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Add demographic and contact info form to index.html #4

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136 changes: 131 additions & 5 deletions index.html
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Original file line number Diff line number Diff line change
@@ -1,3 +1,38 @@
<!-- <!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=, initial-scale=" />
<title>Home</title>
</head>
<body>

<nav>
<a href="index.html"><b>Index</b></a>
<a href="./pages/signup.html"><b>Sign UP</b></a>
<h1>Home</h1>
</nav>

<table border="solid">
<thead>
<th>Item</th><th>Qty</th><th>Price</th><th>Total</th>
</thead>
<tbody>
<tr>
<td>Milk</td><td>2</td><td>$8.00</td><td>$16.00</td>
</tr>
<tr>
<td>Eggs Pack</td><td>1</td><td>$6.00</td><td>$6.00</td>
</tr>
</tbody>
<tfoot>
<tr>
<td>Total</td><td></td><td></td><td>$22.00</td> </tr>
</tfoot>
</table>
<script src="script.js"></script>
</body>
</html> -->
<!DOCTYPE html>
<html lang="en">
<head>
Expand All @@ -6,14 +41,105 @@
<title>Home</title>
</head>
<body>

<nav>
<a href="index.html"><b>Home</b></a>

<a href="signup.html"><b>Sign UP</b></a>
<h1>Home</h1>
</nav>
<h1>Home</h1>



<iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/kg4Na-RbSrA" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>

<script src="script.js"></script>
</body>
</html>
<form action="../results.html" method="GET">
<fieldset>
<legend>Demographic Info</legend>

<label>
Full Name
<input type="text" placeholder="Enter your name" name="fullname" />
</label>

<br />

<label>
Sex
<select name="sex">
<option value="1">male</option>
<option value="2">female</option>
<option value="3">other</option>
</select>
</label>

<br>

<label for="dob">Date Of Birth</label>
<input type="date" value="2000-01-01" name="dob" />


<br>

</fieldset>

<fieldset>
<legend>Contact Info</legend>

<label>
Email
<input type="email" name="email" />
</label>

<br />

<label>
County
<input list="counties" name="county" />
<datalist id="counties">
<option value="Caroni"></option>
<option value="Mayaro"></option>
<option value="Nariva"></option>
<option value="Saint Andrew"></option>
<option value="Saint David"></option>
<option value="Saint George"></option>
<option value="Saint Patrick"></option>
<option value="Victoria"></option>
</datalist>
</label>

<br />

<label>
Telephone
<input type="tel" name="telephone" />
</label>
</fieldset>

<fieldset>
<legend>Courses</legend>

<label>
<input type="checkbox" name="courses" value="info1601" checked/>
<span>Info 1601</span>
</label>

<label>
<input type="checkbox" name="courses" value="comp1602"/>
<span>COMP 1602</span>
</label>

<label>
<input type="checkbox" name="courses" value="comp1603"/>
<span>COMP 1603</span>
</label>

<label>
<input type="checkbox" name="courses" value="comp1604"/>
<span>COMP 1604</span>
</label>

</fieldset>

<br>
<input type="submit" value="signup" />
</form>