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Oct 21st, 2019
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  1. <!doctype html>
  2.  
  3. <!-- ***************************************************************************************
  4. Author : Jorge Hasbun
  5. Course : WEB-Online
  6. URL : ocelot.aul.fiu.edu/~jhasb006
  7. Professor : Michael Robinson
  8. Program # : 2
  9.  
  10. Due Date : 10/2/19
  11. Certification:
  12. I hereby certify that this work is my own and none of it is the work of any other person.
  13.  
  14. ..........{ Jorge Hasbun }..........
  15.  
  16. **************************************************************************************** -->
  17. <html>
  18.  
  19.  
  20. <head>
  21.  
  22. <title> Hasbun, J - program2.php </title>
  23.  
  24. </head>
  25.  
  26. <?php include('header.php'); ?>
  27. <br>
  28. <?php include('mainMenu.php'); ?>
  29.  
  30. <br>
  31.  
  32. <form method="POST" action="controller2.php">
  33. <table width="70%" align="center" border="0" cellpadding="10px" cellspacing="10px" font: 15px Calibri >
  34. <tr>
  35. <tr>
  36.  
  37. <td align="left"> Telephone Number </td>
  38. <td>
  39. <input type="text" name="Telephone" style="width: 100%;">
  40. </td>
  41.  
  42. </tr>
  43.  
  44. <tr>
  45. <td align="left"> Email Address</td>
  46. <td width="125px">
  47. <input type="text" name="Email" style="width: 100%;">
  48. </td>
  49. </tr>
  50.  
  51. <tr>
  52. <td width="125px" align="left"> Last, First Name </td>
  53. <td width="125px">
  54. <input type="text" name="lastFirstName" style="width: 600%;">
  55. </td>
  56. </tr>
  57.  
  58. <tr>
  59. <td width="125px" align="left"> Full Address </td>
  60. <td width="125px">
  61. <input type="text" name="fullAddress" style="width: 600%;">
  62. </td>
  63. </tr>
  64.  
  65.  
  66.  
  67. </tr>
  68. <tr>
  69. <td align="right"> City</td>
  70.  
  71. <td>
  72. <input name="City" style="width: 100%;"></input>
  73. </td>
  74.  
  75.  
  76. <td align="right"> Major </td>
  77. <td>
  78. <input type="radio" name="radName">
  79. &nbsp; IT
  80. </td>
  81.  
  82.  
  83. <td>
  84. <input type="radio" name="radName">
  85. &nbsp; CS
  86. </td>
  87.  
  88.  
  89. <td>
  90. <input type="radio" name="radName">
  91. &nbsp; Robotics
  92. </td>
  93.  
  94. <td>
  95. <input type="radio" name="radName">
  96. &nbsp; Law
  97. </td>
  98.  
  99. <td>
  100. <input type="radio" name="radName">
  101. &nbsp; Cyber
  102. </td>
  103.  
  104. </tr>
  105.  
  106. <tr>
  107.  
  108. <td align="right"> State </td>
  109.  
  110. <td>
  111. <input name="State" style="width: 100%;"></input>
  112. </td>
  113.  
  114. <td align="right"> Coffee </td>
  115.  
  116. <td>
  117. <input type="checkbox" name="Light">
  118. &nbsp; Light
  119. </td>
  120.  
  121. <td>
  122. <input type="checkbox" name="Cuban">
  123. &nbsp; Cuban
  124. </td>
  125.  
  126. <td>
  127. <input type="checkbox" name="Sweet">
  128. &nbsp; Sweet
  129. </td>
  130.  
  131. <td>
  132. <input type="checkbox" name="Dark">
  133. &nbsp; Dark
  134. </td>
  135.  
  136. <td>
  137. <input type="checkbox" name="Decaf">
  138. &nbsp; Decaf
  139. </td>
  140.  
  141.  
  142.  
  143. </tr>
  144.  
  145. <tr>
  146.  
  147. <td align="right"> Country </td>
  148.  
  149. <td>
  150. <input name="Country" style= "width: 100%;"></input>
  151. </td>
  152.  
  153. <td align="right"> Dropdown </td>
  154.  
  155. <td colspan="2" align="center">
  156. <select name="dropdown" style ="width: 100%";>
  157. <option value="Choice 1"> Choice 1 </option>
  158. <option value="Choice 2"> Choice 2 </option>
  159. <option value="Choice 3"> Choice 3 </option>
  160.  
  161. </select>
  162. </td>
  163.  
  164.  
  165.  
  166. </tr>
  167. <tr>
  168. <td align="right"> Zip</td>
  169.  
  170. <td>
  171. <input name="zipCode" style="width: 100%;"></input>
  172. </td>
  173.  
  174. <td align="right"> Comments</td>
  175.  
  176. <td>
  177. <textarea name="Comments" style="height: 90px; width: 100%;"></textarea>
  178. </td>
  179. </tr>
  180.  
  181. </table>
  182.  
  183.  
  184. <p align="center">$message</p>
  185.  
  186.  
  187. <div style="text-align: center">
  188. <input type="submit" value="Save" name="save">
  189. <input type="submit" value="Find" name="find">
  190. <input type="submit" value="Modify" name="modify">
  191. <input type="submit" value="Delete" name="delete">
  192. <input type="reset" value ="Clear Screen">
  193. </div>
  194. </form>
  195. <br>
  196.  
  197. <?php include('mainMenu.php'); ?>
  198.  
  199.  
  200. </body>
  201. </html>
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