<!DOCTYPE HTML>
<html>
<head>
<meta http-equiv="content-type" content="text/html" />
<meta name="author" content="Evandry" />
<title>Selamat Datang di Facebook</title>
</head>
<body>
<h1 style="font-family: arial;">Mendaftar</h1>
<h4 style="font-family: arial;">Gratis, sampai kapan pun.</h4>
<form>
<a><b style="font-family: arial;">Nama Depan                         Nama Belakang</b></a><br />
<input type="text" name="namadepan" size="25"/>  
<input type="text" name="namabelakang" size="25"/><br />
<a><b style="font-family: arial;">Email Anda</b></a><br />
<input type="text" name="email" size="57"/><br />
<a><b style="font-family: arial;">Masukkan ulang Email</b></a><br />
<input type="text" name="email" size="57"/><br />
<a><b style="font-family: arial;">Kata Sandi Baru</b></a><br />
<input type="password" name="Password" size="57"/> <br />
<a><b style="font-family: arial;">Tanggal Lahir</b></a><br />
<select style="font-family: arial;" name="Tanggal">
<option value="" selected="selected">Tanggal</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>  
<select style="font-family: arial;" name="Bulan">
<option value="" selected="selected">Bulan</option>
<option value="Januari">Januari</option>
<option value="Februari">Februari</option>
<option value="Maret">Maret</option>
<option value="April">April</option>
<option value="Mei">Mei</option>
<option value="Juni">Juni</option>
<option value="Juli">Juli</option>
<option value="Agustus">Agustus</option>
<option value="September">September</option>
<option value="Oktober">Oktober</option>
<option value="November">November</option>
<option value="Desember">Desember</option>
</select>  
<select style="font-family: arial;" name="Tahun">
<option value="" selected="selected">Tahun</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
</select><br /><br />
<input style="font-family: arial;" type="radio" name="Perempuan" size="12"/>Perempuan   <input type="radio" name="Laki-Laki" size="12"/>Laki-Laki<br/><br />
<h4 style="font-family: arial; font-size: x-small;">Dengan mengeklik Mendaftar, Anda menyetujui Ketentuan kami<br />dan bahwa Anda telah membaca Kebijakan Penggunaan Data<br />kami, termasuk Penggunaan Cookie.</h4><br />
<td><input style="font-family: arial; font-size: large;" type="submit" name="register" value="Mendaftar" bgcolor="green"/></td>
</form>
</body>
</html>
Tidak ada komentar:
Posting Komentar