Untitled

<html>
<head>
<title>application</title>
<Script type="text/javascript">
<!--
	function date_valid()
	{
		var m=document.vidya.month.value;
		var d=document.vidya.date.value;
		if(((m==4) || (m==6) || (m==9) ||(m==11)) && d>30)
			alert("invalid date");
		else if(m==2 && d>28 && document.vidya.year.value%4!=0)
			alert("invalid date");

			
	}
//-->
</script>	
</head>
<body>
<center>
<table border="1">
<tr>
<td><center>APPLICATION FORM</center></td></tr>
<tr><td>Name
<form name="vidya">
<input type="text" name="name" id="NM" size="20">
</td>
</tr>
<tr><td>Date of birth
<select size="1" name="month">
<option>----select month----</option>
<script language="javascript">
var i
for(i=1;i<=12;i++)
document.writeln("<option value=" + i + ">" + i + "</option>")
</script>

</select>
<select size="1" name="date">
<option>----select date----</option>
<script language="javascript">
var i
for(i=1;i<=31;i++)
document.writeln("<option value=" + i + ">" + i + "</option>")
</script>
</select>
<select size="1" name="year">
<option>----select year----</option>
<script language="javascript">
var i
for(i=1956;i<=2006;i++)
document.writeln("<option value=" + i + ">" + i + "</option>")
</script>
</select>
</br>
<center><input type="Submit" value="Submit" onClick="date_valid()"></center>
</td>
</tr>
</table>
</center>
</form>
</body>
</html>