<html>
<head>
<title>Personal
Information</title>
<link href='/personalwebsite.com/css/style.css' rel='stylesheet' type='text/css'>
</head>
<body>
<form method='POST' action='/personalwebsite.com/controllers/signup.php'>
<div class='form-row'>
<span class='label'>Name:</span><input type='text' name='name'>
</div>
<div class='form-row'>
<span class='label'>Birthdate:</span>
<select type='radio' name='birth_month'>
<?php
$months=array('Jan',
'Feb',
'Mar',
'Apr',
'May',
'Jun',
'Jul',
'Aug',
'Sep',
'Oct',
'Nov',
'Dec');
foreach($months as $month){?>
<option value="<?php echo
$month ?>"><?php echo $month ?></option>
<?php }
?>
</select>
<select type='radio' name='birth_day'>
<?php
for($day=1;$day<=31;$day++){?>
<option value="<?php echo
$day ?>"><?php echo $day ?></option>
<?php }
?>
</select>
<select type='radio' name='birth_year'>
<?php
for($year=1994;$year>=1942;$year--){?>
<option value="<?php echo
$year ?>"><?php echo $year ?></option>
<?php }
?>
</select>
</div>
<div class='form-row'>
<span class='label'>Address:</span><input type='text' name='address'>
</div>
<div class='form-row'>
<span class='label'>Contactno:</span><input type='text' name='contactno'>
</div>
<div class='form-row'>
<span class='label'>Email:</span><input type='text' name='email'>
</div>
<div class='form-row'>
<span class='label'> </span><input type='submit' value='Submit'>
</div>
</form>
</body>
</html>
No comments:
Post a Comment