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- <html>
- <head>
- <title>Reservation Form</title>
- </head>
- <body>
- <!-- TITLE ON THE TOP -->
- <h1 style="padding-left:440px;padding-top:10px;color:SlateGray">RESERVATION FORM
- <div style="padding-left:140px;padding-top:10px;">FOR</div>
- <div style="padding-top:10px;"> E-LEARNING CONFERENCE</div></h1>
- <p><h3 style="padding-left:450px"> Please insert your personal details below:</h3>
- <h3 style="padding-left:450px">All columns are required to fill in.</h3></p>
- <form action="WebAssgn2.php" method="POST">
- <label style="padding-left:450px">Title           :
- <select name="gender">
- <option value="Male">Mr</option>
- <option value="Female">Mrs</option>
- </select>
- </label>
- <p style="padding-left:450px">First Name : <input type="text" name="firstname" placeholder="First Name" required /> </p>
- <p style="padding-left:450px">Last Name : <input type="text" name="lastname" placeholder="Last Name" required /></p>
- <p style="padding-left:450px">Affiliation  : <input type="text" name="affiliation" placeholder="Affiliation" required /></p>
- <p style="padding-left:450px">Email         : <input type="email" name="mail" placeholder="E-mail" pattern="^[_A-Za-z0-9-\+]+(\.[_A-Za-z0-9-]+)*@[A-Za-z0-9-]+(\.[A-Za-z0-9]+)*(\.[A-Za-z]{2,})$" required/></p>
- <p style="padding-left:470px"><br><input type="submit" value="Submit">
- <span style="padding-left:10px"><input type="reset" value="Clear"></span>
- <span style="padding-left:10px"><input type="button" value="Go to Query Form" onclick="window.location.href='queryForm.php'"></span></p>
- </form>
- </body>
- </html>
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