User Registration Form Demo
<source lang="html4strict">
<html>
<head>
<title>Index</title>
</head>
<body>
User Registration Form
<form name="forml" method="post" action="UserRegistrationFormOutput.php" enctype="multipart/form-data">
| Name |
<div align="left"
<input type="text" name="name" size="25" maxlength="25">
</div>
|
<tr>
<td width="49%"> </td>
<td height="2" colspan="2"> </td>
</tr>
<tr>
<td width="49%" height="57">Address</td>
<td height="57" colspan="2">
<textarea name="address" cols="25" rows="4"> </textarea>
</td>
</tr>
<tr>
<td width="49%"> </td>
<td height="2" colspan="2"> </td>
</tr>
<tr>
<td width="49%"> Date of Birth</td>
<td height="2" colspan="2">
<select name=birth_month>
<option selected value=1>January
<option value=2> February
<option value=3>March
<option value=4>April
<option value=5>May
<option value=6>June
<option value=7>July
<option value=8>August
<option value=9>September
<option value=10>October
<option value=11>November
<option value=12>December
</select>
<select name=birth_day>
<option selected value=1>01
<option value=2>02
<option value=3>03
<option value=4>04
<option value=5>05
<option value=6>06
<option value=7>07
<option value=8>08
<option value=9>09
<option value=10>10
<option value=11>11
<option value=12>12
<option value=13>13
<option value=14>14
<option value=15>15
<option value=16>16
<option value=17>17
<option value=18>18
<option value=19>19
<option value=20>20
<option value=21>21
<option value=22>22
<option value=23>23
<option value=24>24
<option value=25>25
<option value=26>26
<option value=27>27
<option value=28>28
<option value=29>29
<option value=30>30
<option value=31>31</option>
</select>
<input maxlength=4 name=birth_year size=4>
(Year)</td>
</tr>
<tr>
<td width="49%" height="2"> </td>
<td height="2" width="17%"> </td>
<td height="2" width="34%"> </td>
</tr>
<tr>
<td width="49%">Gender</td>
<td height="2" width="17%"><input type="radio" name="gender" value="M">Male </td>
<td height="2" width="34%"><input type="radio" name="gender" value="F">Female </td>
</tr>
<tr>
<td width="49%" height="5"> </td>
<td height="5" colspan="2"> </td>
</tr>
<tr>
<td width="49%">Music Preference </td>
<td height="2" colspan="2">
<input type="checkbox" name="pop" value="1">
Pop |
<input type="checkbox" name="rock" value="1">
Rock |
<input type="checkbox" name="jazz" value="1">
Jazz |
<input type="checkbox" name="metal" value="1">
Metal |
<input type="checkbox" name="instrumental" value="1">
Instrumental |
|
</td>
</tr>
<tr>
<td width="49%" height="2"> </td>
<td colspan="2" height="2"> </td>
</tr>
<tr>
<td colspan="3">
<input type="submit" name="Submit" value="Submit">
</td>
</tr>
</table>
</form>
</body>
</html>
</source>
