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89 lines (77 loc) · 2.65 KB
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Registration Form</title>
</head>
<body>
<form action="/process" method="post">
<div>
<label>First Name*: </label>
<input type="text" name="first name"
placeholder="Your name..." >
</div>
<div>
<label>Last Name*: </label>
<input type="text" name=" last name"
placeholder="Your name..." >
</div>
<div>
<label>Email Address*: </label>
<input type="text" name="email"
placeholder="Your email..." >
</div>
<div>
<label>Password*: </label>
<input type="password" name="password"
placeholder="Your password..." >
</div>
<div>
<label>Confirm Password*: </label>
<input type="password" name="password"
placeholder="Your password..." >
</div>
<div>
<label> Birthday: </label>
<input type="date" name="dob"
placeholder="Your name..." >
</div>
<div>
<label> Gender Identiy: </label>
<input type="checkbox" name="male"
id="male" checked >
<label for="male"> male
<input type="checkbox" name="female"
id="female" checked >
<label for="female"> female
<input type="checkbox" name="non-binary"
id="non-binary" checked >
<label for="non-binary"> non-binary
<input type="checkbox" name="I pefer not to answer"
id="I pefer not to answer" checked >
<label for="I pefer not to answer"> I pefer not to answer
</div>
<div> <label> A short description about myself: </label>
<div><textarea name="comment" cols="20" rows="3"></textarea></div>
</div>
<div><label> Favorite Language: </label>
<select name="Language">
<option>JavaScript</option>
<option>HTML </option>
<option>CSS</option>
</select>
</div>
<div>
<input type="checkbox" name="offers"
id="offers" checked >
<label for="offers">Yes, I would like to recieve periodic emails updates</label>
</div>
<input type="submit" value="Create Account" >
<p>
* Indicates a required Field
</p>
</form>
</body>
</html>