GUVI-project/index.html at main · yashwant-manchu/GUVI-project · GitHub

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<!DOCTYPE html>
<html>
  <head>
    <meta charset="utf-8">
	<meta name="viewport" content="width=device-width, intial-scale=1">
    <title>Sign Up Form</title>
    <link rel="stylesheet" href="style.css">
  </head>
  <body>

   <form class="signup-form" action="request.php" method="post">

      <!-- form header -->
      <div class="form-header">
        <h1>Sign Up</h1>
      </div>

      <!-- form body -->
      <div class="form-body">

        <!-- Firstname and Lastname -->
        <div class="horizontal-group">
          <div class="form-group left">
            <label for="firstname" class="label-title">First name *</label>
            <input type="text" name="first_name" id="first_name" class="form-input" placeholder="Enter your first name" required="required" />
          </div>
          <div class="form-group right">
            <label for="lastname" class="label-title">Last name </label>
            <input type="text" name="last_name" id="last_name" class="form-input" placeholder="Enter your last name" />
          </div>
        </div>


        <!-- sex and Date of Birth -->
        <div class="horizontal-group">
          <div class="form-group left">
            <label class="label-title">Sex:</label>
            <div class="input-group">
              <label for="male"><input type="radio" name="sex" value="male" id="male">Male</label>
              <label for="female"><input type="radio" name="sex" value="female" id="female"> Female</label>
            </div>
          </div>
          <div class="form-group right">
            <label class="label-title"> Date of Birth </label>
            <div >
              <input type="date" name="date_of_birth" value="date_of_birth" id="date_of_birth">

            </div>
          </div>
        </div>
		<!-- Email -->
        <div class="form-group">
          <label for="email" class="label-title">Email *</label>
          <input type="email" name="email_id" id="email_id" class="form-input" placeholder="Enter your email address" required="required">
        </div>
		<div class="form-group">
          <label for="phone_number" class="label-title"> phone number *</label>
          <input type="text" name="phone_number" id="phone_number" class="form-input" placeholder="Enter your phone number" required="required">
        </div>
		<div class="form-group">
          <label for="user-id" class="label-title">User id *</label>
          <input type="text" name="user_id" id="user_id" class="form-input" placeholder="Enter your User Name" required="required">
        </div>

<!-- Password and confirm password -->
        <div class="horizontal-group">
          <div class="form-group left">
            <label for="password" class="label-title">Password *</label>
            <input type="password"  name="password" id="password" class="form-input" placeholder="Enter your password" required="required">
          </div>
          <div class="form-group right">
            <label for="confirm-password" class="label-title">Confirm Password *</label>
            <input type="password" class="form-input" name="confirm_password" id="confirm_password" placeholder="Enter your password again" required="required">
          </div>
        </div>


      <!-- form-footer -->
      <div class="form-footer">
        <span>* required</span>
        <button type="submit" class="btn">Sign Up</button>
      </div>

    </form>

      </body>
</html>