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Mar 22nd, 2017
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  1. <!doctype html>
  2. <html>
  3.   <head>
  4.     <meta charset="utf-8"/>
  5.     <title></title>
  6.  
  7.  
  8.    
  9.   </head>
  10.   <body>
  11.  
  12.   <p>
  13.     <label for="first_name" id="name1_label">first name: </label>
  14.     <input type="text" name="name1" id="name1"><br/>
  15.  
  16.     <label for="last_name" id="name2_label">last name: </label>
  17.     <input type="text" name="name2" id="name2"><br/>
  18.  
  19.     <label for="initial" id="initial_label">middle initial: </label>
  20.     <input type="text" name="initial" id="initial"><br/>
  21.  
  22.     <label for="address" id="address_label">home address: </label>
  23.     <input type="text" name="address" id="address"><br/>
  24.  
  25.     <label for="city" id="city_label">city: </label>
  26.     <input type="text" name="city" id="city"><br/>
  27.  
  28.     <label for="state" id="state_label">state: </label>
  29.     <input type="text" name="state" id="state"><br/>
  30.  
  31.     <label for="zip_code" id="ZIPcode_label">ZIP code: </label>
  32.     <input type="text" name="ZIPcode" id="ZIPcode"><br/>
  33.  
  34.     <label for="username" id="username_label">username: </label>
  35.     <input type="text" name="username" id="username"><br/>
  36.  
  37.     <label for="password" id="password_label">password: </label>
  38.     <input type="text" name="password" id="password"><br/>
  39.  
  40.     <label for="password_confirm" id="password2_label">confirm password: </label>
  41.     <input type="text" name="password2" id="password2"><br/>
  42.  
  43.     <label for="user_agreement" id="agreement_label">user agreement: </label>
  44.     <input type="radio" name="agreement" id="agreement"><br/>
  45.   </p>
  46.  
  47.   <p>
  48.     <input type="submit" value="Submit">
  49.   </p>
  50.  
  51.     <script type="text/javascript" charset="utf-8">
  52.  
  53.     </script>
  54.  
  55.   </body>
  56. </html>
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