Üye Olma Formu Html Kodu

<form action=verial.asp method=post name=form1>

Adınızı Giriniz:   <input type=text name=ad> <br>

Şifrenizi Giriniz:<input type=password name=sifre><br>

Cinsiyetiniz<br>       <input type=radio name=cinsiyet value=bay> Bay <br>
                        <input type=radio name=cinsiyet value=bayan> Bayan <br>
<input type=radio name=cinsiyet value=belirtilmemiş> Belirtilmemiş <br>
Takımınız :     
<input type=checkbox name=Takım1> Galatasaray
<input type=checkbox name=Takım2> Fenerbahçe
<input type=checkbox name=Takım3> Beşiktaş
<input type=checkbox name=Takım4> Trabzonspor <br>

Mesajınız <br>
<textarea cols=30 rows=5></textarea><br>

Doğum Tarihiniz:
<select name=gun>
<option> 01 </option>
<option> 02 </option>
<option> 03 </option>
<option> 04 </option>
<option> 05 </option>
<option> 06 </option>               
<option> 07 </option>
<option> 08 </option>
<option> 09 </option>
<option> 10 </option>
<option> 11 </option>
<option> 12 </option>
<option> 13 </option>
<option> 14 </option>
<option> 15 </option>
<option> 16 </option>
<option> 17 </option>
<option> 18 </option>
<option> 19 </option>
<option> 20 </option>
<option> 21 </option>
<option> 22 </option>
<option> 23 </option>
<option> 24 </option>
<option> 25 </option>
<option> 26 </option>
<option> 27 </option>
<option> 28 </option>
<option> 29 </option>
<option> 30 </option>
<option> 31 </option>
                       
<select name=ay>
<option> OCAK </option>
<option> ŞUBAT</option>
<option> ARALIK </option>
</select>

<select name=ay>
<option> OCAK </option>
<option> ŞUBAT</option>                                  <option> MART </option>
<option> NİSAN </option>
<option> MAYIS </option>
<option> HAZİRAN </option>
<option> TEMMUZ</option>
<option> AĞUSTOS </option>
<option> EYLÜL </option>
<option> EKİM </option>
<option> KASIM </option>
<option> ARALIK </option>
</select>  

<select name=yil>
<option> 1970 </option>
<option> 1971 </option>
<option> 1972 </option>
<option> 1973 </option>
<option> 1974 </option>
<option> 1975 </option>
<option> 1976 </option>
<option> 1977 </option>
<option> 1978 </option>
<option> 1979 </option>
<option> 1980 </option>
<option> 1981 </option>
<option> 1982 </option>
<option> 1983 </option>
<option> 1984 </option>
<option> 1985 </option>
<option> 1986 </option>
<option> 1987 </option>
<option> 1988 </option>
<option> 1989 </option>
<option> 1990 </option>
<option> 1991 </option>
<option> 1992 </option>
<option> 1993 </option>
<option> 1994 </option>
<option> 1995 </option>
<option> 1996 </option>
<option> 1997 </option>
<option> 1998 </option>
<option> 1999 </option>
<option> 2000 </option>
<option> 2001 </option>
<option> 2002 </option>
<option> 2003 </option>
<option> 2004 </option>
<option> 2005 </option>
<option> 2006 </option>
<option> 2007 </option>
<option> 2008 </option>
<option> 2009 </option>
<option> 2010 </option>
<option> 2011 </option>
<option> 2012 </option>
</select>
<br>
Eğitim Durumunuz <select name=egitim>
<option> Üniversite </option>
<option> Lise </option>
<option> İlk okul</option>
<option> Okul Terk </option>
<option> Okula Gitmedim </option>
                        </select>
<br>
<input type=submit value=Gönder>
                        <input type=reset value=Sil>
</form>