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Have a check mark box form how to collect the information?

Question asked by Marcy Chandler on Oct 16, 2013
We have this unsubscribe form on a landing page: http://pages.bkd.com/SurveySuccessTest.html
 
I am needing to collect this information when people make their selections. I saw in the community the best way to accomplish this is through an alert email and using tokens except there are no tokens for check mark boxes. We have tried to set up a report but it doesn’t seem to collect the information as people fill out the check mark boxes.

Ultimately I rather be able to run a report on the information collected then send an alert email every time but am  not sure how we get the report to realize it is a check mark form not a text form.
 
These are discussions I am going off: http://community.marketo.com/MarketoDiscussionDetail?id=90650000000Pb8zAAC
http://community.marketo.com/MarketoArticle?id=kA050000000LA3VCAW
 
If we can't build a report, how would I go about building that alert email with the form being checkmark boxes instead of text fields where the information is being filled out. Do I need to make custom tokens for that or can I use the tokens provided.

Any help would be greatly appreciated. Let me know if I am not making sense or you need any additional information.

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