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Homeless_registration.html
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Homeless_registration.html
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<!DOCTYPE html>
<!-- saved from url=(0064)file:///C:/xampp/htdocs/helping_hands/Homeless_registration.html -->
<html><head><meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
<title></title>
<style>
body{
margin: 0;
padding: 0;
background: url(https://thenypost.files.wordpress.com/2017/10/nyc-homeless-shelter.jpg?quality=90&strip=all);
background-size: cover;
background-attachment: fixed;
background-position: center;
font-family: sans-serif;
}
.btn
{
height: 30px;
width: 150px;
text-align: center;
cursor: pointer;
background: #39dc79;
color: #000;
}
.login-box{
width: 430px;
height: 860px;
background: rgba(0, 0, 0, 0.5);
color: #fff;
top: 65%;
left: 50%;
position: absolute;
transform: translate(-50%,-50%);
box-sizing: border-box;
padding: 70px 30px;
}
h1{
margin: 0;
padding: 0 0 15px;
text-align: center;
font-size: 30px;
}
.login-box p{
margin: 0;
padding: 0;
font-weight: bold;
}
.login-box input{
width: 100%;
margin-bottom: 20px;
}
.login-box input[type="text"], input[type="password"]
{
border: none;
border-bottom: 1px solid #fff;
background: transparent;
outline: none;
height: 40px;
color: #fff;
font-size: 16px;
}
.login-box input[type="submit"]
{
border: none;
outline: none;
height: 40px;
background: #1c8adb;
color: #fff;
font-size: 18px;
border-radius: 20px;
}
.login-box input[type="submit"]:hover
{
cursor: pointer;
background: #39dc79;
color: #000;
}
.login-box a{
text-decoration: none;
font-size: 14px;
color: #fff;
}
.login-box a:hover
{
color: #39dc79;
}
</style>
</head>
<body>
<div class="login-box">
<h1><b><u>HELP HOMELESS</u></b></h1>
<form action="final_image.php" method="POST" enctype="multipart/form-data">
<p>Name</p>
<input type="text" name="Name" placeholder="Enter name">
<p>Email</p>
<input type="text" name="Email" placeholder="Enter email">
<p>Mobile Number</p>
<input type="text" name="Mobile" placeholder="Enter mobile">
Select image to upload:
<input type="file" name="image">
<p>Address</p>
<textarea name="address" rows="5" cols="20"></textarea>
<p>City</p>
<select name="city" >
<option>--SELECT--</option>
<option value='LB NAGAR'>LB NAGAR</option>
<option value='DILSHUKNAGAR'>DILSHUKNAGAR</option>
<option value='KOTHAPET'>KOTHAPET</option>
<option value='NAGOLE'>NAGOLE</option>
<option value='BALAPUR'>BALAPUR</option>
</select><br><br>
<p>Description</p>
<textarea name="description" rows="10" cols="50" placeholder="Describe the person's current situation"></textarea>
<br>
<br>
<input class="btn" type="submit" name="HELP" value="UPLOAD" style= "align:center">
</div>
</body></html>