vetform18a/form2.html at master · deborahweisman/vetform18a · GitHub

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<!DOCTYPE HTML>
<html lang="he-IL">
<head>
<meta charset="UTF-8">
	<title>טופס</title>
<style type="text/css">
body {margin: 2em 5em;}
div {display:block; margin:1em;padding:.3em;}
label {display:block;padding:0px;margin:1px;}
input {display:block;padding:10px;margin:1px;}
</style>

</head>
<body dir="rtl">
<form action="https://www.huji.ac.il/payment/index.php/starting" method="post">
<input type="hidden" id="token" name="token" value="cbc8fcc51933a997507b7db159e8ee3aa52bc7b27bffe3bd5c22da63356e8d21">

<input type="hidden" id="lang" name="lang" value="he" />
<input type="hidden" id="sid" name="sid" value="100" />

 <div>
    <label for="name">שם</label>
    <input type="text" id="name" name="name" required>
  </div>
    <div>
    <label for="zehut">תעודת זהות</label>
    <input type="number" id="zehut" name="zehut" required>
  </div>

  <div>
    <label for="email">דוא״ל</label>
    <input type="email" id="email" name="email" required>
  </div>


    <div>


  <div>

	    <button type="submit">בצע תשלום</button>

    </div>
</form>
</body>

</html>