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refugee_signup.html
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refugee_signup.html
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<!DOCTYPE html>
<html lang="en" >
<head>
<meta charset="UTF-8">
<title>Refugee Details</title>
<link href='https://fonts.googleapis.com/css?family=Titillium+Web:500,300,1000' rel='stylesheet' type='text/css'>
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/normalize/5.0.0/normalize.min.css">
<link rel="stylesheet" href="css/style.css">
<style type="text/css">
select{
background-color:#D3D3D3;
margin-left: 300px;
}
#fileToUpload{
padding-top:15px;
height: 120px;
width: 150px;
float:right;
}
#left{
float: left;
width: 50%;
}
#right{
float: right;
width: 50%;
}
#r{
float: right;
}
.header1
{
background-color:#1ab188;
padding:10px;
}
</style>
</head>
<body>
<div class="form">
<ul class="tab-group">
<div class="tab-content">
<h1 class="header1">Register Refugee</h1>
<form action="php/refugee.php" method="POST" enctype="multipart/form-data" >
<div class="field-wrap">
<input id="fileToUpload" type="file" name="fileToUpload" >
<br/>
</div>
<div class="top-row">
<div class="field-wrap">
<label>
Organization Name<span class="req">*</span>
</label>
<input type="text" required autocomplete="off" name="org_name" />
</div>
<div class="field-wrap">
<label>
First Name<span class="req">*</span>
</label>
<input type="text"required autocomplete="off" name="fname"/>
</div>
<div class="field-wrap">
<label>
Last Name<span class="req">*</span>
</label>
<input type="text"required autocomplete="off" name="lname"/>
</div>
</div>
<div class="field-wrap">
<label>
Email Address
</label>
<input type="email"required autocomplete="off" name="email"/>
</div>
<div class="field-wrap">
<label>
Age<span class="req">*</span>
</label>
<input type="age"required autocomplete="off" name="age"/>
</div>
<div class="field-wrap">
<label>
Gender<span class="req">*</span>
</label>
<select name="gender">
<optgroup >
<option>
MALE
</option>
<option>
FEMALE
</option>
<option>
NOT TO SAY
</option>
</optgroup>
</select>
<br/>
</div>
<div class="field-wrap">
<label>
PLACE<span class="req">*</span>
</label>
<input type="text-area"required autocomplete="off" name="location"/>
</div>
<button type="submit" name="submit" class="button button-block"/>Register Refugee</button>
</form>
</div>
</div><!-- tab-content -->
</div> <!-- /form -->
</ul>
<script src='http://cdnjs.cloudflare.com/ajax/libs/jquery/2.1.3/jquery.min.js'></script>
<script src="javascript/java.js"></script>
</body>
</html>