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Nama : Putri Sinta Wulandari

NIM : 1202202041
Mata Kuliah : Pemrograman Web 03-02

Formulir Registrasi

<!DOCTYPE html>
<html>
<head>
<title> Form Registrasi </title>
</head>
<body style="margin-top: 40px;">
<h1> Form Registrasi </h1>
<fieldset style="height: auto; width: 600px;">
<legend> Biodata </legend>
<table>
<tr>
<td> Nama Mahasiswa </td>
<td> : </td>
<td>
<input type="text" placeholder="Nama lengkap">
</td>
</tr>
<tr>
<td> Nomor Induk Mahasiswa (NIM) </td>
<td> : </td>
<td>
<input type="text" placeholder="120220xxxx" maxlength="8">
</td>
</tr>
<tr>
<td> Alamat Mahasiswa </td>
<td> : </td>
<td>
<textarea cols="22" rows="3" placeholder="Alamat Anda">
</textarea>
</td>
</tr>
<tr>
<td> Tanggal Lahir </td>
<td> : </td>
<td>
<input type="date">
</td>
</tr>
<tr>
<td> Jenis Kelamin </td>
<td> : </td>
<td>
<input type="radio" name='jenis_kelamin' value='pria'/>Pria
<input type="radio" name='jenis_kelamin' value='perempuan'
/>Perempuan
</td>
</tr>
<tr>
<td> Upload Foto </td>
<td> : </td>
<td>
<input id="file-upload" type="file">
</td>
</tr>
<tr>
<td> URL Website </td>
<td> : </td>
<td>
<input type="url" placeholder="urlwebsite.com">
</td>
</tr>
<tr>
<td> Perguruan Tinggi </td>
<td> : </td>
<td>
<input type="text" placeholder="IT Telkom Surabaya">
</td>
</tr>
</table>
</fieldset>

<fieldset style="height: auto; width: 600px;">


<table>
<legend> Info Akun </legend>
<tr>
<td> Email </td>
<td> : </td>
<td>
<input type="email" placeholder="Email Anda">
</td>
</tr>
<tr>
<td> Username </td>
<td> : </td>
<td>
<input type="text" placeholder="Username Anda">
</td>
</tr>
<tr>
<td> Password </td>
<td> : </td>
<td>
<input type="password" name="sandi1" placeholder="Password
Anda" required >
</td>
</tr>
<tr>
<td> Ulangi Password </td>
<td> : </td>
<td>
<input type="password" name="sandi2" placeholder="Password
Anda" required >
</td>
</tr>
</table>
</fieldset>

<fieldset style="height: auto; width: 600px;">


<table>
<legend> Kemampuan Dasar </legend>
<tr>
<td> HTML </td>
<td>
<input type="checkbox">
</td>
<td> CSS </td>
<td>
<input type="checkbox">
</td>
<td> JavaScript </td>
<td>
<input type="checkbox">
</td>
<td> PHP </td>
<td>
<input type="checkbox">
</td>
<td> MySQL </td>
<td>
<input type="checkbox">
</td>
<td> Laravel </td>
<td>
<input type="checkbox">
</td>
<td> React Native </td>
<td>
<input type="checkbox">
</td>
</tr>
</table>
</fieldset>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>
<input type="reset" name="reset" value="reset" />
<input type="submit" name="submit" value="submit"/>
<input type="button" name="button" value="button" />
</td>
</tr>
</body>
</html>

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