-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathindex.html
64 lines (61 loc) · 2.32 KB
/
index.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>Form</title>
</head>
<body>
<h1>Volunteer Form</h1>
<form action="http://bloomingdale.sat.iit.edu/kriedan/lab3formscript.php" method="post">
<fieldset>
<legend>
<h2>My Information</h2>
</legend>
<label>First Name:<input type="text" name="first_name_field"></label>
<label>Last Name:<input type="text" name="last_name_field"></label>
<label>Phone Number:<input type="text" name="phone_field"></label>
<label>Email Address:<input type="text" name="email_field"></label>
</fieldset>
<fieldset>
<legend>
<h2>Gender</h2>
</legend>
<label>Male <input type="radio" name="gender_field" value="male"></label>
<label>Female <input type="radio" name="gender_field" value="female"></label>
</fieldset>
<fieldset>
<legend>
<h2>Age</h2>
</legend> <select name="age_field">
<option>under 18</option>
<option>18-24</option>
<option>25-34</option>
<option>35-44</option>
<option>45-54</option>
<option>55-64</option>
<option>65 and over</option>
</select>
</fieldset>
<fieldset>
<legend>
<h2>My Availability</h2>
</legend>
<label>Sunday<input type="checkbox" name="available_field[]" value="Sunday"></label>
<label>Monday<input type="checkbox" name="available_field[]" value="Monday"></label>
<label>Tuesday<input type="checkbox" name="available_field[]" value="Tuesday"></label>
<label>Wednesday<input type="checkbox" name="available_field[]" value="Wednesday"></label>
<label>Thursday<input type="checkbox" name="available_field[]" value="Thursday"></label>
<label>Friday<input type="checkbox" name="available_field[]" value="Friday"></label>
<label>Saturday<input type="checkbox" name="available_field[]" value="Saturday"></label>
</fieldset>
<fieldset>
<legend>
<h2>Comments</h2>
</legend>
<textarea name="comments_field" placeholder="Add any addtional comments that may be useful."></textarea>
</fieldset>
<input type="hidden" name="hidden_field" value="ahussain9">
<input type="submit" value="Submit">
</form>
</body>
</html>