Untitled

<!DOCTYPE html>
<html>
	<body>
	<?php
	//include "footer.php";
	//include "header.php";

	function test_input($data)
	{
		$data = trim($data);
		$data =	stripslashes($data);
		$data = htmlspecialchars($data);
		return $data;
	}
		$firstName = $lastName = $telephonenumber = $email = $birthdate = $where = "";

		if ($_SERVER["REQUEST_METHOD"] == "POST")
		{
			$firstName = test_input($_POST["firstName"]);
			$lastName = test_input($_POST["lastName"]);
			$telephonenumber = test_input($_POST["telephonenumber"]);
			$email = test_input($_POST["email"]);
			$birthdate = test_input($_POST["birthdate"]);
			$radio = test_input($_POST["where"]);
			$when = test_input($_POST["when"]);
		}
		?>
		<style>
		.split{
			width: 50%;

			top: -10px;
			padding-top: 10px;

		}
		.left {
			left: 10px;


		}
		.right {
			right: -60px;
			position: fixed;
		}

		</style>

		<div class="split left">
		<form method="post" action="input.php">
			<fieldset>
				<legend> <b>Personal Information</b> </legend>
				<p>

				<label>First Name </label><br>
				<input type="text" name="firstName" />
			</p>
			<p>

				<label>Last Name </label><br>
				<input type="text" name="lastName" />
			</p>

				<label>Telephone Number </label><br>
				<input type="number" name="telephonenumber" />
			</p>

				<label>Email </label><br>
				<input type="email" name="email" />
			</p>

				<label>Birth Date </label><br>
				<input type="date" name="birthdate" />
			</p>
			</fieldset>

			<br>
			<form method="get" action="input.php">
			<fieldset>
				<legend> <b>Profession</b> </legend>
				<input type="radio" name="where" value="Student" >Student <br/>
				<input type="radio" name="where" value="Doctor">Doctor <br/>
				<input type="radio" name="where" value="Farmer">Farmer <br/>
				<input type="radio" name="where" value="Engineer">Engineer <br/>
			</fieldset>
			<br>

			<form method="get" action="input.php">
			<fieldset>

				<legend> <b>Favorite Sports</b></legend>
				<select name="when" size ="4">
					<option  value="Hockey"> Hockey </option>
					<option  value="Football"> Football </option>
					<option  value="Curling"> Curling </option>
					<option value="Tennis"> Tennis </option>
				</select>
			</p>
			</fieldset>
			<br>

			<input type="submit"/>
			<input type="reset"/>
			</div>

			<div class="split right">
			<?php
			echo "<br><br><br><br>";
			echo 'First name: ', $firstName;
			echo "<br>";
			echo 'Last name: ', $lastName;
			echo "<br>";
			echo 'Telephone number: ', $telephonenumber;
			echo "<br>";
			echo 'Email: ', $email;
			echo "<br>";
			echo 'Birth Date: ', $birthdate;
			echo "<br>";
			echo 'Profession: ', $radio;
			echo "<br>";
			echo 'Favorite sport: ', $when;


			?>
			</div>


	</body>
</html>