\documentclass{article}

\usepackage{hyperref}

\begin{document}

\begin{Form}[action={http://exampe.com}]
\begin{tabular}{l}
    \TextField{Name} \\\\
    \CheckBox[width=1em]{Check} \\\\
    \Submit{Submit}\\
\end{tabular}
\end{Form}


\end{document}
