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- <!-- CSS FILE - http://pastebin.com/pRMpDHYu // NOTE:CREATE FOLDER STYLES -->
- <!doctype html>
- <head>
- <title>Формуляр</title>
- <link href="styles/style.css" rel="stylesheet" type="text/css" />
- </head>
- <body>
- <table border="1">
- <tr>
- <td><label for="LN">Last Name</label></td>
- <td><input type="text" name="Lastname" size="40" id="LN" maxlength="256" /></td>
- </tr>
- <tr>
- <td><label for="FN">First Name</label></td>
- <td><input type="text" name="Firstname" id="FN" size="40" maxlength="256" /></td>
- </tr>
- <tr>
- <td><label for="Ad">Adress</label></td>
- <td><textarea name="Adress" rows="3" id="Ad"></textarea></td>
- </tr>
- <tr>
- <td><label for="CT">City</label></td>
- <td>
- <input type="text" name="City" id="CT" size="15" maxlength="40">
- <label for="ST">State:</label>
- <input type="text" name="State" id="ST" size="12" maxlength="40">
- </td>
- </tr>
- <tr>
- <td><label for="ZP">Zip/Postal code</label></td>
- <td><input type="text" name="Zip/Postalcode" id="ZP" size="40" maxlength="256"></td>
- </tr>
- <tr>
- <td><label for="CO">Country</label></td>
- <td>
- <select name="Country" id="CO">
- <option value="Value 1"
- selected="selected">
- Bulgaria
- </option>
- <option value="Value 2">England</option>
- <option value="Value 3">Romania</option>
- </select>
- </td>
- </tr>
- <tr>
- <td><label for="PH"><p>Phone(Country code,<br>area code,number)</label></td>
- <td>
- (+<input type="text" name="Phone" id="PH" size="5" placeholder="359" />)
- <input type="text" name="Phone" id="PH" size="5" placeholder="883" />
- -<input type="text" name="Phone" id="PH" size="5" placeholder="888888" />
- </td>
- </tr>
- <tr>
- <td><label for="EM">Email</label></td>
- <td>
- <input type="email" required="true" pattern="[^ @]*@[^ @].[^ @]"
- placeholder="[email protected]" name="Email" id="EM" size="40" maxlength="256" />
- </td>
- </tr>
- <tr>
- <td><label for="BD">Birth date</label></td>
- <td>
- Month:<input type="text" name="Birthdate" id="BD" size="1" placeholder="1" />
- Day:<input type="text" name="Birthdate" id="BD" size="1" placeholder="1" />
- Year:<input type="text" name="Birthdate" id="BD" size="1" placeholder="1994" />
- </td>
- </tr>
- <tr>
- <td><label for="GD">Gender</label></td>
- <td>
- <select name="sleep" id="GD">
- <option selected="selected">Male</option>
- <option>Female</option>
- <option>Child</option>
- </select>
- </td>
- </tr>
- <tr>
- <td><label for="SD">Starting date</label></td>
- <td>
- <input type="radio" name="Time" value="Winter 2014" id="SD" />Winter 2014
- <input type="radio" name="Time" value="Spring 2014" id="SD" />Spring 2014
- </td>
- </tr>
- <tr>
- <td><label for="CQ">Coments/Questions</label></td>
- <td>
- <textarea name="Coments" size="50" rows="4" id="CQ"
- maxlength="100" placeholder="Please send me more information about the logding "></textarea>
- </td>
- </tr>
- <tr>
- <form>
- <td colspan="2" bgcolor="#999">
- <center>
- <input type="submit" value="Submit" />
- <input type="reset" name="resetBtn" value="Clear this form" />
- </center>
- </td>
- </form>
- </tr>
- </table>
- </body>
- </html>
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