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Security Checklist to answer before continuing to page

Hi all

I am trying to create a checklist of items which a user would need to answer before being allowed to continue a page. The items I need to put are , Country of residence (with a pull down menu) which one answer is correct to proceed to the next question, which is their dialling code, again one answer will be correct to proceed. Is this possible or do I need some custom code.

Any help would be appreciated.

Here is my site Read-Only: LINK
(how to share your site Read-Only link)