\documentclass[a4paper]{article} 
\usepackage[utf8]{inputenc}
\usepackage[T1]{fontenc}
\usepackage{fourier}
\usepackage{alterqcm}
\usepackage{fullpage}
\thispagestyle{empty}

\begin{document}
{\Large
NAME: 

FIRST NAME:

\bfseries
\vspace{1cm}
\AQannexe[propstyle=\bfseries\arabic]{1}{10}{4}%
 \hspace{2cm}
\AQannexe[propstyle=\bfseries\alph]{11}{20}{3}}
\end{document}

