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  • Formulario

    Uploaded by

    Antonio Garcia
    6 views8 pages
    Formulario http

    Copyright

    © © All Rights Reserved

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    Formulario http

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views8 pages

    Formulario

    Uploaded by

    Antonio Garcia
    Formulario http

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 8

    <html>

    <head>

    <title></title>

    <link rel="stylesheet" type="text/css" href="formuproyecto.css" />

    <script language="javascript" src="formuproyecto.js">

    </script>

    </head>

    <body>

    <fieldset id="registrousuario">

    <form method = "POST" name ="formulario">

    <br>

    <br>

    <table id="tabla" border="0" height=110%


    width=50% align="center" background="master.jpg">

    <tr>

    <td
    colspan="2"><center><h1>Registrate</center></td>

    </tr>

    <tr height="50">

    <td>Nombre:</td>

    <td>

    <input name="nombre"
    type="Text" size="35" maxlength="35"/>
    </td>

    </tr>

    <tr height="50">

    <td>Apellidos:</td>

    <td>

    <input name="apellidos"
    type="Text" size="35" maxlength="35"/>

    </td>

    </tr>

    <tr height="50">

    <td>Fecha de nacimiento: </td>

    <td>

    <input
    name="nacimiento" type="text" size="28" maxlength="25"/>

    </td>

    </tr>

    <tr height="50">

    <td>Domicilio:</td>

    <td>

    <input type="text"
    name="direccion" size="58" maxlength="58"/>

    </td>

    </tr>
    <tr height="50">

    <td>Cdigo Postal: </td>

    <td>

    <input type="text"
    name="postal" size="5" maxlength="5"/>

    </td>

    </tr>

    <tr height="50">

    <td>Ciudad:</td>

    <td>

    <select
    id="opciones" name="opciones">

    <option
    value="">- Selecciona un estado-</option>

    <option value="1">Aguascalientes</option>

    <option value="1">Baja California</option>

    <option value="1">Baja California Sur</option>

    <option value="1">Campeche</option>

    <option value="1">Chiapas</option>

    <option value="1">Chihuahua</option>
    <option value="1">Coahuila</option>

    <option value="1">Colima</option>

    <option value="1">Distrito Federal</option>

    <option value="1">Durango</option>

    <option value="1">Estado de Mxico</option>

    <option value="1">Guanajuato</option>

    <option value="1">Guerrero</option>

    <option value="1">Hidalgo</option>

    <option value="1">Jalisco</option>

    <option value="1">Michoacn</option>

    <option value="1">Morelos</option>

    <option value="1">Nayarit</option>

    <option value="1">Nuevo Len</option>

    <option value="1">Oaxaca</option>

    <option value="1">Puebla</option>

    <option value="1">Quertaro</option>
    <option value="1">Quintana Roo</option>

    <option value="1">San Luis Potos</option>

    <option value="1">Sinaloa</option>

    <option value="1">Sonora</option>

    <option value="1">Tabasco</option>

    <option value="1">Tamaulipas</option>

    <option value="1">Tlaxcala</option>

    <option value="1">Veracruz</option>

    <option value="1">Yucatn</option>

    <option value="1">Zacatecas</option>

    </select>

    </td>

    </tr>

    <tr height="50">

    <td>Sexo:</td>
    <td>Hombre <input
    type="radio" name="sexo[]" id="radio1" value=/>

    &nbsp; &nbsp; &nbsp;

    Mujer <input
    type="radio" name="sexo[]" id="radio2" value=/>

    </td>

    </tr>

    <tr>

    <td>Correo:</td>

    <td>

    <input type="text"
    name="correo" size="22" maxlength="30"/>

    @ <select name=correo>

    <option value="ejemplo.com" id="emas">ejemplo.com

    <option value="hotmail.com"id="emas">hotmail.com

    <option value="gmail.com" id="emas">gmail.com

    <option value="yahoo.com.mx" id="emas">yahoo.com.mx

    <option value="live.com.mx" id="emas"> live.com.mx

    </select>

    </td>

    <tr height="50">
    <td>

    Contrasea:

    </td>

    <td>

    <input
    type="password" id="pass" name="password" size="20" maxlength="20"/>

    </td>

    </tr>

    <tr height="50">

    <td>

    Confirmar contrasea:

    </td>

    <td>

    <input
    type="password" id="pass2" size="20" maxlength="20"/>

    </td>

    </tr>

    <tr height="50">

    <td>Comentarios</td>

    <td>

    <textarea
    class="areadetexto" name="coment"> </textarea>

    </td>

    </tr>
    <tr>

    <td colspan="2">Acepta
    trminos y condiciones?

    &nbsp;&nbsp;&nbsp;

    <input type="checkbox"
    name="gusto[]" id="check1" value="1"/>si

    <input type="checkbox"
    name="gusto[]" id="check2" value="2"/>no

    </td>

    </tr>

    <tr height="50">

    <td
    colspan="2"><center><input class="botonenviar" type="button"
    onclick="valida_envia();"/></center></td>

    </tr>

    </table>

    </form>

    </fieldset>

    </body>

    </html>

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