Create a Registration (Application) Form
<html>
<head>
<title>APPLICATION FORM </title>
<style>
input:focus {box-shadow: 2px 1px 4px 2px skyblue;}
.mybutton {
color: rgb(255, 255, 255); font-size: 12px; line-height: 16px; padding: 6px; border-radius: 5px; font-family: Georgia, serif; font-weight: bold; background-image: linear-gradient(to right, rgb(28, 110, 164) 0%, rgb(35, 136, 203) 41%, rgb(20, 78, 117) 100%); box-shadow: rgb(0, 0, 0) 5px 5px 15px 5px; border: 2px solid rgb(28, 110, 164); display: inline-block;}
.mybutton:hover {
background: springgreen;color:blue; }
.mybutton:active {
background: orangered; }
legend{background:red;color:white; }
fieldset{border:3px solid darkslateblue;}
fieldset:hover{border:2px solid blue;}
legend:hover{background:darkgreen;font-size: 20px;}
</style>
</head>
<body leftmargin="200px">
<center><h1>ITCI Computer Institute Hardoi</h1>
<h2>Address:- Near SBI Bank, Infront of Gandhi Bhawan Hardoi UP Pin 241001<br>☎ +91 9026728220, +91 8423606968</h2>
<hr size="10"color="red"width="600">
<div style="background:teal;"><h2>Registraion Form<br></h2></div><hr size="10"color="red"width="600">
</center>
<form>
<fieldset>
<legend><h5>Personal Details</h5></legend>
<table width="100%" cellpadding="10px">
<tr>
<td>Applicant's full name </td>
<td>
<select >
<option>--Select --</option>
<option>Mr.</option>
<option>Ms.</option>
<option>Others</option>
</select>
<input type="text" size="20"/>
</td>
<td>Care Of </td>
<td><label>Parents</label><input type="radio" name="care" checked/><label>Guardian </label><input type="radio" name="care"/></td>
</tr>
<tr>
<td>Father's Name </td>
<td>
<select disabled >
<option>Mr.</option>
</select>
<input type="text" size="20"/>
</td>
<td>Mother's Name </td>
<td>
<select disabled >
<option>Mrs.</option>
</select>
<input type="text" size="20"/>
</td>
</tr>
<tr>
<td>Gender</td>
<td>
<label>Male</label><input type="radio" name="Gender"/>
<label>Female </label><input type="radio" name="Gender"/>
<label>Others </label><input type="radio" name="Gender"/>
</td>
<td>Date of Birth</td>
<td>
<input type="date"/>
</td>
</tr>
<tr>
<td>Marital Status</td>
<td>
<select>
<option>--Select--</option>
<option>Single</option>
<option>Married</option>
<option>Divorced</option>
<option>Widowed</option>
</select>
</td>
<td>Category </td>
<td>
<select>
<option>--Select--</option>
<option>General</option>
<option>OBC</option>
<option>SC</option>
<option>ST</option>
</select>
</td>
</tr>
<tr>
<td>Handicapped </td>
<td><label>No</label><input type="radio" name="Handicapped" checked/><label>Yes</label><input type="radio" name="Handicapped"/></td>
<td>Ex-Serviceman </td>
<td><label>No</label><input type="radio" name="Serviceman" checked/><label>Yes</label><input type="radio" name="Serviceman"/></td>
</tr>
<tr>
<td>EWS </td>
<td><label>No</label><input type="radio" name="EWS" checked/><label>Yes</label><input type="radio" name="EWS"/></td>
<td>Religion </td>
<td>
<select>
<option>--Select--</option>
<option>Hindu</option>
<option>Muslim</option>
<option>Jain</option>
<option>Christianity</option>
</select>
</td>
</tr>
</table>
</fieldset><br>
<fieldset>
<legend><h5>Contact Details</h5></legend>
<table width="100%" cellpadding="10px">
<tr>
<td>Mobile Number</td>
<td><input type="tel"/></td>
<td>Email ID</td>
<td><input type="email"/></td>
</tr>
<tr>
<td>Address Line 1</td>
<td><input type="text"/></td>
<td>Address Line 2</td>
<td><input type="text"/></td>
</tr>
<tr>
<td>City</td>
<td><input type="text"/></td>
<td>State</td>
<td>
<select>
<option>--Select--</option>
<option value="Andhra Pradesh">Andhra Pradesh</option>
<option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
<option value="Arunachal Pradesh">Arunachal Pradesh</option>
<option value="Assam">Assam</option>
<option value="Bihar">Bihar</option>
<option value="Chandigarh">Chandigarh</option>
<option value="Chhattisgarh">Chhattisgarh</option>
<option value="Dadar and Nagar Haveli">Dadar and Nagar Haveli</option>
<option value="Daman and Diu">Daman and Diu</option>
<option value="Delhi">Delhi</option>
<option value="Lakshadweep">Lakshadweep</option>
<option value="Puducherry">Puducherry</option>
<option value="Goa">Goa</option>
<option value="Gujarat">Gujarat</option>
<option value="Haryana">Haryana</option>
<option value="Himachal Pradesh">Himachal Pradesh</option>
<option value="Jammu and Kashmir">Jammu and Kashmir</option>
