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Simple Registration Form For Website (HTML)

The document contains an HTML registration form with fields for user ID, name, phone number, email, birthdate, course, gender, and sex. The form allows the user to submit, reset, or cancel the registration.

Uploaded by

Cheska
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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58 views3 pages

Simple Registration Form For Website (HTML)

The document contains an HTML registration form with fields for user ID, name, phone number, email, birthdate, course, gender, and sex. The form allows the user to submit, reset, or cancel the registration.

Uploaded by

Cheska
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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<html>

<head>

<title> Registration Form </title>

</head>

<body background = "bg.png">

<form>

<center> <h1> <p style = "color:white;"> Registration Form </p> </h1>

<h3> <p style = "color:white;">

<label for "userid"> User ID: <br> </label>

<input type = "text" id = "userid" name = "User ID" placeholder = "juandc69"


maxlength = "8"> <br> <br>

<label for "firstname"> First Name: <br> </label>

<input type = "text" id = "firstname" name = "First Name" placeholder = "Juan">


<br> <br>

<label for "lastname"> Last Name: <br> </label>

<input type = "text" id = "lastname" name = "Last Name" placeholder = "Dela


Cruz"> <br> <br>

<label for "phonenumber"> Phone Number: <br> </label>

<input type = "tel" id = "phonenumber" placeholder = "0912-345-6789" pattern


= "[0-9]{4}-[0-9]{3}-[0-9]{4}" name = "Phone Number" maxlength = "13"> <br> <br>

<label for "email"> Email: <br> </label>

<input type = "email" id = "email" placeholder = "[email protected]"


name = "Email"> <br> <br>
<label for "birthdate"> Birthdate: <br> </label>

<input type = "date" id = "birthdate" name = "Birthdate"> <br> <br>

<label for "course"> Course: <br> </label>

<select name = "Course" id = "course">

<option value= "BSIT"> BSIT </option>

<option value= "BSCS"> BSCS </option>

<option value= "BSOA"> BSOA </option>

</select> <br> <br>

<label for "gender"> Gender: <br> </label>

<select name = "Gender" id = "gender">

<option value= "Feminine"> Feminine </option>

<option value= "Masculine"> Masculine </option>

<option value= "Lesbian"> Lesbian </option>

<option value= "Gay"> Gay </option>

<option value= "Bisexual"> Bisexual </option>

<option value= "Transgender"> Transgender </option>

</select> <br> <br>

<label for "sex"> Sex: <br> </label>

<input type = "radio" name = "Sex" id = "sex" value = "Male"> Male <br>

<input type = "radio" name = "Sex" id = "sex" value = "Female"> Female <br>
<br>

<input type = "submit" value = "Submit">

<input type = "reset" value = "Reset">

<button type = "button" onclick = "Cancel"> Cancel </button>

</p> </h3> </center>


</form>

</body>

</html>

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