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User talk:150.204.50.18

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This is an old revision of this page, as edited by 150.204.50.18 (talk) at 12:31, 30 March 2006. The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Revision as of 12:31, 30 March 2006 by 150.204.50.18 (talk)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)

<HTML> <HEAD> <TITLE>UK Lifestyle</TITLE> <SCRIPT TYPE="text/javascript" LANGUAGE="JavaScript"> </SCRIPT> </HEAD> <BODY> <FORM name="nameForm"> Please enter your name and surname

Name<input type="text" name="name" size=25 maxlength=25> Surname<input type="text" name="surname" size=25 maxlength=25>

Email Address<input type="text" name="email address" size=25 maxlength=25> Email Address for verification<input type="text" name="verification" size=25 maxlength=25>

Telephone Number<input type="text" name="email address" size=25 maxlength=25> Mobile Number<input type="text" name="verification" size=25 maxlength=25>



Sex: Male <input type="radio" name="sex" value="Male"> Female <input type="radio" name="sex" value="Female">

Media: CD <input type="checkbox" name="media" value="cd"> DVD <input type="checkbox" name="media" value="DVD"> Video <input type="checkbox" name="media" value="video">

<input type="button" onclick="form_validate()" value="Submit"> <input type="reset" value="Clear">

Section 2- Your Home



Flat <input type="radio" name="house" value="Flat"> Bungalow <input type="radio" name="sex" value="Bungalow"> Detached House <input type="radio" name="sex" value="Detached House"> Semi-Detached House <input type="radio" name="sex" value="Bungalow">

Media: CD <input type="checkbox" name="media" value="cd"> DVD <input type="checkbox" name="media" value="DVD"> Video <input type="checkbox" name="media" value="video">

<input type="button" onclick="form_validate()" value="Submit"> <input type="reset" value="Clear"> </FORM> </BODY> </HTML>

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