Cleanup.
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\documentclass{article}
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\usepackage{hyperref}
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\begin{document}
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\begin{Form}[action={http://your-web-server.com/path/receiveform.cgi}]
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\begin{tabular}{l}
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\TextField{From } \\\\
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\TextField{have 1} \\\\
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\TextField{have 2} \\\\
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\TextField{have 3} \\\\
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\TextField{finally show} \\\\
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\CheckBox[width=1em]{Has the polynomial as many solutions as its degree ? } \\\\
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\Submit{Submit}\\
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\end{tabular}
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\end{Form}
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\end{document}
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