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79 lines (76 loc) · 1.7 KB
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<!DOCTYPE html>
<html>
<form style="background-color:lightblue">
<h1>Application Form</h1>
<p>
Required fields are followed by
<strong><span aria-label="required">*</span></strong>
</p>
<section>
<h2>Personal Information</h2>
<p>
<label for="name">
<span>Name: </span>
<strong><span aria-label="required">*</span></strong>
</label>
<input type="text" id="name" name="username" required />
</p>
<p>
<label for="age">
<span>Age: </span>
<strong><span aria-label="required">*</span></strong>
</label>
<input type="number" id="age" name="user-age" required />
</p>
<p>
<label for="mail">
<span>E-Mail: </span>
<strong><span aria-label="required">*</span></strong>
</label>
<input type="email" id="mail" name="user-mail" required />
</p>
<p>
<label for="phone-num">
<span>PhoneNumber: </span>
<strong><span aria-label="required">*</span></strong>
</label>
<input type="password" id="phone-num" name="number" required />
</p>
<fieldset>
<legend>EDUCTAION</legend>
<ul>
<li>
<label for="t_1">
<input type="radio" id="t_1" name="EDUCATION" value="A" />
1st YEAR
</label>
</li>
<li>
<label for="t_2">
<input type="radio" id="t_2" name="EDUCATION" value="B" />
2st YEAR
</label>
</li>
<li>
<label for="t_3">
<input type="radio" id="t_3" name="EDUCATION" value="C" />
3st YEAR
</label>
</li>
<li>
<label for="t_4">
<input type="radio" id="t_4" name="EDUCATION" value="D" />
4st YEAR
</label>
</li>
</ul>
</fieldset>
</section>
<section>
<p>
<button type="submit">Submit</button>
</p>
</section>
</form>
<div id="success-message">🎉 Form submitted successfully!</div>
</html>