-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathindex.html
74 lines (69 loc) · 4.05 KB
/
index.html
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
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<title>Survey</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link href="https://fonts.googleapis.com/css?family=Roboto:400,500" rel="stylesheet">
<link rel="stylesheet" href="https://use.fontawesome.com/releases/v5.6.3/css/all.css" integrity="sha384-UHRtZLI+pbxtHCWp1t77Bi1L4ZtiqrqD80Kn4Z8NTSRyMA2Fd33n5dQ8lWUE00s/" crossorigin="anonymous">
<link rel="stylesheet" type="text/css" media="screen" href="assets/css/survey.css" />
</head>
<body>
<form id="survey-form">
<h1 id="title">Membership Signup</h1>
<p id="description">Join us! Simply complete the fields below to access member benefits.</p>
<div class="account">
<div class="survey-field">
<p class="section-name">Account</p>
<label for="name" id="name-label"><input type="text" placeholder="Full Name" id="name" required></label>
<label for="email" id="email-label"><input type="email" placeholder="Email" id="email" required></label>
<label for="password" id="password-label"><input type="password" placeholder="Password" id="password" required></label>
</div>
</div>
<div class="personal">
<div class="survey-field">
<div class="birth-day">
<p class="section-name">Date of Birth</p>
<label for="number" id="number-labe"><input type="number" placeholder="MM" id="number" min="01" max="12" required></label>
<label for="birth-day" id="birth-day-label"><input type="number" placeholder="DD" id="birth-day" min="01" max="31" required></label>
<label for="birth-year" id="birth-year-label"><input type="number" placeholder="YYYY" id="birth-year" min="1900" max="2019" required></label>
</div>
</div>
<div class="survey-field">
<div class="gender-field">
<p class="section-name">Gender</p>
<label for="female" class="radio-label"><input type="radio" value="female" id="female" name="gender">Female</label>
<label for="male" class="radio-label"><input type="radio" value="male" id="male" name="gender">Male</label>
<label for="male" class="radio-label"><input type="radio" value="gender" id="no-answer" name="gender">Prefer not to answer</label>
<label for="custom" class="radio-label" id="custom-gender"><input type="radio" value="custom" id="custom" name="gender"><input type="text" id="custom-gender" placeholder="Custom"></label>
</div>
</div>
</div>
<div class="survey-field">
<p class="section-name">How did you hear about us?</p>
<select id="dropdown" required>
<option data-icon="assets/images/caret-square-down-solid.svg" value="">Please choose an option</option>
<option value="ad">Ad</option>
<option value="search">Search Engine</option>
<option value="blog-article">Blog/Article</option>
<option value="social-media">Social Media</option>
<option value="friend">Friend</option>
</select>
</div>
<div class="survey-field">
<p class="section-name">Email Subscriptions</p>
<div class="email-sub">
<label for="sales"><input type="checkbox" value="sales" id="sales">Sales Promotions</label>
<label for="news"><input type="checkbox" id="news" value="news">News & Events</label>
<label for="member"><input type="checkbox" value="member" id="member">Membership Updates</label>
</div>
</div>
<div class="survey-field">
<p class="section-name">Additional Comments</p>
<textarea id="comments"></textarea>
</div>
<button type="submit" id="submit">Submit</button>
</form>
</body>
</html>