73 lines
2.3 KiB
HTML
73 lines
2.3 KiB
HTML
<!doctype html>
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<html lang="en">
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<head>
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<meta charset="utf-8">
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<title>Formulaire</title>
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</head>
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<body>
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<form method="post" action="https://dwarves.iut-fbleau.fr/requete.php" enctype="encodage">
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<div class="nom">
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<label for="name">Nom :</label>
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<input type="text" id="name" name="name" required />
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</div>
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<div class="prenom">
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<label for="prenom">Prénom :</label>
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<input type="text" id="prenom" name="prenom" required />
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</div>
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<div class="email">
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<label for="email">Email :</label>
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<input type="email" id="email" name="email" required />
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</div>
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<div class="dateofbirth">
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<label for="dateofbirth">Date de naissance :</label>
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<input type="date" id="dateofbirth" name="dateofbirth" required />
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</div>
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<div class="postalcode">
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<label for="postalcode">Code postale :</label>
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<input type="number" id="postalcode" name="postalcode" maxlength="5" required />
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</div>
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<div class="tel">
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<label for="telephone">Téléphone portable :</label>
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<input type="tel" id="telephone" name="telephone" pattern="^0[67][0-9]{8}$" required />
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</div>
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<div class="sexe">
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<label>Sélectionnez votre sexe :</label><br>
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<input type="radio" id="male" name="sexe" value="Homme" />
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<label for="male">Homme</label><br>
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<input type="radio" id="female" name="sexe" value="Femme" />
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<label for="female">Femme</label><br>
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</div>
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<div class="semestre">
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<label for="semestre">semestre :</label>
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<select id="semester" name="semestre" required>
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<option value="S1">S1</option>
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<option value="S2" selected >S2</option>
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<option value="S3">S3</option>
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<option value="S4">S4</option>
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</select>
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</div>
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<div class="niveauHTML">
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<label for="niveauHTML">Niveau HTML :</label>
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<input type="range" id="niveauHTML" name="niveauHTML" min="0" max="10" step="1" value="5" required />
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</div>
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<div class="zonetexte">
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<label for="zonetexte">Message :</label>
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<input type="textarea" id="zonetexte" name="zonetexte" />
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</div>
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<button type="submit">submit</button>
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<button type="reset">reset</button>
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</form>
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</body>
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</html> |