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- <!DOCTYPE html>
- <html>
- <head>
- <meta charset="UTF-8">
- <title>Registration Form</title>
- <style>
- table, td {
- padding: 7px;
- border-collapse: collapse;
- border: 2px solid black;
- }
- h1 {
- margin: 0px;
- padding: 0px;
- }
- </style>
- </head>
- <body>
- <form method="post" action="submit.php">
- <table>
- <td>
- <h1>Registration Form</h1><br>
- <label for="Name">Name</label><br>
- <input type="text" placeholder="Input your name" id="Name" name="Personal_Information1"><br>
- <label for="Family">Family</label><br>
- <input type="text" id="Family" name="Personal_Information2"><br>
- <label for="E-mail">E-mail</label><br>
- <input type="text" id="E-mail" name="Personal_Information3"><br><br>
- Choose a course:<br>
- <input type="radio" id="PHP" name="Course" value="PHP">
- <label for="PHP">PHP</label><br>
- <input type="radio" id="Lisp" name="Course" value="Lisp">
- <label for="Lisp">Lisp</label><br>
- <input type="radio" id="Perl" name="Course" value="Perl">
- <label for="Perl">Perl</label><br>
- <input type="radio" id="Unix" name="Course" value="Unix">
- <label for="Unix">Unix</label><br><br>
- Additional information for you?<br>
- <textarea id="Additional_Information" name="Additonal Information" rows="6" cols="40"></textarea><br><br>
- <input type="checkbox" id="Confirmation" name="Confirmation">
- <label for="Confirmation">Confirm the receiving of the confirmation</label><br>
- <input type="submit">
- <input type="reset">
- </td>
- </table>
- </form>
- </body>
- </html>
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