<form  action="register.php" autocomplete="on">
    <h1> Sign up </h1>
    <p>
         <label for="firstnamesignup" class="fname" data-icon="u">First Name:</label>
         <input id="firstnamesignup" name="firstnamesignup" required="required" type="text" placeholder="First" />
    </p>
    <p>
         <label for="lastnamesignup" class="lname" data-icon="u">Last Name:</label>
         <input id="lastnamesignup" name="lastnamesignup" required="required" type="text" placeholder="Last" />
    </p>
    <p>
         <label for="usernamesignup" class="uname" data-icon="u">Username:</label>
         <input id="usernamesignup" name="usernamesignup" required="required" type="text" placeholder="Username" />
    </p>
    <p>
         <label for="passwordsignup" class="youpasswd" data-icon="p">Password:</label>
         <input id="passwordsignup" name="passwordsignup" required="required" type="password" placeholder="Password"/>
    </p>
    <p>
         <label for="passwordsignup_confirm" class="password" data-icon="p">Confirm Password:</label>
         <input id="passwordsignup_confirm" name="passwordsignup_confirm" required="required" type="password" placeholder="Password"/>
    </p>
    <p>
         <label for="emailsignup" class="youmail" data-icon="e" >Email:</label>
         <input id="emailsignup" name="emailsignup" required="required" type="email" placeholder="example@domain.com"/>
    </p>
    <p>
         <label>Date of Birth:</label>
         <select name="month" onChange="changeDate(this.options[selectedIndex].value);">
         <option value="na">Month</option>
         <option value="1">January</option>
         <option value="2">February</option>
         <option value="3">March</option>
         <option value="4">April</option>
         <option value="5">May</option>
         <option value="6">June</option>
         <option value="7">July</option>
         <option value="8">August</option>
         <option value="9">September</option>
         <option value="10">October</option>
         <option value="11">November</option>
         <option value="12">December</option>
         </select>
         <select name="day" id="day">
         <option value="na">Day</option>
         <option value="na">1</option>
         <option value="na">2</option>
         <option value="na">3</option>
         <option value="na">4</option>
         <option value="na">5</option>
         <option value="na">6</option>
         <option value="na">7</option>
         <option value="na">8</option>
         <option value="na">9</option>
         <option value="na">10</option>
         <option value="na">11</option>
         <option value="na">12</option>
         <option value="na">13</option>
         <option value="na">14</option>
         <option value="na">15</option>
         <option value="na">16</option>
         <option value="na">17</option>
         <option value="na">18</option>
         <option value="na">19</option>
         <option value="na">20</option>
         <option value="na">21</option>
         <option value="na">22</option>
         <option value="na">23</option>
         <option value="na">24</option>
         <option value="na">25</option>
         <option value="na">26</option>
         <option value="na">27</option>
         <option value="na">28</option>
         <option value="na">29</option>
         <option value="na">30</option>
         <option value="na">31</option>
         </select>
         <select name="year" id="year">
         <option value="na">Year</option>
         <option value="na">2009</option>
         <option value="na">2008</option>
         <option value="na">2007</option>
         <option value="na">2006</option>
         <option value="na">2005</option>
         <option value="na">2004</option>
         <option value="na">2003</option>
         <option value="na">2002</option>
         <option value="na">2001</option>
         <option value="na">2000</option>
         <option value="na">1999</option>
         <option value="na">1998</option>
         </select>
         <script language="JavaScript" type="text/javascript">
         function changeDate(i){
         var e = document.getElementById('day');
         while(e.length>0)
         e.remove(e.length-1);
         var j=-1;
         if(i=="na")
         k=0;
         else if(i==2)
         k=28;
         else if(i==4||i==6||i==9||i==11)
         k=30;
         else
         k=31;
         while(j++<k){
         var s=document.createElement('option');
         var e=document.getElementById('day');
         if(j==0){
         s.text="Day";
         s.value="na";
         try{
         e.add(s,null);}
         catch(ex){
         e.add(s);}}
         else{
         s.text=j;
         s.value=j;
         try{
         e.add(s,null);}
         catch(ex){
         e.add(s);}}}}
         y = 1998;
         while (y-->1908){
         var s = document.createElement('option');
         var e = document.getElementById('year');
         s.text=y;
         s.value=y;
         try{
         e.add(s,null);}
         catch(ex){
         e.add(s);}}
         </script>
    </p>
    <p>
         <label>Gender:</label>
         <select name="Gender">
         <option value="male">Male</option>
         <option value="female">Female</option>
         </select>
    </p>
    <p class="signin button">
    <input type="submit" value="Register"/>
    </p>
</form>