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index.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>Registration Form</title>
</head>
<body>
<h1>Benjamin & Kumba Academy</h1>
<h2>Center Street-Montserrado</h2>
<h3>Student Registration Form</h3>
<hr>
<hr>
<form method="POST">
<table>
<tbody>
<tr>
<td>
Name:
</td>
<td>
<input type="text" placeholder="Last Name">
<input type="text" placeholder="First Name">
<input type="text" placeholder="Middle Name">
</td>
</tr>
<tr>
<td>
Gender:
</td>
<td>
<select>
<option>Male</option>
<option>Female</option>
<option>Other</option>
</select>
</td>
</tr>
<tr>
<td>
Date of Birth:
</td>
<td>
<input type="date">
</td>
</tr>
<tr>
<td>
County of Origin:
</td>
<td>
<select>
<option> Lofa</option>
<option> Bomi</option>
<option> Bong</option>
<option> Sineo</option>
<option> Margibi</option>
<option> Montserrado</option>
<option> Grand Gedeh</option>
<option> Grand Kru</option>
<option> Grand Bassa</option>
<option> Grand Cape Mount</option>
<option> Gbapolu</option>
<option> River Cess</option>
<option> River Gee</option>
<option> Mary Land</option>
<option> Nimba</option>
</select>
</td>
</tr>
<tr>
<td>
Password:
</td>
<td>
<input type="password" placeholder="Password">
</td>
</tr>
<tr>
<td>
Email:
</td>
<td>
<input type="email" placeholder="@gmail.com">
</td>
</tr>
<tr>
<td>
Phnoe no:
</td>
<td>
<select placeholder="Country Code" name="code">
<option value="+234">+235</option>
<option value="+111">+111</option>
<option value="+231">+231</option>
<option value="+232">+232</option>
</select>
<input type="tel" placeholder="0880971128">
</td>
</tr>
<tr>
<td>
<br>
</td>
</tr>
<tr>
<td>
<b>Parents Information</b>
</td>
</tr>
<tr>
<td>
<b>Father Name:</b>
</td>
<td>
<input type="text" placeholder="Last Name">
<input type="text" placeholder="First Name">
<input type="text" placeholder="Middle Name">
</td>
</tr>
<tr>
<td>
Gender:
</td>
<td>
<select name="Gender" id="Gender">
<option>Male</option>
<option>Female</option>
<option>Other</option>
</select>
</td>
</tr>
<tr>
<td>
Father's Occupation:
</td>
<td>
<input type="radio" name="Occupation">Farmer
<input type="radio" name="Occupation">Programmer
<input type="radio" name="Occupation">Engineer
<input type="radio" name="Occupation">Carpentar
<input type="radio" name="Occupation">Masioner
<input type="radio" name="Occupation">Plumber
</td>
</tr>
<tr>
<td>
Phnoe no :
</td>
<td>
<select placeholder="Country Code" name="code">
<option value="+234">+235</option>
<option value="+111">+111</option>
<option value="+231">+231</option>
<option value="+232">+232</option>
</select>
<input type="tel" placeholder="0880971128">
</td>
</tr>
<tr>
<td>
<br>
</td>
</tr>
<tr>
<td>
<b>Mother Name:</b>
</td>
<td>
<input type="text" placeholder="Last Name">
<input type="text" placeholder="First Name">
<input type="text" placeholder="Middle Name">
</td>
</tr>
<tr>
<td>
Gender:
</td>
<td>
<select name="Gender" id="Gender">
<option>Male</option>
<option>Female</option>
<option>Other</option>
</select>
</td>
</tr>
<tr>
<td>
Mother's Occupation:
</td>
<td>
<input type="radio" name="Occupation">Farmer
<input type="radio" name="Occupation">Programmer
<input type="radio" name="Occupation">Engineer
<input type="radio" name="Occupation">Carpentar
<input type="radio" name="Occupation">Masioner
<input type="radio" name="Occupation">Plumber
</td>
</tr>
<tr>
<td>
Phnoe no :
</td>
<td>
<select placeholder="Country Code" name="code">
<option value="+234">+235</option>
<option value="+111">+111</option>
<option value="+231">+231</option>
<option value="+232">+232</option>
</select>
<input type="tel" placeholder="0880971128">
</td>
</tr>
<tr>
<td>
<input type="submit" value="submit">
</td>
</tr>
</tbody>
</table>
</form>
<footer>
<a href="./index2.html">Report Card</a>
</footer>
</body>
</html>