See Getting Results for details. Each type of field must have a unique name, so when the information is returned to you, you understand where it came from. Also, some fields need to have other values defined as well. Here is an example of a simple form. Use it as base for your own form.
RED lines explain the previous line.
Size refers to how many character the field takes up on the screen. Name is the name you are giving this field. This causes the different options to be grouped under the name. Size in this field refers to the number of lines to be displayed. I could have set it to 1 so only 1 line would display, forcing the reader to scroll the box in order to see the other options.