Untitled

<html>
	<body>
		<div style="background-color: #37da7e; color: #000099; font-family: arial;">
	<header>
		<div style="background-color: #007633; width: 600px; height: 60px; margin: auto; bottom-margin: 10px; text-align: center; border-radius: 10px; color: #ffffff; font-size: 36px; line-height: 50px">
			Course Registration Form
		</div>
	</header>

<style>
td.BlueText {
	text-align: left;
}
</style>
<section>
<p>
<div style="background-color: #62da97; width: 900px; min-height: 450px; margin: auto; border: solid #000000 1px; border-raidus: 10px; padding: 5px; text-align: center;">

<table style="width: 800px; margin: auto">
<form>
<tr>
	<td class="BlueText">Term:
		<input type="radio" name="Season" value="Fall" style="margin-left: 95px;"/>Fall
		<input type="radio" name="Season" value="Spring"/>Spring</td>
	<td class="BlueText">Address Line 1:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 10px;"/></td>
</tr>
<tr>
	<td class="BlueText">First Name:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 50px;"/></td>
	<td class="BlueText">Address Line 2:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 10px;"/></td>
</tr>
<tr>
	<td class="BlueText">Middle Intial:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 42.991px;"/></td>
	<td class="BlueText">City:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 89px;"/></td>
</tr>
<tr>
	<td class="BlueText">Last Name:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 51px;"/></td>
	<td class="BlueText">State:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 79px;"/></td>
</tr>
<tr>
	<td class="BlueText">Phone Number:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 21px;"/></td>
	<td class="BlueText">Zip Code:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 51px;"/></td>
</tr>
<tr>
	<td class="BlueText">Work Phone:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 41px;"/></td>
	<td class="BlueText">Email Address:<input type="text"; class="text"; style="background-color: #beec6a; font-family: arial; border: solid #000099 1px; border-radius: 5px; margin-left: 13px;"/></td>
</tr>
<tr>
	<td class="BlueText">Select Courses you are Interested in:</td>
</tr>
<tr>
	<td class="BlueText">English:<input type="radio" name="English" value="English1" style="margin-left:72px;"/>English 1<input type="radio" name="English" value="English2" style="margin-left:30px;"/>English 2<input type="radio" name="English" value="English3" style="margin-left:30px;"/>English 3</td>
</tr>
<tr>
	<td class="BlueText">History:<input type="radio" name="History" value="History1" style="margin-left:75px;"/>History Pt1<input type="radio" name="History" value="History2" style="margin-left:18px;"/>History Pt2<input type="radio" name="History" value="WorldHistory" style="margin-left:17px;"/>World Hist.</td>
</tr>
<tr>
	<td class="BlueText">Communications:<input type="radio" name="Communications" value="Speech1" style="margin-left:5px;"/>Speech 1<input type="radio" name="Communications" value="Speech2" style="margin-left:28px;"/>Speech 2<input type="radio" name="Communications" value="PublicSpeaking" style="margin-left:28px;"/>Public Speaking</td>
</tr>
<tr>
	<td class="BlueText">Economics:<input type="radio" name="Economics" value="MacroEcon" style="margin-left:46px;"/>Macro Econ.<input type="radio" name="Economics" value="MicroEcon" style="margin-left:4px;"/>Micro Econ.<input type="radio" name="Economics" value="WorldEcon" style="margin-left:14px;"/>World Econ.</td>
</tr>
<tr>
	<td class="BlueText">Electives:</td>
</tr>
<tr>
	<td class="BlueText"><input type="checkbox" name="Electives" value="Accounting"/>Accounting<input type="checkbox" name="Electives" value="ChildCare"/>Child Care<input type="checkbox" name="Electives" value="Computer Science"/>Computer Science<input type="checkbox" name="Electives" value="Criminology"/>Criminology</td>
</tr>
<tr>
	<td class="BlueText"><input type="checkbox" name="Electives" value="EarthScience"/>Earth Science<input type="checkbox" name="Electives" value="Education"/>Education<input type="checkbox" name="Electives" value="Film"/>Film<input type="checkbox" name="Electives" value="FineArts"/>Fine Arts</td>
</tr>
<tr>
	<td class="BlueText"><input type="checkbox" name="Electives" value="Geography"/>Geography<input type="checkbox" name="Electives" value="HealthScience"/>Health Science<input type="checkbox" name="Electives" value="Humanities"/>Humanities<input type="checkbox" name="Electives" value="Accounting"/>Law</td>
</tr>
<style>
.button {
	background-color: #990000;
	color: #ffffff;
	font-family: Arial;
	border: solid #660000 2px;
	padding: 2px;
	border-radius: 5px;
}
</style>
<tr>
	<button class="button">
	Send Info
	</button>
	<button class="button">
	Reset
	</button>
</tr>
</form>
</table>
</div>
</p>
</section>
</body>