Membership Form

Membership Form

Thanks for choosing to join The Widget Club. To register, please fill in your details below and click Send Details.

 
CODE FOLLOWS

<?php
// Include the header file (assumed to contain common HTML and styles)
include('includes/header.php');
?>


<!DOCTYPE html>
<html lang="en">
  <head>
    <title>Membership Form</title>
    <link rel="stylesheet" type="text/css" href="css/common.css" />
  </head>
  <body>
    <h1>Membership Form</h1>

    <p>Thanks for choosing to join The Widget Club. To register, please fill
in your details below and click Send Details.</p>

    <form action="process_registration_multi.php" method="post">
      <div style="width: 30em;">

        <label for="firstName">First name</label>
        <input type="text" name="firstName" id="firstName" value="" />

        <label for="lastName">Last name</label>
        <input type="text" name="lastName" id="lastName" value="" />

        <label for="password1">Choose a password</label>
        <input type="password" name="password1" id="password1" value="" />
        <label for="password2">Retype password</label>
        <input type="password" name="password2" id="password2" value="" />

        <label for="genderMale">Are you male...</label>
        <input type="radio" name="gender" id="genderMale" value="M" />
        <label for="genderFemale">...or female?</label>
        <input type="radio" name="gender" id="genderFemale" value="F" />

        <label for="favoriteWidgets">What are your favorite widgets?</label>
        <select name="favoriteWidgets[]" id="favoriteWidgets" size="3"
multiple="multiple">
          <option value="superWidget">The SuperWidget</option>
          <option value="megaWidget">The MegaWidget</option>
          <option value="wonderWidget">The WonderWidget</option>
        </select>

        <label for="newsletterWidgetTimes">Do you want to receive our
'Widget Times' newsletter?</label>
          <label for="newsletterWidget
  Times"></label><label for="newsletterWidget
Times"></label><input type="checkbox" name="newsletter[]" id="newsletterWidget
Times" value="widgetTimes" />
    <label for="newsletterFunWithWidgets">Do you want to receive our
'Fun with Widgets' newsletter?</label>
          <label for="newsletterFunWith
  Widgets"></label><label for="newsletterFunWith
Widgets"></label><input type="checkbox" name="newsletter[]" id="newsletterFunWith
Widgets" value="funWithWidgets" />

        <label for="comments">Any comments?</label>
        <textarea name="comments" id="comments" rows="4" cols="50">
</textarea>

        <div style="clear: both;">
          <input type="submit" name="submitButton" id="submitButton"
value="Send Details" />
          <input type="reset" name="resetButton" id="resetButton"
value="Reset Form" style="margin-right: 20px;" />
        </div>
     </div>
   </form>

  </body>
</html>

<?php
// Include the footer file (assumed to contain closing HTML and scripts)
include('includes/footer.php');
?>