Try Google form creator

Forms should be easy, but they are one of the hardest things to make for the web. Among other things, Google has made sharing and collecting information easy.
Here's an example form created in a couple of minutes:



Here are a few screen-shots to get you started on your own:

To access this service, go to docs.google.com
Log in using your gmail account or make a Google ID using your own email and password
Choose "Form" from the "New" drop-down menu @ top -left of screen

Choose the Type of question you want to ask

Fill in the form info and make your first question
*Note: to add fields within a question,
just click in the next box and start typing
To add fields within a question, as with a multiple choice, simply click the next semi-greyed box and start typing. To add a question click "Add Question" as show above.