Untitled

<html>
<form action="convert.php" method="post">
Type:<br />
<input type="radio" name="type" value="xd" /> Xats To Days<br />
<input type="radio" name="type" value="dx" /> Days To Xats<br />
<br />
Amount: <input type="text" name="amo" /><br />
<br />
<br />
Username: <input type="text" name="user" /><br />
Password: <input type="password" name="password" /><br />
</form>
</html>