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public text v1 · immutable
#2128286 ·published 2012-03-15 02:45 UTC
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<form name="form1" method="post" action="InternetService.php">
<table>
  <tr>
    <td width="35%">First Name:</td>
    <td width="65%">
      <input type="text" name="firstName" id="firstName"></td>
    </tr>
  <tr>
    <td>Last Name:</td>
    <td><input type="text" name="lastName" id="lastName">
    </td>
    </tr>
  <tr>
    <td>Package Type:</td>
    <td><table width="50%" border="0">
      <tr bgcolor="#99CC00">
        <td>A</td>
        <td><input type="radio" name="packageType" value="optionA"></td>
      </tr>
      <tr>
        <td bgcolor="#333333">B</td>
        <td bgcolor="#333333"><input type="radio" name="packageType" value="optionB"></td>
      </tr>
      <tr>
        <td bgcolor="#99CC00">C</td>
        <td bgcolor="#99CC00"><input type="radio" name="packageType" value="optionC"></td>
      </tr>
    </table></td>
    </tr>
  <tr>
    <td>Hours Used:</td>
    <td><label for="hoursUsed"></label>
      <input type="text" name="hoursUsed" id="hoursUsed"></td>
  </tr>
  <tr>
    <td>Non-profit:</td>
    <td><input type="checkbox" name="nonProfit" id="nonProfit">
      <label for="nonProfit"></label></td>
  </tr>
  <tr>
    <td height="39" colspan="2"><table width="100%" border="0">
      <tr>
        <td><input type="submit" name="submit" id="submit" value="Submit"></td>
        <td><input type="reset" name="Reset" id="Reset" value="Reset"></td>
      </tr>
    </table></td>
  </tr>
  </table>
</form>