Live a life

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Select desired age:
<select ... >
<option ... >10</option>
<option ... >15</option>
<option ... >20</option>
<option ... >25</option>
</select>

Choose country of birth:
<select ... >
<option ... >Russia</option>
<option ... >USA</option>
<option ... >Gonduras</option>
</select>

Choose starting capital:
<select ... >
<option ... >$10</option>
<option ... >$100</option>
<option ... >$1,000</option>
<option ... >$10,000</option>
<option ... >$100,000</option>
<option ... >$1,000,000</option>
<option ... >$10,000,000</option>
</select>

<input ... >