<!
DOCTYPE html>
<HTML>
<HEAD>
<TITLE> Form </TITLE>
</HEAD>
<BODY>
<H2> Please provide the following information </H2>
<FORM METHOD="POST" ACTION="mailto:[email protected]">
<P>Emial address: <INPUT TYPE="text" NAME="uremail"
SIZE="60" MAXLENGTH="50"
<BR><BR>
Password:<INPUT TYPE="password" NAME="password"
SIZE="60" MAXLENGTH="50"
<BR><BR>
Comment:
<BR>
<TEXT AREA NAME="comments" ROWS="4" COLS="50" WRAP>
</TEXT AREA>
<BR>
Which food do you like the most?
<BR>
<INPUT TYPE="checkbox" NAME="food" VALUE="Idli Sambhar"
Checked>Idli Sambhar
<INPUT TYPE="checkbox" NAME="food"
VALUE="Noodles">Noodles
<INPUT TYPE="checkbox" NAME="food"
VALUE="Samosa">Samosa
<BR>
Do you like pasta?
<BR>
<INPUT TYPE="radio" NAME="rate" VALUE="Yes">Yes
<BR>
<INPUT TYPE="radio" NAME="rate" VALUE="No">No
<BR>
<INPUT TYPE="radio" NAME="rate" VALUE="So So">So So
<BR>
CITY/STATE:
<BR>
<SELECT NAME="city" SIZE="3">
<OPTION VALUE="Amritsar">Amritsar
<OPTION VALUE="Ludhiana">Ludhiana
<OPTION VALUE="Chandigarh" SELECTED>Chandigarh</Select>
<P>
<INPUT TYPE="Submit" VALUE="SUBMIT">
<INPUT TYPE="Reset" VALUE="RESET">
</FORM>
</BODY>
</HTML>