You are on page 1of 5

<html>

<head>
<title> ASDFGHJKL </title>
</head>
<body>
<fieldset>
<legend align="center"> IDENTITAS DIRI </legend>
<form>
<center>
<table border="40" width="50%" height="50%"
bgcolor="red">
<tr>
<td>No.Anggota</td>
<td><input type="text"
name="no.anggota"></td>
</tr>
<tr>
<td>No.Identitas</td>
<td><input type="text"
name="no.identitas"></td>
</tr>
<tr>
<td>Fakultas</td>
<td><select name="pekerjaan">
<option
value="teknikinformatika">Teknik Informatika
<option
value="kedokteran">Kedokteran

<option
value="ekonomi">Ekonomi
<option
value="pertanian">Pertanian
</select></td>
</tr>
<tr>
<td>Nama Anggota</td>
<td><input type="text"
name="namaanggota"></td>
</tr>
<tr>
<td>Tanggal Lahir</td>
<td>Tanggal
<select name="1">
<option value="1">1
<option value="2">2
<option value="3">3
<option value="4">4
<option value="5">5
<option value="6">6
<option value="7">7
<option value="8">8
<option value="9">9
<option value="10">10
</select>
Bulan
<select name="januari">

<option
value="januari">Januari
<option
value="februari">Februari
<option
value="maret">Maret
<option value="april">April
<option value="mei">Mei
</select>
Tahun
<select name="1998">
<option value="1998">1998
<option value="1999">1999
<option value="2000">2000
<option value="2001">2001
</select></td>
</tr>
<tr>
<td>Tipe Anggota</td>
<td><select name="member">
<option
value="leader">Leader
<option
value="coleader">Co-Leader
<option value="elder">Elder
</select></td>
</tr>
<tr>
<td>Jenis Kelamin</td>

<td><input type="radio"
name="jkl value="p">Pria<input type="radio" name="jkl"
value="w">Wanita</td>
</tr>
<tr>
<td>Alamat Lengkap</td>
<td><textarea name="alamat"
rows="7" cols="40"></textarea></td>
</tr>
<tr>
<td>Kode Pos</td>
<td><input type="text"
name="kodepos"></td>
</tr>
<tr>
<td>No.HP</td>
<td><input type="text"
name="nohp"></td>
</tr>
<tr>
<td>Alamat Email</td>
<td><input type="text"
name="alamatemail"></td>
</tr>
<tr>
<td>Password</td>
<td><input type="text"
name="password"></td>
</tr>

<tr>
<td>Ulangi Password</td>
<td><input type="text"
name="ulangipassword"></td>
</tr>
</table>
</center>
</form>
</fieldset>
</body>
</html>

You might also like