registration/reg_form.html at master · trilug/registration · GitHub

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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
    "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
  <meta name="generator" content=
  "HTML Tidy for HTML5 for Linux version 5.2.0" />
  <title>Join TriLUG!</title>
  <style>
    .error {
      color: red;
    }

    form,p {
      max-width: 40em;
    }

    form {
      margin-left: auto;
      margin-right: auto;
    }

    label {
      margin-bottom: 2ex;
      display: inline-block;
    }

    input {
      display: block;
    }

    input[name="zipcode"] {
      width: 5em;
    }

    input[type="submit"] {
      margin-left: auto;
      margin-right: auto;
    }

    .optional:before {
      content: "[*]";
      font-weight: bold;
    }
  </style>
</head>
<body>
  <div id="missing" style="display: none">
    <p><strong>Error:  Required field(s) not filled out.</strong></p>
  </div>
  <div class="error">
    <p id="exception"></p>
  </div>
  <form method="post" action="#">
      <p>
        Thank you for your interest in TriLUG! The process of
        becoming a member is very simple. Just fill out and submit
        the form below, and then talk to one of the members of the
        Steering Committee at the next meeting you attend (or the
        same one, if you're filling this out while you're there).
        They can quickly process your request and get you set up in
        no time.
      </p>
    <hr width="50%" />

    <label>
      First Name
      <input name="first" required />
    </label>

    <label>
      Last Name
      <input name="last" required />
    </label>

    <br/>

    <label>
      Street Address 1
      <input name="addr1" required />
    </label>

    <br/>

    <label class="optional">
      Street Address 2
      <input name="addr2" />
    </label>

    <br/>

    <label>
      City
      <input name="city" required />
    </label>

    <label>
      State
      <input name="state" size="2" required />
    </label>

    <label>Zip
      <input type="number" name="zipcode" required pattern="[0-9]{5}" />
    </label>

    <br/>

    <label>
      Email
      <input type="email" name="email" required />
    </label>

    <br/>

    <label class="optional">
      Preferred User ID
      <input name="username" />
    </label>

    <p class="optional">
      Optional fields. You can leave the User ID blank if you don't want shell or email.
    </p>

    <input type="submit" value="Submit" />
  </form>

  <div id="success" style="display: none">
    <p>
      Thank you for requesting membership in TriLUG!  Be sure to come to a
      meeting in person in order to complete the process.  See you there!
    </p>
  </div>

  <hr width="50%" />
  <div align="center">
    Reload the <a href="$script_name">form</a> <strong>|</strong>
    Back to <a href="/">TriLUG</a>
  </div>
</body>
</html>