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<input value="1" type="checkbox" checked name="need_id"> Advocacy
<input value="2" type="checkbox" checked name="need_id"> Domestic Viol
+ence
<input value="3" type="checkbox" checked name="need_id">Racial Diversi
+ty

my %fdat = $q->Vars;
my $html = <output from favorite flavor of templating language>
my $fif = new HTML::FillInForm;
$html = $fif->fill(scalarref => \$html,
                    fdat => \%fdat);