ProductionProblem3/FINAL_PP3 at master · ozahid/ProductionProblem3 · GitHub

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<!DOCTYPE html>
<html lang="en">

<head>
<meta charset="UTF-8">
<title>Production Problem</title>
</head>

<body>


<form action="http://bloomingdale.sat.iit.edu/kriedan/lab3formscript.php" method="POST">
  <fieldset id="myinfo">
    <legend>My Info</legend>

    <label>First Name:<input type="text" name="first_name_field"></label><br /><br />
    <label>Last Name:<input type="text" name="last_name_field"></label><br /><br />
	<label>Phone Number:<input type="tel" name="phone_field"></label><br /><br />
	<label>Email Address:<input type="tel" name="email_field"></label><br /><br />

	<p id= "gender">
	<label>Gender:</label>
	<label><input type="radio" name="gender_field" checked value="Male"> Male</label>
	<label><input type="radio" name="gender_field">Female</label>
	</p>


	<p id="age">
	<label>Age: </label>
	<select name="age_field">
	<option selected disabled>Select Age</option>
	<option value="Under 18">Under 18</option>
	<option value="18-24">18-24</option>
	<option value="25-34">25-34</option>
	<option value="35-44">35-44</option>
	<option value="45-54">45-54</option>
	<option value="55-64">55-64</option>
	<option value="65 and Over">65 and over</option>
	</select>
	</p>
	</fieldset>
<br />


<fieldset id="availability">
<legend>My Availability</legend>
<input type="checkbox" name="available_field[]" value="Monday"/>Monday<br />
<input type="checkbox" name="available_field[]" value="Tuesday"/>Tuesday<br />
<input type="checkbox" name="available_field[]" value="Wednesday"/>Wednesday<br />
<input type="checkbox" name="available_field[]" value="Thursday"/>Thursday<br />
<input type="checkbox" name="available_field[]" value="Friday"/>Friday<br />
<input type="checkbox" name="available_field[]" value="Saturday"/>Saturday<br />
<input type="checkbox" name="available_field[]" value="Sunday"/>Sunday<br />
</fieldset>
<br />


<label>Comments:</label><br />
<textarea cols="60" rows="20" name="comments_field"  id="commentarea"></textarea>

<br />
<p>
<input type="hidden" name="hidden_field" value="ozahid">
</p>
<input type="submit" value="Submit">
<br />

</form>
</body>
</html>