Untitled

<!DOCTYPE html>
<html>
    <head>
        <title>2017/11/29</title>
    </head>
    <body>
    <form action="/action_page.php">
First name:<br>
<input type="text" name="firstname" value="Jannaye">
<br>
<br>
Last name:<br>
<input type="text" name="lastname" value="Wilson">
<br>
<br>
Username:<br>
<input type="text" name="username" value="Your ID">
<br>
<br>
Password:<br>
<input type="text" name="password" value="Your last name">
<br>
<br>
<input type="submit" value="Submit">
</form>
    </body>
</html>