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forms.html
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52 lines (45 loc) · 2.08 KB
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>Veridian Dynamics Register With Us</title>
</head>
<body>
<h1>Register With Us</h1>
<form method="POST" action="https://docs.google.com/forms/d/e/1FAIpQLSfclhlUy_SyZYUAqtuvdSPfDvG2z8ko7euHQw3JNk59PDsyjA/formResponse">
<!-- Email -->
<label for="email">Email:</label>
<input type="email" id="email" name="email" placeholder="Enter your email" required><br><br>
<!-- Password -->
<label for="password">Password:</label>
<input type="password" id="password" name="password" placeholder="Enter your password" required><br><br>
<!-- Bio -->
<label for="bio">Short Bio:</label>
<textarea id="bio" name="bio" rows="4" cols="50" placeholder="Tell us about yourself"></textarea><br><br>
<!-- How did you hear about us -->
<label>How did you hear about us:</label><br>
<input type="radio" id="billboard" name="howHeard" value="billboard">
<label for="billboard">Billboard</label><br>
<input type="radio" id="radioAd" name="howHeard" value="radio advertisement">
<label for="radioAd">Radio Advertisement</label><br>
<input type="radio" id="internetAd" name="howHeard" value="internet advertisement">
<label for="internetAd">Internet Advertisement</label><br>
<input type="radio" id="other" name="howHeard" value="other">
<label for="other">Other</label><br><br>
<!-- Web Browser -->
<label for="browser">Web Browser:</label>
<select id="browser" name="browser">
<option value="chrome">Chrome</option>
<option value="firefox">Firefox</option>
<option value="edge">Edge</option>
<option value="safari">Safari</option>
<option value="other">Other</option>
</select><br><br>
<!-- Submit Button -->
<input type="submit" value="Submit">
</form>
<!-- Google Form Embed -->
<iframe src="https://docs.google.com/forms/d/e/1FAIpQLSfclhlUy_SyZYUAqtuvdSPfDvG2z8ko7euHQw3JNk59PDsyjA/viewform?embedded=true"
width="640" height="586" frameborder="0" marginheight="0" marginwidth="0">Loading…</iframe>
</body>
</html>