<option value="Jharkhand">Jharkhand</option>
<option value="Karnataka">Karnataka</option>
<option value="Kerala">Kerala</option>
<option value="Madhya Pradesh">Madhya Pradesh</option>
<option value="Maharashtra">Maharashtra</option>
<option value="Manipur">Manipur</option>
<option value="Meghalaya">Meghalaya</option>
<option value="Mizoram">Mizoram</option>
<option value="Nagaland">Nagaland</option>
<option value="Odisha">Odisha</option>
<option value="Punjab">Punjab</option>
<option value="Rajasthan">Rajasthan</option>
<option value="Sikkim">Sikkim</option>
<option value="Tamil Nadu">Tamil Nadu</option>
<option value="Telangana">Telangana</option>
<option value="Tripura">Tripura</option>
<option value="Uttar Pradesh">Uttar Pradesh</option>
<option value="Uttarakhand">Uttarakhand</option>
<option value="West Bengal">West Bengal</option>
</select>
</td>
</tr>
<tr>
<td>Pin Code</td>
<td><input type="text"/></td>
</tr>
</table>
</fieldset><br>
<fieldset>
<legend><h5>Qualification Details</h5></legend>
<table width="100%" cellpadding="10px">
<tr>
<th>Sr No.</th>
<th>Qualification</th>
<th>Board/University</th>
<th>Passing Year</th>
<th>Max Marks</th>
<th>Marks Obtain</th>
<th>Percentage</th>
</tr>
<tr>
<td>1</td>
<td>
<select>
<option>--Select--</option>
<option>10th</option>
<option>12th</option>
<option>Graduate</option>
<option>Post Graduate</option>
</select>
</td>
<td>
<input type="text"/>
</td>
<td>
<input type="number" min="1990" max="2022"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="100"/>
</td>
</tr>
<tr>
<td>2</td>
<td>
<select>
<option>--Select--</option>
<option>10th</option>
<option>12th</option>
<option>Graduate</option>
<option>Post Graduate</option>
</select>
</td>
<td>
<input type="text"/>
</td>
<td>
<input type="number" min="1990" max="2022"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="100"/>
</td>
</tr>
<tr>
<td>3</td>
<td>
<select>
<option>--Select--</option>
<option>10th</option>
<option>12th</option>
<option>Graduate</option>
<option>Post Graduate</option>
</select>
</td>
<td>
<input type="text"/>
</td>
<td>
<input type="number" min="1990" max="2022"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="100"/>
</td>
</tr>
<tr>
<td>4</td>
<td>
<select>
<option>--Select--</option>
<option>10th</option>
<option>12th</option>
<option>Graduate</option>
<option>Post Graduate</option>
</select>
</td>
<td>
<input type="text"/>
</td>
<td>
<input type="number" min="1990" max="2022"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="10000"/>
</td>
<td>
<input type="number" min="0" max="100"/>
</td>
</tr>
</table>
</fieldset><br>
<fieldset>
<legend><h5>Language Knowledge</h5></legend>
<table width="100%">
<tr>
<td>Language</td>
<td>Reading</td>
<td>Writing</td>
<td>Spoken</td>
</tr>
<tr>
<td>Hindi</td>
<td><input type="checkbox"/></td>
<td><input type="checkbox"/></td>
<td><input type="checkbox"/></td>
</tr>
<tr>
<td>English</td>
<td><input type="checkbox"/></td>
<td><input type="checkbox"/></td>
<td><input type="checkbox"/></td>
</tr>
<tr>
<td>Urdu</td>
<td><input type="checkbox"/></td>
<td><input type="checkbox"/></td>
<td><input type="checkbox"/></td>
</tr>
</table>
</fieldset><br>
<fieldset>
<legend><h5>Identification Details</h5></legend>
<table align="center">
<tr>
<td>Aadhar Card Number</td>
<td><input type="text" maxlength="12"/></td>
<td>PAN Card Number</td>
<td><input type="text" maxlength="9"/></td>
</tr>
<tr>
<td>Upload Photo</td>
<td><input type="file"/></td>
<td>Upload Signature</td>
<td><input type="file"/></td>
</tr>
</table>
</fieldset>
<br/>
<center>
<input type="submit" value="Submit"action="post"class="mybutton">
<input type="reset" value="Back"action="post"class="mybutton">
</center>
</form>
<address align="right">
Written by <a href="mailto:itcihardoi@gmail.com">Satyam Trivedi</a>.<br>
Contact us at:<br>
Head Post Office Road, Hardoi<br>
India
</address>
</body>
</html>
.png)
No comments:
Post a Comment
*******Please Comment, Like and Share******
दोस्तों पूरी पोस्ट पढने के लिए धन्यवाद, आशा करता हूँ आप को यह पोस्ट पसंद आई होगी और भी अधिक जानकारी के लिए या मुझसे जुड़ने के लिए आप मुझे मेरे फेसबुक पेज information & technology computer institutions और इन्स्टाग्राम ID:- satyam_hardoi को फॉलो कर सकते है,
मेरा youtube चैनल itci computer hardoi सर्च करे और पाए कंप्यूटर से सम्बंधित सभी विडियो और हाँ प्लीज नई अपडेट पाने के लिए चैनल को सब्सक्राइब जरुर करें, धन्यवाद | आपका $ सत्यम सर् $