Registration Form : form « Form « HTML / CSS






Registration Form

   
<?xml version="1.0" ?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
    "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">

<head>
  <title>Registration</title>
</head>

<body>
<h2>User Registration</h2>
<form action="" method="post"
      name="frmRegister">

<fieldset>
    <legend accesskey="y">About <u>Y</u>ou (ALT + Y)</legend>

<table>
  <tr>
    <td><label for="userName">User name:</label></td>
    <td><input type="text" name="txtUserName" size="20" id="userName" /></td>
  </tr>
  <tr>
    <td><label for="password">Password:</label></td>
    <td><input type="password" name="pwdPassword" size="20" id="password" /></td>
  </tr>
  <tr>
    <td><label for="confPassword">Confirm Password:</label></td>
    <td><input type="password" name="pwdPasswordConf" size="20" id="confPassword" /></td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td><label for="firstName">First name:</label></td>
    <td><input type="text" name="txtFirstName" size="20" id="firstName" /></td>
  </tr>
  <tr>
    <td><label for="lastName">Last name:</label></td>
    <td><input type="text" name="txtLastName" size="20" id="lastName" /></td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td><label for="email">Email address:</label></td>
    <td><input type="text" name="txtEmail" size="20" id="email" /></td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td>Gender:</td>
    <td><input type="radio" name="radSex" value="male" />Male</td>
  </tr>
  <tr>
    <td></td>
    <td><input type="radio" name="radSex" value="female" />Female</td>
  </tr>
  <tr><td>&nbsp;</td><td>&nbsp;</td></tr>
</table>
</fieldset>

<fieldset>
    <legend accesskey="u">About <u>U</u>s (ALT + U)</legend>
<table>
  <tr>
    <td><label for="referrer">How did you hear about us?</label>:</td>
    <td>
      <select name="selReferrer" id="referrer">
        <option selected="selected" value="">Select answer</option>
        <option value="website">Another website</option>
        <option value="printAd">Magazine ad</option>
        <option value="friend">From a friend</option>
        <option value="other">Other</option>
      </select>
    </td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>

  <tr>
    <td><label for="mailList">Please select</label></td>
    <td><input type="checkbox" name="chkMailingList" id="mailList" /></td>
  </tr>

</table>

</fieldset>

<input type="submit" value="Register now" />

</form>
</body>
</html>

   
    
  








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