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  1. <!DOCTYPE html>
  2. <html>
  3. <head>
  4.     <title>Registration form</title>
  5. </head>
  6. <body>
  7. <h1>Register</h1>
  8.     <form>
  9.         <label For="first">First Name: </label>
  10.         <input name="first" id="first" type="text" placeholder="John" required>
  11.  
  12. <label for=last>Last Name:</label>
  13. <input name="last" id="last" type="text" placeholder="Smith" required>
  14.  
  15. <div>
  16.    
  17.  
  18. <label for="male">Male</label>
  19.     <input id="male" name=gender type="radio" value="Male">
  20.     <label for="female">Female</label>
  21.     <input id="female" name=gender type="radio" value="Female">
  22.     <label for="other">Other</label>
  23.     <input id="other" name=gender type="radio" value="Other">
  24.  
  25. </div>
  26.  
  27. <div>
  28.     <label>Email:
  29.     <input name="email" type="email" placeholder=Example@email.com name="" required >
  30.     </label>
  31.     <label> Password:
  32. <input type="password" name="password" placeholder=password required="">
  33. </label>
  34. </div>
  35. <div>
  36.     <label> Birthday:
  37.     <select name="Month"> <option>Month</option>
  38.         <option>January</option>
  39. <option>Febuary</option>
  40. <option>March</option>
  41. <option>April</option>
  42. <option>May</option>
  43. <option>June</option>
  44. <option>July</option>
  45. <option>August</option>
  46. <option>September</option>
  47. <option>October</option>
  48. <option>November</option>
  49. <option>December</option>
  50.  
  51.  
  52.     </select>
  53.     <select name="Day">
  54.  
  55. <option>Day</option>
  56. <option>1</option>
  57. <option>2</option>
  58. <option>3</option>
  59. <option>4</option>
  60. <option>5</option>
  61. <option>6</option>
  62. <option>7</option>
  63. <option>8</option>
  64. <option>9</option>
  65. <option>10</option>
  66. <option>11</option>
  67. <option>12</option>
  68. <option>13</option>
  69. <option>14</option>
  70. <option>15</option>
  71. <option>16</option>
  72. <option>17</option>
  73. <option>18</option>
  74. <option>19</option>
  75. <option>20</option>
  76. <option>21</option>
  77. <option>22</option>
  78. <option>23</option>
  79. <option>24</option>
  80. <option>25</option>
  81. <option>26</option>
  82. <option>27</option>
  83. <option>28</option>
  84. <option>29</option>
  85. <option>30</option>
  86. <option>31</option>
  87.  
  88.  
  89.  
  90.  
  91.  
  92.  
  93.     </select>
  94.     <select name="Year">
  95. <option>Year</option>
  96. <option>1994</option>
  97. <option>1995</option>
  98. <option>1996</option>
  99. <option>1997</option>
  100. <option>1998</option>
  101. <option>1999</option>
  102. <option>2000</option>
  103. <option>2001</option>
  104. <option>2002</option>
  105. <option>2003</option>
  106. <option>2004</option>
  107. <option>2005</option>
  108. <option>2006</option>
  109. <option>2007</option>
  110. <option>2008</option>
  111. <option>2009</option>
  112.  
  113.  
  114.  
  115.  
  116.  
  117.  
  118.  
  119.  
  120.     </select>
  121.     </label>
  122.  
  123. </div>
  124. <div>
  125.     <label for="agreed">I agree to the terms and conditons:</label>
  126. <input type="checkbox" id="agreed" name="agreed">
  127. </div>
  128.  
  129.  
  130. <input type="submit" name="">
  131.  
  132.  
  133.     </form>
  134.  
  135. </body>
  136. </html>
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