Any comments on this event ?

1