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  • Datos Personales

    Uploaded by

    Andrea_RS
    80 views4 pages

    Original Title

    <HTML> <HEAD> <TITLE>Datos Personales</Title> </Head> <Body Bgcolor="#FFFFCC">

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    © Attribution Non-Commercial (BY-NC)

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    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    80 views4 pages

    Datos Personales

    Uploaded by

    Andrea_RS

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 4

    <HTML>

    <HEAD>

    <TITLE>Datos personales</title>

    </head>

    <body bgcolor="#FFFFCC">

    <center>

    <font size="5">Introduce tus datos personales para darte de alta</font>

    </center>

    <br>

    <br>

    <form action="mailto:micuenta@servidor.es"METHOD="POST"

    ENCTYPE="text/plain">

    <TABLE BORDER="0" CELLSPACING="1" CELLPADDING="4">

    <TR>

    <TD>Nombre: </TD>

    <TD><INPUT TYPE="text" NAME="Nombre" SIZE="15"></TD>

    </TR>

    <TR>

    <TD>Apellidos:</TD>

    <TD><INPUT TYPE="text" NAME="Apellidos SIZE"30"></TD>

    </TR>

    <TR>

    <TD>Login:</TD>

    <TD><INPUT TYPE="TEXT" NAME="Login!></TD>

    </TR>
    <TR>

    <TD>password:</TD>

    <TD><INPUT TYPE="password" NAME="password</TD>

    </TR>

    <TR>

    <TD>Repite tu password:</TD>

    <TD><INPUT TYPE="password" NAME="confirmpassword"></TD>

    </TR>

    <TR>

    <TD>sexo:</TD>

    <TD><INPUT TYPE="radio" NAME="sexo" VALUE="hombre">hombre

    <INPUT TYPE="radio" NAME="sexo" VALUE="mujer">Mujer</TD>

    </TR>

    <TR>

    <TD> Edad:</TD>

    <TD>

    <INPUT TYPE="radio" NAME="edad" VALUE="10">0-15

    <INPUT TYPE="radio" NAME="edad" VALUE="25">16-30

    <INPUT TYPE="radio" NAME="edad" VALUE="40">31-50

    <INPUT TYPE="radio" NAME="edad" VALUE="60">50-Más</TD>

    </TR>

    <TR>
    <TD>Provincia:</TD>

    <TD><SELECT NAME="Provincia">

    <OPTION VALUE="Tamaulipas">tamaulipas

    <OPTION VALUE="Nuevo leon"> nuevo leon

    <OPTION VALUE="San luis potosi"> san luis potosi

    <OPTION VALUE="Veracruz"> veracruz

    <OPTION VALUE="df"> DF

    <OPTION VALUE="Puebla">puebla

    </select> </td>

    </TR>

    <TR>

    <TD>Navegadores que utilizas:</TD>

    <TD>Netscape communicator<INPUT TYPE="checkbox" NAME="Netscape" VALUE="si">

    Internet explorer<INPUT TYPE="checkbox" NAME="Explorer" VALUE="si">

    mosaic <INPUT TYPE="checkbox" NAME="mosaic" VALUE="si">

    otros <INPUT TYPE="checkbox" NAME="otros" VALUE="si"></TD>

    </TR>

    <TR>

    <TD VALIGN="top">Cometarios y sugerencias:</TD>

    <TD><TEXTAREA NAME="Cometarios" ROWS="8" COLS="50"></TEXTAREA></TD>

    </TR>

    <TR>

    <TD COLSPAN="2" ALIGN="CENTER><INPUT TYPE="Submit" VALUE"Enviar">

    <INPUT TYPE="Reset" VALUE="Borrar"></TD>


    </TR>

    </TABLE>

    </FORM>

    </BODY>

    </HTML>

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