Give a way plugin

I’m looking for a ‘Give a way plugin’.

People have to answer 2 or 3 (simple) questions.
After they have answered them a form wil appears where they have to leaf theire name etc.
Such as: http://www.first-impressions.nl/sli-4211 or http://win-nike-air-max.onlinedeelname.nl/index.php?offer_id=270

Thanks!