<ul> <li><input type ="checkbox" name ="chkFries" value ="11.00">Fries</li> <li><input type ="checkbox" name ="chkSoda" value ="12.85">Soda</li> <li><input type ="checkbox" name ="chkShake" value ="1.30">Shake</li> <li><input type ="checkbox" name ="chkKetchup" value =".05">Ketchup</li> </ul> <input type ="submit"> </form>