Where did you hear about this product?
<input type="radio" name="question" value="a">Friend</input><br>
<input type="radio" name="question" value="b">Magazine (please specify:)</input> <input type="text" name="magname"><br>
<input type="radio" name="question" value="c">Brochure</input><br>
<input type="radio" name="question" value="d">Other (please specify:)</input> <input type="text" name="other"><br>