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a guest Mar 25th, 2019 76 Never
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  1. <html>
  2. <head></head>
  3. <h1>Please fill in this form:</h1>
  4. <form action="" method="post">
  5. <p>Enter your name:</p>
  6. <input type="text" name="FirstName" id="FirstName" value="Peter" readonly></p>
  7. <p>Enter your Surname:</br>
  8.   <input type="text" name="LastName" id="LastName" value="Borg" disabled></p>
  9.   <p> Gender:
  10.     <select name="gender">
  11.       <option value="male">Male</option>
  12.       <option value="female">Female</option>
  13.       <option value="X">X</option>
  14.     </select></p>
  15.  
  16.     <p>Enter any comments here: </br>
  17.       <textarea name="message" rows="20" cols="80">
  18.       </textarea></p>
  19.  
  20.       <p>Country:<br>
  21.         <input type="radio" name="country" value="Malta" checked> Malta<br>
  22.         <input type="radio" name ="country" value="Gozo"> Gozo<br>
  23.       </p>
  24.   <input type="submit" value="Submit">
  25. </form>
  26. <body>
  27. </html>
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