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  • Assessment Form

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    Fatima Freeman
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    This is a representation of a form that I created.

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    This is a representation of a form that I created.

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    42 Ansichten3 Seiten

    Assessment Form

    Hochgeladen von

    Fatima Freeman
    This is a representation of a form that I created.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Als TXT, PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 3

    <!DOCTYPE html> <html lang="en"> <head> <meta charset="utf-8" /> <title>Title Here</title> <link rel="stylesheet" href="assessmentform.

    css" /> </head> <body> <h2>Logo Here</h2> <h2>Company Name Here</h2> <p>Thank you for choosen this organization as your technical resource.</p> <p>This organization is a not for profit organization that is dedicated to helpi ng adults become more sufficient with the everyday changes that we see happen with technol ogy. This organization has a variety of classes that you can enroll in from social media to any technical trade.</p> <p>For all first time users, please fill out the form below before proceeding wi th any of the assessment quizzes:</p> <h3>Personal Information</h3> <p>Please fill out the form before porceeding with the Basic Assessment Quiz.</p > <form method="post" action="showform.php"encctype="multipart/form-data">

    <fieldset> <h3 class="account">Please Enter Name</h3> <ul> <li> <label for="first_name">First Name</label> <input type="text" id="first_name" name ="first_name" required=" required"> </li> <li> <label for="last_name">Last Name</label> <input type="text" id="last_name" name="last_name" required="req uired"> </li> <li> <label for="email">Email</label> <input type="email" id="email" name="email" required="required"> </li> <li> <label for="username">Username</label> <input type="username" id="username" name="username" required="r

    equired"> </li> <li> <label for="password">Password</label> <input type="password" id="password" name="password" required="r equired"> </li> <li> <label for="password">Re-enter Password</label> <input type="password" id="password2" name="password2" required= "required"> </li> </ul> </fieldset>

    <fieldset> <h3 class="address">Address</h3> <ul> <li> <label for="street_address">Street Address:</label> <input type="street_address" id="street_address" name="s treet_address" required="required"> </li> <li> <label for="city">City:</label> <input type="city" id="city" name="city" required="requi red"> </li> <li> <label="state">State:</label> <select id="state" name="state" required="required"> <option value="AL">Alabama</option> </select> <li> <label for="zip_code>Zip Code</label> <input type="text" id="zip_code" name="zip_code" maxleng th="10" required="required"> </li> </ul>

    </fieldset> <fieldset> <h3 class="public-account">Public Account</h3> <ul> <li>

    <label for="bio">Biography</label> <textarea id="bio" name="bio" rows="8" cols="50"></textarea> </li> <li> <label>Gender:</label> <fieldset class="radio"> </fieldset> <ul> <li> <label for="male">Male</label> <input type="radio" id="gender_male" nam e="gender" value="male"> </li> <li> <label for="female">Female</label> <input type="radio" id="gender_female" n ame="gender" value="female"> </li> </ul> <fieldset> <h3 class="emails">E-mails</h3> <ul> <li> <input type="checkbox" id=""emai l_ok_msg_from_users" name="email_signup[]" value="user_emails" class="small"> <label for="checkbox" id=""email _ok_msg_from_users">It is Ok for users to email me.</label> </li> <li> <input type="checkbox" id="email _ok_occassional_updates" name="email_signup[]" value="occassional_updates"> <label for="email_ok_occassional _updates">Email me with occassional promotions.</label> </li> </ul> </fieldset> </ul> <fieldset> <input type="submit" value="Create Account"> </fieldset> </form> <footer> <p>Some Company &copy; 2013</p> </footer> </body> </html>

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