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50 lines (24 loc) · 1.49 KB
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<!doctype html>
<html>
<head>
<title>Facetook</title>
</head>
<body>
<img src="facetook.png" width = "300">
<form action="output.php" method = "post">
<input type = "text" name="first_name" value = "First name"><br>
<input type = "text" name="last_name" value = "Last name"><br>
<input type = "radio" name="gender" value = "M">Male<br>
<input type = "radio" name="gender" value = "F">Female<br>
<input type = "radio" name="gender" value = "O">Other<br>
To have the best experience on our site we recommend users upload additonal information. Please select what info you will be providing.<br>
<input type = "checkbox" name="id" value = "id">Current photo ID<br>
<input type = "checkbox" name="birth_certificate" value = "birth certificate">Birth Certificate<br>
<input type = "checkbox" name="selfie" value = "selfie">Automatic selfie every 2 minutes while using the site<br>
<input type = "checkbox" name="phone_audio" value = "phone audio">Access to phone audio at all times<br>
<input type = "submit" name = "submit" value = "submit">
</form>
<?php
?>
</body>
</html>