Quiz11

<!DOCTYPE html>
<html>
<head>
	<title>Quiz 11 (Yusuf A/XI RPL 2)</title>
	<link rel="stylesheet" type="text/css" href="quizcss.css">
</head>
<body>
<form>
  <fieldset >
    <legend class="title"><font color="#FFFFFF">Formulir Pendaftaran Calon Peserta</font></legend>
<table cellpadding="15" cellspacing="0" align="center" border="0">
  <tr>
  	<td width="250">Nama</td>

  	<td width="150"><input type="text" name="nama" class="nama1"></td>
  </tr>
  <tr>
  	<td width="250">Nomor Induk Penduduk</td>

  	<td width="150"><input type="text" name="nik" class="nik1"></td>
  </tr>
  <tr>
  	<td width="250">Kelamin</td>
  	<td width="150"><input type="radio" value="radiobutton" name="Kelamin" class="male1" >Pria/Male</td>
  	<td ><input type="radio" value="radiobutton" name="Kelamin" class="female1" value="radiobutton">Wanita/Female</td>
  </tr>
  <tr>
  	<td width="250">TTL</td>
  	<td width="150">
  	<input type="date" name="tanggal">
  </td>
  </tr>
  <tr>
  	<td width="250"> Agama</td>
  	<td width="150"> <select>
  		<option value="islam">Islam</option>
  		<option value="Katolik">Katolik</option>
  		<option value="Buddha">Buddha</option>
  		<option value="Hindu">Hindu</option>
  		<option value="Konghucu">Konghucu</option>
  	</select></td>
  </tr>
  <tr>
  	<td width="250"> Status</td>
  	<td width="150"><select>
  		<option value="kawin">Kawin</option>
  		<option value="BKawin">Belum kawin</option>
  	</select></td>
  </tr>
  <tr>
	<td></td>
	<td><input type="submit" name="submit" class="button" value="SIMPAN">
		<input type="submit" name="submit2" class="button" value="SUBMIT"></td>
	</tr>
  </fieldset>
</form>
</table>
</body>
</html>