Email Distributed Form Example

   

     

                    

                  

             

 This is an example of a Checkbox

 This is an example of a Radio Button

Email Distributed Form Code


HTML Code For Your Webpage

<h1>Email Distributed Form Example</h1>
<form action="https://formmail.webapps.csus.edu/confirm.aspx" class="uniForm" method="post"><input name="Title" type="hidden" value="Test" /> <input name="email" type="hidden" value="irt-webservices-test@csus.edu" /><fieldset>
<p><label>Name:</label><input class="textInput" name="Full_Name" size="35" type="text" /></p>
<p><label>Phone Number:</label><input class="textInput" name="Class_Year" size="35" type="text" /></p>
<p><label>E-mail Address:</label><input class="textInput" name="E-Mail_Address" size="35" type="text" /></p>
<p><label>Department: </label><input class="textInput" name="Degrees" size="35" type="text" /></p>
<p><label>Street:</label><input class="textInput" name="Street" size="35" type="text" /></p>
<p><label>City:</label><input class="textInput" name="City" size="35" type="text" /></p>
<p><label>State:</label><input class="textInput" name="State" size="35" type="text" /></p>
<p><label>Zipcode:</label><input class="textInput" name="Zip" size="35" type="text" /><br /> <br /> <input checked="checked" name="maillist" type="checkbox" value="on" /> This is an example of a Checkbox</p>
<p><input checked="checked" name="gender" type="radio" value="male" /> This is an example of a Radio Button</p>
<p><label>Additional comments</label></p>
<textarea cols="25" id="Comments" name="Comments" aria-label="Insert Comments" rows="14"></textarea>
<p><input type="submit" value="Submit Form" /></p>
<h1>Email Distributed Form Code</h1>
<hr width="100%" />