s-pugh
diff --git a/‎user-input-with-forms/exercises/index.html
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@@ -9,6 +9,26 @@
   </head>
   <body>
     <!-- TODO: add form here -->
+     <form
+      action="https://handlers.education.launchcode.org/request-parrot"
+      method="POST">
+      <label>Test Name <input type="text" name="testName"/></label>
+      <label>Test Date <input type="date" name="testDate"/></label>
+      <label>Rocket Type <select name="rocketType">
+        <option value="">* Please select an option *</option>
+        <option value="1">Brant</option>
+        <option value="2">Lynx</option>
+        <option value="3">Orion</option>
+        <option value="4">Terrier</option>
+      </select></label>
+      <label>Number of Rocket Booster <input type="number" name="boosterCount" min="1" max="10"></label>
+      <label>Wind Rating:</label>
+        <label>No Wind<input type="radio" name="windRating" value="0"></label>
+        <label>Mild<input type="radio" name="windRating" value="10"></label>
+        <label>Strong<input type="radio" name="windRating" value="20"></label>
+      <label>Use production grade servers <input type="checkbox" name="productionServers"></label>
+      <button>Run Simulation</button>
+     </form>
   </body>
 
 </html>