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form.html
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117 lines (74 loc) · 3.62 KB
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<!DOCTYPE html>
<html>
<head>
<title>Sir_Roll</title>
</head>
<body style="background-color:#dddd7b">
<form>
<label for="first_name">First Name:</label>
<input type="text" id="first_name" name="first_name" placeholder="Enter only your first name">
<br><br>
<label for="fast_name">Last Name:</label>
<input type="text" id="last_name" name="last_name" placeholder="Enter only your last name">
<br><br>
<label for="title">Title:</label>
<label for="Sir.">Sir.:</label>
<input type="radio" value="Sir." id="Sir." name="title">
<label for="Mr.">Mr.:</label>
<input type="radio" value="Mr." id="Mr." name="title">
<label for="Mrs.">Mrs.:</label>
<input type="radio" value="Mrs." id="Mrs." name="title">
<label for="Miss.">Miss.:</label>
<input type="radio" value="Miss." id="Miss." name="title">
<label for="Doc.">Doc.:</label>
<input type="radio" value="Doc." id="Doc." name="title">
<label for="Hon.">Hon.:</label>
<input type="radio" value="Hon." id="Hon." name="title">
<label for="Rev.">Rev.:</label>
<input type="radio" value="Rev." id="Rev." name="title">
<label for="Rev.Sr.">Rev.Sr.:</label>
<input type="radio" value="Rev.Sr." id="Rev.Sr." name="title">
<br><br>
<label for="payment">Payment:</label>
<select id="payment">
<option value="momo">Mobile Money</option>
<option value="visa">Visa card</option>
<option value="mastercard">Mastercard</option>
<option value="paypal">PayPal</option>
<option value="paystack">PayStack</option>
<option value="direct">Direct Transfer</option>
</select>
<br><br>
<label for="email">Email:</label>
<input type="email" id="email" name="email" placeholder="eg:someonespecial@gmail.com">
<br><br>
<label for="dob">Date of Birth:</label>
<input type="date" id="dob" name="dob">
<br><br>
<label for="school">School Attended:</label>
<input type="text" id="school" name="school" placeholder="type the name of the school you attended">
<br><br>
<label for="phone">Phone Number:</label>
<input type="tel" id="phone" name="phone" placeholder="eg:+233xxxxxxxxx">
<br><br>
<label for="user">Username:</label>
<input type="username" id="user" name="user" placeholder="Enter your username">
<br><br>
<label for="pass">Password:</label>
<input type="password" id="pass" name="pass" placeholder="Use a strong password" maxlength="12">maximum of 12 characters
<br><br>
<label for="slider">Rate Us:</label>
1<input type="range" step="10" value="50">10
<br><br>
<label for="sub">Subscribe:</label>
<input type="checkbox" id="sub" name="sub">
<br><br>
<label for="upload">Upload a File:</label>
<input type="file" id="upload" name="upload" accept=".xlsx, .docx, .jpg, .xls, .doc, .txt">
<br><br>
<input type="reset">
<br><br>
<input type="submit">
</form>
</body>
</html>