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basic.html
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basic.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>basic info</title>
<link href="https://fonts.googleapis.com/css2?family=Raleway:wght@400;500;600;700;800&display=swap" rel="stylesheet">
<link rel="stylesheet" href="css/basic.css">
</head>
<body>
<div id="container">
<div id="box-1">
<img src="images/sustain 4.jpg" alt="sustain-logo">
<hr>
</div>
<div id="box-2">
<h1>Basic Information</h1>
<hr>
<form action="" method="POST">
<div class="flex">
<div class="div-1">
<label for="fname">First Name</label>
<input type="text" name="fname">
</div>
<div class="div-2">
<label for="lname">Last Name</label>
<input type="text" name="lname">
</div>
</div>
<div class="flex">
<div class="div-1">
<label for="email">Email</label>
<input type="email" name="email" >
</div>
<div class="div-2">
<label for="password">Password</label>
<input type="password" name="password">
</div>
</div>
<div class="flex">
<div class="div-1">
<label for="phoneNo">Phone Number</label>
<input type="number" name="phoneNo" pattern="[0-9]*" inputmode="numeric">
</div>
<div id="date-box" class="div-2">
<label>Birthdate</label>
<select name="DOBDay" id="day">
<option> Day </option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select name="DOBMonth" id="month">
<option> Month </option>
<option value="January">January</option>
<option value="Febuary">Febuary</option>
<option value="March">March</option>
<option value="April">April</option>
<option value="May">May</option>
<option value="June">June</option>
<option value="July">July</option>
<option value="August">August</option>
<option value="September">September</option>
<option value="October">October</option>
<option value="November">November</option>
<option value="December">December</option>
</select>
<select name="DOBYear" id="year">
<option> Year </option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
</select>
</div>
</div>
<div>
<label for="address">Address</label>
<input type="text" name="address">
</div>
<div class="flex">
<div class="div-1">
<label for="city">City</label>
<input type="text" name="city">
</div>
<div class="div-2">
<label for="state">State</label>
<select name="State" id="state">
<option> State </option>
<option value="Abia">Abia</option>
<option value="Adamawa">Adamawa</option>
<option value="Akwa Ibom">Akwa Ibom</option>
<option value="Anambra">Anambra</option>
<option value="Bauchi">Bauchi</option>
<option value="Bayelsa">Bayelsa</option>
<option value="Benue">Benue</option>
<option value="Borno">Borno</option>
<option value="Cross River">Cross River</option>
<option value="Delta">Delta</option>
<option value="Ebonyi">Ebonyi</option>
<option value="Edo">Edo</option>
<option value="Ekiti">Ekiti</option>
<option value="Enugu">Enugu</option>
<option value="FCT - Abuja">FCT - Abuja</option>
<option value="Gombe">Gombe</option>
<option value="Imo">Imo</option>
<option value="Jigawa">Jigawa</option>
<option value="Kaduna">Kaduna</option>
<option value="Kano">Kano</option>
<option value="Katsina">Katsina</option>
<option value="Kebbi">Kebbi</option>
<option value="Kogi">Kogi</option>
<option value="Kwara">Kwara</option>
<option value="Lagos">Lagos</option>
<option value="Nasarawa">Nasarawa</option>
<option value="Niger">Niger</option>
<option value="Ogun">Ogun</option>
<option value="Ondo">Ondo</option>
<option value="Osun">Osun</option>
<option value="Oyo">Oyo</option>
<option value="Plateau">Plateau</option>
<option value="Rivers">Rivers</option>
<option value="Sokoto">Sokoto</option>
<option value="Taraba">Taraba</option>
<option value="Yobe">Yobe</option>
<option value="Zamfara">Zamfara</option>
</select>
</div>
</div>
<div id="btn">
<button id="next-btn">Next</button>
</div>
</form>
</div>
<div id="box-3">
<hr>
<p id="support">Questions? Email: [email protected]</p>
<div>
<p><a href="#">Privacy Policy</a></p>
<p><a href="#">Terms of service</a></p>
</div>
<p id="copyright">© 2019 LifeBox Labs</p>
</div>
</div>
</body>
</html>