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Text File  |  2003-04-18  |  4.4 KB  |  101 lines
  1. <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 3.2//EN">
  2. <HTML>
  3.    <HEAD>
  4.       <TITLE>
  5.          DOCUMENT TITLE
  6.       </TITLE>
  7.       <META HTTP-EQUIV="DESCRIPTION" CONTENT="">
  8.       <META HTTP-EQUIV="KEYWORDS" CONTENT="">
  9.       <META HTTP-EQUIV="GENERATOR" CONTENT="MPS HTMLGATE XP - http://www.mpsoftware.dk">
  10.    </HEAD>
  11.    <BODY>
  12.       <H1>
  13.          <FONT FACE="Verdana" SIZE="2">Registration Form</FONT>
  14.       </H1>
  15.       <HR WIDTH="90%" SIZE="1">
  16.       <P>
  17.          <FONT FACE="Verdana" SIZE="2">The instructions for registration go here.</FONT>
  18.       </P>
  19.       <FORM ACTION="" METHOD="post">
  20.          <HR WIDTH="90%" SIZE="1">
  21.          <H2>
  22.             User Information
  23.          </H2>
  24.          <PRE>
  25.     First Name: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="FirstName">
  26.      Last Name: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="LastName">
  27.          Title: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="Title">
  28.        Company: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="Company">
  29. Street Address: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="StreetAddr">
  30.           City: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="City">
  31.          State: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="State">
  32.       Zip Code: <INPUT TYPE="text" SIZE="30" MAXLENGTH="10" NAME="ZipCode">
  33.      Telephone: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="Phone">
  34.            FAX: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="FAX">
  35.         E-mail: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="Email">
  36.            URL: <INPUT TYPE="text" SIZE="30" MAXLENGTH="256" NAME="URL">
  37.          </PRE>
  38.          <HR WIDTH="90%" SIZE="1">
  39.          <H2>
  40.             <FONT FACE="Verdana" SIZE="2">Product or Event, Information</FONT>
  41.          </H2>
  42.          <P>
  43.             <FONT FACE="Verdana" SIZE="2">Select the mutually exclusive options that apply to [Product or Event]:</FONT>
  44.          </P>
  45.          <DL>
  46.             <DD>
  47.                <FONT FACE="Verdana" SIZE="2"><SELECT NAME="Options" SIZE="1">
  48.                   <OPTION SELECTED>
  49.                      Option 1
  50.                   </OPTION>
  51.                   <OPTION>
  52.                      Option 2
  53.                   </OPTION>
  54.                   <OPTION>
  55.                      Option 3
  56.                   </OPTION>
  57.                   <OPTION>
  58.                      Option 4
  59.                   </OPTION>
  60.                   <OPTION>
  61.                      Option 5
  62.                   </OPTION>
  63.                </SELECT></FONT>
  64.             </DD>
  65.          </DL>
  66.          <P>
  67.             <FONT FACE="Verdana" SIZE="2">Select the independent options that apply to [Product or Event]:</FONT>
  68.          </P>
  69.          <DL>
  70.             <DD>
  71.                <PRE>
  72. <FONT FACE="Verdana" SIZE="2"><INPUT TYPE="checkbox" NAME="C1" VALUE="C1">Check 1    <INPUT TYPE="checkbox" NAME="C2" VALUE="C2">Check 2    <INPUT TYPE="checkbox" NAME="C3" VALUE="C3">Check 3    <INPUT TYPE="checkbox" NAME="C4" VALUE="C4">Check 4
  73. <INPUT TYPE="checkbox" NAME="C5" VALUE="C5">Check 5    <INPUT TYPE="checkbox" NAME="C6" VALUE="C6">Check 6    <INPUT TYPE="checkbox" NAME="C7" VALUE="C7">Check 7    <INPUT TYPE="checkbox" NAME="C8" VALUE="C8">Check 8
  74. <INPUT TYPE="checkbox" NAME="C9" VALUE="C9">Check 9    <INPUT TYPE="checkbox" NAME="C10" VALUE="C10">Check 10   <INPUT TYPE="checkbox" NAME="C11" VALUE="C11">Check 11   <INPUT TYPE="checkbox" NAME="C12" VALUE="C12">Check 12</FONT>
  75.                </PRE>
  76.             </DD>
  77.          </DL>
  78.          <P>
  79.             <FONT FACE="Verdana" SIZE="2">Supply the following information relating to [Product]:</FONT>
  80.          </P>
  81.          <DL>
  82.             <DD>
  83.                <FONT FACE="Verdana" SIZE="2">Registration Number<BR>
  84.                 <INPUT TYPE="text" SIZE="20" MAXLENGTH="256" NAME="RegNumber"><BR>
  85.                 Serial Number<BR>
  86.                 <INPUT TYPE="text" SIZE="20" MAXLENGTH="256" NAME="SerNumber"></FONT>
  87.             </DD>
  88.          </DL>
  89.          <HR WIDTH="90%" SIZE="1">
  90.          <H2>
  91.             <FONT FACE="Verdana" SIZE="2">Form Submission</FONT>
  92.          </H2>
  93.          <P>
  94.             <FONT FACE="Verdana" SIZE="2">[This is an explanation of what will happen after you submit the form.]</FONT>
  95.          </P>
  96.          <P>
  97.             <FONT FACE="Verdana"><INPUT TYPE="submit" VALUE="Register"> <INPUT TYPE="reset" VALUE="Clear Form"></FONT>
  98.          </P>
  99.       </FORM>
  100.    </BODY>
  101. </HTML>