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index.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>Survey-Form</title>
<link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-QWTKZyjpPEjISv5WaRU9OFeRpok6YctnYmDr5pNlyT2bRjXh0JMhjY6hW+ALEwIH" crossorigin="anonymous">
<link rel="preconnect" href="https://fonts.googleapis.com">
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
<link href="https://fonts.googleapis.com/css2?family=Kanit:ital,wght@0,100;0,200;0,300;0,400;0,500;0,600;0,700;0,800;0,900;1,100;1,200;1,300;1,400;1,500;1,600;1,700;1,800;1,900&family=Rubik:ital,wght@0,300..900;1,300..900&display=swap" rel="stylesheet">
<link href="https://cdn.jsdelivr.net/npm/[email protected]/font/bootstrap-icons.css" rel="stylesheet">
</head>
<style>
.bgcolor{
color: orange;
font-size: 20px;
}
.form-label input{
background-color: #EEEEEE;
}
.table input[type="radio"] {
display: block;
margin: 0 auto;
}
.form-label{
font-family: "Kanit", sans-serif;
font-weight: 700;
font-style: normal;
}
</style>
</head>
<body>
<div class="container p-5 border">
<form class="row g-3">
<div class="row">
<div class="col-sm-12 col-md-6 col-lg-4">
<div class="form-group">
<label for="name" class="form-label">Name:</label>
<span class="text-danger">*</span>
<input type="text" class="form-control" id="first" required>
<small class="form-text text-muted">First</small>
</div>
</div>
<div class="col-sm-12 col-md-6 col-lg-4">
<div class="form-group p-2">
<label for="last" class="form-label">
<span class="text-danger"></span></label>
<input type="text" class="form-control" id="last" required>
<small class="form-text text-muted">Last</small>
</div>
</div>
</div>
<div class="mb-3 col-sm-12 col-md-6 col-lg-4">
<label for="emailInfo" class="form-label">Email address</label>
<span class="text-danger">*</span>
<input type="email" class="form-control" id="exampleFormControlInput1" required>
</div>
<div class="mb1 ">
<label for="Rating" class="form-label">Your Experience</label>
<span class="text-danger">*</span>
<div class="row">
<div class="col ">
<i class="bi bi-star-fill bgcolor"></i>
<i class="bi bi-star-fill bgcolor"></i>
<i class="bi bi-star-fill bgcolor"></i>
<i class="bi bi-star-fill bgcolor"></i>
<i class="bi bi-star-fill bgcolor"></i>
</div>
</div>
<p>Overall,How would you rate your experience with us?</p>
</div>
<div class="row g-1">
<div class="col">
<label class="form-label">How are you satisfied with us</label>
<span class="text-danger">*</span>
</div>
<table class="table table-striped">
<thead>
<tr class="text-center">
<th scope="col"></th>
<th scope="col">Very Unsatisfied</th>
<th scope="col">Unsatisfied</th>
<th scope="col">Neutral</th>
<th scope="col">Satisfied</th>
<th scope="col">Very Satisfied</th>
</tr>
</thead>
<tbody>
<tbody>
<tr>
<td scope="row">Purchase</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
</tr>
<tr>
<td scope="row">Service</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
</tr>
<tr>
<td scope="row">Company Overall</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
</tr>
</tbody>
</table>
</div>
<div class="row g-1">
<div class="col">
<label class="form-label">How likely are you to</label>
<span class="text-danger">*</span>
</div>
<table class="table table-striped">
<thead>
<tr class="text-center">
<th scope="col"></th>
<th scope="col">Very Unlikely</th>
<th scope="col">Unlikely</th>
<th scope="col">Neutral</th>
<th scope="col">likely</th>
<th scope="col">Very likely</th>
</tr>
</thead>
<tbody>
<tbody>
<tr>
<td scope="row" >Buy from us again</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
</tr>
<tr class="text-wrap">
<td scope="row">Recommend our product to others</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
</tr>
<tr class="text-wrap">
<td scope="row">Recommend our company to others</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
<td>
<input class="form-check-input" type="radio" name="purchaseSatisfaction" id="purchaseSatisfaction1">
</td>
</tr>
</tbody>
</table>
</div>
<div class="row g-1 form-label">
<div class="col-sm-12 col-md-12 col-lg-12">
<label for="">Additional comments or suggestions</label>
<textarea
class="form-control"
id="exampleFormControlTextarea1"
rows="5"
></textarea>
</div>
</div>
<div class="row g-1 form-label">
<div class="col-sm-1 col-md-1 col-lg-1">
<input
class="btn border"
type="submit"
value="Submit"
/>
</div>
</div>
<script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.bundle.min.js" integrity="sha384-YvpcrYf0tY3lHB60NNkmXc5s9fDVZLESaAA55NDzOxhy9GkcIdslK1eN7N6jIeHz" crossorigin="anonymous"></script>
</form>
</div>
</body