User-Credential-Form-PHP/user.php at main · jmathtech/User-Credential-Form-PHP · GitHub

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58

<!DOCTYPE HTML>

<html>

	<head>

		<title>User Credentials</title>
		<link rel="stylesheet" href="css/formstyle.css" />

	</head>

		<body>


				 <form action="connect.php" method="Post">


						<h2>User Credentials </h2>

				  <label> First name:<br/></label>
				  <input type="text" id="Cus_FirstName" name="Cus_FirstName" value="" required><br><br>

				  <label> Last name:<br/></label>
				  <input type="text" id="Cus_LastName" name="Cus_LastName" value="" required><br><br>

				  <label> Email:<br/></label>
				  <input type="text" id="Cus_Email" name="Cus_Email" value=""><br><br>

				  <label> Phone:<br/></label>
				  <input type="text" id="Cus_Phone" name="Cus_Phone" value="" required><br><br>

				  <label> Address:<br/></label>
				  <input type="text" id="Cus_Address" name="Cus_Address" value=""><br><br>

				  <label> Business Name:<br/></label>
				  <input type="text" id="Cus_BusinessName" name="Cus_BusinessName" value=""><br><br>

				  <label> Business Phone:<br/></label>
				  <input type="text" id="Cus_BusinessPhone" name="Cus_BusinessPhone" value=""><br><br>

				  <label> Business Email:<br/></label>
				  <input type="text" id="Cus_BusinessEmail" name="Cus_BusinessEmail" value=""><br><br>

				  <label> Business Tax ID:<br/></label>
				  <input type="text" id="Cus_BusinessTaxID" name="Cus_BusinessTaxID" value=""><br><br>

				  <label> No.# of Staff:<br/></label>
				  <input type="text" id="Cus_NumOfStaff" name="Cus_NumOfStaff" value=""><br><br>

				  <input type="submit" value="Submit" />


				</form>

		</body>

 </html>