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kunbata

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kunbata
Jun 8th, 2023
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  1. <html>
  2. <head>
  3.   <title> CBE REGISTRATION FORM </title>
  4. </head>
  5.   <body>
  6.  
  7.     <form action="form.php" method="POST">
  8.  
  9.     <p align = "center"> <font aria-setsize = "18", color = "WHITE"> <B> WELCOME TO ENTER YOUR INFORMATION IN CBE COLLAGE - DODOMA CAMPUSS
  10.        </font></p> </B>  <BR><BR>
  11.  
  12.         <FONT COLOR="YELLOW"> <B> FIRST NAME:  </FONT> </B> <input type ="text" name = "fname" PLACEHOLDER = "Enter your First Name">   <br> <br>
  13.  
  14.         <FONT COLOR="YELLOW"> <B> SECOND NAME </FONT> </B>: <input type ="text" name = "sname" PLACEHOLDER = "Enter your Second Name">   <br> <br>
  15.  
  16.       <FONT COLOR="YELLOW"> <B> GENDER: </FONT> </B> <BR> <input type ="Radio" name = "Gender" > FEMALE  <br>
  17.                                  
  18.                 <input type ="Radio" name = "Gender" > MALE  <br> <br>
  19.                      
  20.                 <FONT COLOR="YELLOW"> <B> DOB: </FONT> </B>   <BR> <input type="date">  <br> <br>
  21.  
  22.                   <FONT COLOR="YELLOW"> <B> RELIGION:  </FONT> </B> <BR> <input type ="RADIO" name = "religion"> CHRISTIAN <br>
  23.  <input type ="RADIO" name = "religion"> MUSLIMS <br>
  24.                  <input type ="RADIO" name = "religion"> HINDU <br> <BR>
  25.  
  26.                   <FONT COLOR="YELLOW"> <B> NATIONALISM: </FONT> </B> <BR> <input type="checkbox" name ="nationalism">  TANZANIA <BR>
  27.         <input type="checkbox" name ="nationalism"> UGANDA <BR>
  28.           <input type="checkbox" name ="nationalism"> RWANDA <BR>
  29.             <input type="checkbox" name ="nationalism"> KENYA <BR>
  30.               <input type="checkbox" name ="nationalism"> BURUNDI <BR>
  31.                 <input type="checkbox" name ="nationalism"> DRC <BR>
  32.                   <input type="checkbox" name ="nationalism"> MSUMBIJI <BR>
  33.                     <input type="checkbox" name ="nationalism"> ZAMBIA <BR> <BR>
  34.  
  35.  
  36. <FONT COLOR="YELLOW"> <B> MARITUAL STATUS </FONT> </B> <BR>
  37. <input type ="RADIO" name = "MARITUAL STATUS"> SINGLE <BR>
  38. <input type ="RADIO" name = "MARITUAL STATUS"> MARRIED <BR>
  39. <input type ="RADIO" name = "MARITUAL STATUS"> WIDOW <BR>
  40. <input type ="RADIO" name = "MARITUAL STATUS"> DEVORSE <BR>
  41. <input type ="RADIO" name = "MARITUAL STATUS"> NILL <BR> <br>
  42.  
  43.  
  44.  <FONT COLOR="YELLOW"> <B> EMAIL ADDRESS  </B> </FONT> <BR>
  45.  <input type="email" name="email"> <br> <br>
  46.  
  47. <font color ="YELLOW"> <b> PHONE NUMBER </b></font> <BR>
  48.   <input type="text" name = "phone">
  49.  
  50.  
  51.  </form>
  52. </body>
  53. </html>
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