Mega Code Archive
User Registration Form Demo
<![CDATA[
<html>
<head>
<title>Index</title>
</head>
<body>
<h2 align="center">User Registration Form</h2>
<form name="forml" method="post" action="UserRegistrationFormOutput.php" enctype="multipart/form-data">
<table width="53%" border="0" align="center" cellpadding="5" cellspacing="0">
<tr>
<td width="49%">Name</td>
<td colspan="2">
<div align="left"
<input type="text" name="name" size="25" maxlength="25">
</div>
</td>
</tr>
<tr>
<td width="49%"> </td>
<td height="2" colspan="2"> </td>
</tr>
<tr>
<td width="49%" height="57">Address</td>
<td height="57" colspan="2">
<textarea name="address" cols="25" rows="4"> </textarea>
</td>
</tr>
<tr>
<td width="49%"> </td>
<td height="2" colspan="2"> </td>
</tr>
<tr>
<td width="49%"> Date of Birth</td>
<td height="2" colspan="2">
<select name=birth_month>
<option selected value=1>January
<option value=2> February
<option value=3>March
<option value=4>April
<option value=5>May
<option value=6>June
<option value=7>July
<option value=8>August
<option value=9>September
<option value=10>October
<option value=11>November
<option value=12>December
</select>
<select name=birth_day>
<option selected value=1>01
<option value=2>02
<option value=3>03
<option value=4>04
<option value=5>05
<option value=6>06
<option value=7>07
<option value=8>08
<option value=9>09
<option value=10>10
<option value=11>11
<option value=12>12
<option value=13>13
<option value=14>14
<option value=15>15
<option value=16>16
<option value=17>17
<option value=18>18
<option value=19>19
<option value=20>20
<option value=21>21
<option value=22>22
<option value=23>23
<option value=24>24
<option value=25>25
<option value=26>26
<option value=27>27
<option value=28>28
<option value=29>29
<option value=30>30
<option value=31>31</option>
</select>
<input maxlength=4 name=birth_year size=4>
(Year)</td>
</tr>
<tr>
<td width="49%" height="2"> </td>
<td height="2" width="17%"> </td>
<td height="2" width="34%"> </td>
</tr>
<tr>
<td width="49%">Gender</td>
<td height="2" width="17%"><input type="radio" name="gender" value="M">Male </td>
<td height="2" width="34%"><input type="radio" name="gender" value="F">Female </td>
</tr>
<tr>
<td width="49%" height="5"> </td>
<td height="5" colspan="2"> </td>
</tr>
<tr>
<td width="49%">Music Preference </td>
<td height="2" colspan="2">
<table width="100%" border="0">
<tr>
<td>
<input type="checkbox" name="pop" value="1">
Pop </td>
<td>
<input type="checkbox" name="rock" value="1">
Rock </td>
</tr>
<tr>
<td>
<input type="checkbox" name="jazz" value="1">
Jazz </td>
<td>
<input type="checkbox" name="metal" value="1">
Metal </td>
</tr>
<tr>
<td>
<input type="checkbox" name="instrumental" value="1">
Instrumental </td>
<td> </td>
</tr>
</table>
</td>
</tr>
<tr>
<td width="49%" height="2"> </td>
<td colspan="2" height="2"> </td>
</tr>
<tr>
<td colspan="3">
<div align="center">
<input type="submit" name="Submit" value="Submit">
</div>
</td>
</tr>
</table>
</form>
</body>
</html>
<!-- UserRegistrationFormOutput.php
<html>
<head>
<title>Display Output </title>
</head>
<body>
<h2> Dear
<?php
if ($gender=='M') {
echo "Mr.";
} elseif ($gender=='F') {
echo "Ms.";
}
echo " ", $name;
?> ! You have entered the following information: </h2>
<table border="1">
<tr>
<td>Address </td>
<td>
<?php echo $address; ?>
</td>
</tr>
<tr>
<td>Date of Birth </td>
<td>
<?php echo $birth_month, " ", $birth_day, " ", $birth_year; ?>
</td>
</tr>
<tr>
<td colspan=2>You prefer listening to:
<?php
if (!(empty($pop))) {
if ($pop==1){
echo " Pop ";
}
}
if (!(empty($jazz))) {
if ($jazz==1) {
echo " Jazz ";
}
}
if (!(empty($rock))) {
if ($rock==1){
echo " Rock ";
}
}
if (!(empty($instrumental))) {
if ($instrumental==1) {
echo " Instrumental ";
}
}
if (!(empty($metal))) {
if ($metal==1){
echo " Metal ";
}
}
?>
</td>
</tr>
</table>
</body>
</html>
-->
]]>