                 <input name="choiceId11[]" value="1" type="hidden">
            <input onclick="validate_select_11=1;" name="Answer11_1" value="11-40" type="checkbox">11-40<br>                      <input name="choiceId11[]" value="2" type="hidden">
            <input onclick="validate_select_11=1;" name="Answer11_2" value="41-100" type="checkbox">41-100
            <br>                      <input name="choiceId11[]" value="3" type="hidden">
            <input onclick="validate_select_11=1;" name="Answer1