Information, program-calling, and counting

Counting down from 100..

Enter text 1 here:

How low would you like to count to:

Input Text which is data2 here:

The data for data3 is hidden here.

Check whether you want data4:
Checkbox 1 here

Check whether you want data5:

Checkbox 2 here

The information data6 is a selected option. Select data 6 here:
Option Selection:

The information for data7 is a radio-button-selected data. Select data7 here:

How soon is the Delivery of Product? (select one)

Within 1 week
Within 1 month
Within 2 months
Within 3 months
Within 1 year
Within 1 year
Within 1 year
Within 1 year
Eventually or someday

The following shows a capability to have an input also be a form, although this is a little different.
In other words, this picture is not merely displayed here, but is also an input to the CGI program.