Google survey beta

So Blogger wanted to know my opinion. I happily clicked along to express my desire to be able to include syntax highlighted code easily. Five point question: what is wrong with the webpage below?

Hint: how do I submit this thing? While the looks of the questionnaire were spartan (not like some people who feel that they must style their checkboxes to look like big buttons, and to add insult to injury they make the styling with javascript rather than CSS!) and simple and itself was short, to the subject, this was all ruined by the tiny little problem of sending the results :-). Admittedly I'm using a little unconventional browser (Epiphany aka Gnome Web Browser), but it is based on the same engine as Firefox (Gecko).