Advertisement
Not a member of Pastebin yet?
Sign Up,
it unlocks many cool features!
- <html>
- <head><title>SCHOOL APPLICATION FORM</title></head>
- <body>
- <table border="1" cellspacing="3" cellpadding="4" width="80%"><font face="arial"></font>
- <tr>
- <td> <font face="arial">APPLICATION FOR </td>
- <td colspan="2"><font face="arial"><input type="checkbox" name="q1"> QUARTER 1
- <font face="arial"><input type="checkbox" name="q2"> QUARTER 2  
- <font face="arial"><input type="checkbox" name="q3">QUARTER 3
- <font face="arial"><input type="checkbox" name="q4">QUARTER 4
- <td><font face="arial"> <input type="checkbox" name="all"> SCHOOL YEAR 2014-2015</td>
- </tr>
- <tr>
- <td><font face="arial">LAST (FAMILY) NAME <input type="text" name="ln"></td>
- <td colspan="1"><font face="arial">NICKNAME <input type="text" name="nn"></td>
- <td colspan="1"><font face="arial">DATE OF BIRTH <select size="1">
- <option>January</option>
- <option>February</option>
- <option>March</option>
- <option>April</option>
- <option>May</option>
- <option>June</option>
- <option>July</option>
- <option>August</option></option>
- <option>September</option>
- <option>October</option>
- <option>November</option>
- <option>December</option>
- </select>
- Day <input type="text" name="day" size="2">
- Year <input type="text" name="year" size="2"></td>
- </tr>
- <tr>
- <td colspan="1"><font face="arial">FIRST NAME <input type="text" name="fn" size="46"></td>
- <td colspan="2"><font face="arial">PLACE OF BIRTH <input type="text" name="pob" size="25"></td>
- <td colspan="1"><font face="arial">AGE <input type="text" name="age" size="2"></td>
- </tr>
- <tr>
- <td colspan="1"><font face="arial">MIDDLE NAME <input type="text" name="mn" size="29"></td>
- <td colspan="2"><font face="arial">CITIZENSHIP <input type="text" name="cit" size="29"></td>
- <td colspan="1"><font face="arial">GENDER <input type="radio" name="gen2">FEMALE <input type="radio" name="gen3">MALE </td>
- </tr>
- <tr>
- <td colspan="2"><font face="arial">RELIGION <input type="text" name="mn" size="29"></td>
- </tr>
- <tr>
- <td colspan="1"><font face="arial">HOME ADDRESS (WITH ZIP CODE) <input type="text" name="ha" size="40"></td>
- <td colspan="3"><font face="arial"> MOBILE NO. <input TYPE="text" name="mob"></td>
- <td colspan="2"><font face="arial"> EMAIL ADDRESS <input type="text" name="mob"></td>
- </tr>
- <tr>
- <td><font face="arial"> DEGREE PROGRAM APPLIED FOR <input type="text" name="degree" size="30"></td>
- </tr>
- <tr>
- <td><font face="arial">INTENDED MAJOR <input type="text" name="degree" size="30"></td>
- </tr>
- </table>
- <br>
- <br>
- <br>
- <table border="1" cellspacing="5" cellpadding="7" width="80%"><font face="arial"></font>
- <tr>
- <td><font face="arial">FOREIGN LANGUAGE ABILITY</td>
- </tr>
- <tr>
- <td><font face="arial">LANGUAGE</td>
- <td><font face="arial">READ</td>
- <td><font face="arial">WRITE</td>
- <td><font face="arial">SPEAK</td>
- </tr>
- <tr>
- <td><input type="text" name="un"></td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- </tr>
- <tr>
- <td><input type="text" name="un2"></td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- </tr>
- <tr>
- <td><input type="text" name="un3"></td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- <td><input type="checkbox" name="g">Good <input type="checkbox" name="g">Average <input type="checkbox" name="g">Basic </td>
- </tr>
- </table>
- <table border="1" cellspacing="5" cellpadding="7" width="80%"><font face="arial"></font>
- <tr>
- <td><font face="arial" size="5"><b>*Core subjects include: </b> <br>
- Astronomy<br>
- Charms<br>
- Dark Arts<br>
- Defence Against the Dark Arts<br>
- Flying<br>
- Herbology<br>
- History of Magic<br>
- Potions<br>
- Transfiguration<br>
- <td><font face="arial" size="5"><b>*Electives (third years and up) include:</b> <br>
- Study of Ancient Runes<br>
- Arithmancy<br>
- Muggle Studies<br>
- Care of Margical Creatures<br>
- Divination<br>
- Apparition <sub><sub>(6th & 7th year, those of age only)</sub></sub><br>
- Alchemy <sub><sub>(6th & 7th year, those of age only)</sub></sub><br>
- </tr>
- </body>
- </html>
Advertisement
Add Comment
Please, Sign In to add comment
Advertisement