Checkboxes in Userform Creates Multiple Data Entries

Example:

Userform has three text boxes (1,2,3) and three check boxes (a,b,c).

I would like to add a new line of data for each checkbox that is checked with information from the values of the three textboxes and the caption of the checkbox. So if a and b were checked the data lines would look like this. Is this possible?

1 value.......2 value........3 value.......a caption
1 value.......2 value........3 value.......b caption