<html>
<head>
<title>FORM PENDAFTARAN</title>
<form action="" method="post">
<fieldset>
<legend>FORM REGISTRASI ANGGOTA THOUSAND SUNNY</legend>
<table border="0" cellpadding="3">
<tbody><tr>
<td><label>No. Anggota</label></td>
<td><input name="No_Anggota" type="text"></td>
</tr>
<tr>
<td><label>Nama Lengkap</label></td>
<td><input name="nama" type="text"></td>
</tr>
<tr>
<td><label>Tempat/Tanggal Lahir</label></td>
<td><input name="tempat_lahir" type="text">/
<select name="tgl">
<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 name="bulan">
<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>
</select>-
<select name="tahun">
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
<option value="1997">1997</option>
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
</select>
</td>
</tr>
<tr>
<td><label>Agama</label></td>
<td>
<select name="agama">
<option value="">-PILIH-</option>
<option value="Islam">Islam</option>
<option value="Krisnten">Kristen</option>
<option value="Hindu">Hindu</option>
<option value="Katolik">Katolik</option>
<option value="Budha">Budha</option>
</select>
</td>
</tr>
<tr>
<td><label>Jenis Kelamin</label></td>
<td>
<input name="jk" value="laki-laki" type="radio">Laki-laki
<input name="jk" value="perempuan" type="radio">Perempuan
</td>
</tr>
<tr>
<td><label>Alamat Rumah</label></td>
<td><textarea name="alamat_rumah" rows="10" cols="40"></textarea></td>
</tr>
<tr>
<td><label>No. Telp</label></td>
<td><input name="telp_rumah" type="text"></td>
</tr>
<tr>
<td><label>Nama Sekolah Asal</label></td>
<td><input name="asal_sekolah" type="text"></td>
</tr>
<tr>
<td><label>Alamat Sekolah Asal</label></td>
<td><textarea name="alamat_sekolah" rows="10" cols="40"></textarea></td>
</tr>
<tr>
<td><label>Jurusan</label></td>
<td>
<select name="jurusan">
<option value="">-PILIH-</option>
<option value="TI">TEKNIK INFORMATIKA</option>
<option value="SK">SISTEM KOMPUTER</option>
<option value="SI">SISTEM INFORMASI</option>
<option value="MJ">MANAJEMEN</option>
<option value="AK">AKUNTANSI</option>
</select>
</td>
</tr>
<tr>
<td></td>
<td><input name="tombol_daftar" value="DAFTAR" type="submit"><input name="tombol_batal" value="BATAL" type="reset"></td>
</tr>
</tbody></table>
</fieldset>
</form>
</body>
<head>
<title>FORM PENDAFTARAN</title>
<form action="" method="post">
<fieldset>
<legend>FORM REGISTRASI ANGGOTA THOUSAND SUNNY</legend>
<table border="0" cellpadding="3">
<tbody><tr>
<td><label>No. Anggota</label></td>
<td><input name="No_Anggota" type="text"></td>
</tr>
<tr>
<td><label>Nama Lengkap</label></td>
<td><input name="nama" type="text"></td>
</tr>
<tr>
<td><label>Tempat/Tanggal Lahir</label></td>
<td><input name="tempat_lahir" type="text">/
<select name="tgl">
<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 name="bulan">
<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>
</select>-
<select name="tahun">
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
<option value="1997">1997</option>
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
</select>
</td>
</tr>
<tr>
<td><label>Agama</label></td>
<td>
<select name="agama">
<option value="">-PILIH-</option>
<option value="Islam">Islam</option>
<option value="Krisnten">Kristen</option>
<option value="Hindu">Hindu</option>
<option value="Katolik">Katolik</option>
<option value="Budha">Budha</option>
</select>
</td>
</tr>
<tr>
<td><label>Jenis Kelamin</label></td>
<td>
<input name="jk" value="laki-laki" type="radio">Laki-laki
<input name="jk" value="perempuan" type="radio">Perempuan
</td>
</tr>
<tr>
<td><label>Alamat Rumah</label></td>
<td><textarea name="alamat_rumah" rows="10" cols="40"></textarea></td>
</tr>
<tr>
<td><label>No. Telp</label></td>
<td><input name="telp_rumah" type="text"></td>
</tr>
<tr>
<td><label>Nama Sekolah Asal</label></td>
<td><input name="asal_sekolah" type="text"></td>
</tr>
<tr>
<td><label>Alamat Sekolah Asal</label></td>
<td><textarea name="alamat_sekolah" rows="10" cols="40"></textarea></td>
</tr>
<tr>
<td><label>Jurusan</label></td>
<td>
<select name="jurusan">
<option value="">-PILIH-</option>
<option value="TI">TEKNIK INFORMATIKA</option>
<option value="SK">SISTEM KOMPUTER</option>
<option value="SI">SISTEM INFORMASI</option>
<option value="MJ">MANAJEMEN</option>
<option value="AK">AKUNTANSI</option>
</select>
</td>
</tr>
<tr>
<td></td>
<td><input name="tombol_daftar" value="DAFTAR" type="submit"><input name="tombol_batal" value="BATAL" type="reset"></td>
</tr>
</tbody></table>
</fieldset>
</form>
</body>
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