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form.php
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form.php
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<html>
<body>
<div class="page-wrapper bg-gra-02 p-t-130 p-b-100 font-poppins">
<div class="wrapper wrapper--w680">
<div class="card card-4">
<div class="card-body">
<h2 class="title">Registration Form</h2>
<form method="POST">
<div class="row row-space">
<div class="col-2">
<div class="input-group">
<label class="label">first name</label>
<input class="input--style-4" type="text" name="first_name">
</div>
</div>
<div class="col-2">
<div class="input-group">
<label class="label">last name</label>
<input class="input--style-4" type="text" name="last_name">
</div>
</div>
</div>
<div class="row row-space">
<div class="col-2">
<div class="input-group">
<label class="label">Birthday</label>
<div class="input-group-icon">
<input class="input--style-4 js-datepicker" type="text" name="birthday">
<i class="zmdi zmdi-calendar-note input-icon js-btn-calendar"></i>
</div>
</div>
</div>
<div class="col-2">
<div class="input-group">
<label class="label">Gender</label>
<div class="p-t-10">
<label class="radio-container m-r-45">Male
<input type="radio" checked="checked" name="gender">
<span class="checkmark"></span>
</label>
<label class="radio-container">Female
<input type="radio" name="gender">
<span class="checkmark"></span>
</label>
</div>
</div>
</div>
</div>
<div class="row row-space">
<div class="col-2">
<div class="input-group">
<label class="label">Email</label>
<input class="input--style-4" type="email" name="email">
</div>
</div>
<div class="col-2">
<div class="input-group">
<label class="label">Phone Number</label>
<input class="input--style-4" type="text" name="phone">
</div>
</div>
</div>
<div class="input-group">
<label class="label">Subject</label>
<div class="rs-select2 js-select-simple select--no-search">
<select name="subject" tabindex="-1" class="select2-hidden-accessible" aria-hidden="true">
<option disabled="disabled" selected="selected">Choose option</option>
<option>Subject 1</option>
<option>Subject 2</option>
<option>Subject 3</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 110px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="select2-subject-v2-container"><span class="select2-selection__rendered" id="select2-subject-v2-container" title="Choose option">Choose option</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
<div class="select-dropdown"></div>
</div>
</div>
<div class="p-t-15">
<button class="btn btn--radius-2 btn--blue" type="submit">Submit</button>
</div>
</form>
</div>
</div>
</div>
</div>
</body>
</html>