<Mod edit: Code from attachment posted below. --Atli>
Expand|Select|Wrap|Line Numbers
- <!DOCTYPE html PUBLIC
- "-//W3C//DTD XHTML 1.0 Strict//EN"
- "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
- <html xmlns="http://www.w3.org/1999/xhtml">
- <head>
- <title>Ligwalagwala Funerals</title>
- <meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
- <link rel="stylesheet" href="js_styles.css" type="text/css" />
- <text align="left"/>
- <script type="text/javascript">
- /* <![CDATA[ */
- function checkForNumber(fieldValue) {
- var numberCheck = isNaN(fieldValue);
- if (numberCheck == true) {
- window.alert("Please enter a valid number");
- return false;
- }
- }
- /* ]]> */
- <!--HIDE FROM INCOMPATIBLE BROWSERS
- // STOP HIDING FROM INCOMPATIBLE BROWSERS-->
- </script>
- </head>
- <body>
- <h1><b>Order Here</b></h1>
- <h2><b>Please select below</b></h2>
- <form action="FormProcessor.html" method="get" enctype="application/x-www-form-urlencoded">
- <p><strong>Choose what you need us to assist you with:</strong></p>
- <p><select name="services">
- <option value="funeralcasket">Funeral Casket</option>
- <option value=funeralcremation">Funeral Cremation</option>
- <option value="funeralarrangement">Funeral Arrangement</option>
- <option value=funeralcar">Funeral Car</option>
- <option value="funeralcoffin">Funeral Coffin</option>
- <option value="funeralcost">Funeral Cost</option>
- <option value="funeralflowers">Funeral Flowers</option>
- <option value="funeralhomes">Funeral Homes</option>
- <option value="funeralinformation">Funeral Information</option>
- <option value="funeralmemories">Funeral Memories</option>
- <option value="funeralparlor">Funeral Parlor</option>
- <option value="funeralplanner">Funeral Planner</option>
- <option value="funeralpreplanning">Funeral Pre Planning</option>
- <option value="funeralpaymentsplan">Funeral Payments Plan</option>
- <option value="funeralprices">Funeral Prices</option>
- <option value="funeralprograms">Funeral Programs</option>
- </select></P>
- <table border="0">
- <tr>
- <p><b>Complete the form below</b></p>
- <p>Name<br />
- <input type="text" name="name" size="40" /></p>
- <p>Surname<br />
- <input type="text" name="surname" size="40" /></p>
- <p>Residential Address<br />
- <input type="text" name="residential_address" size="60" /></p>
- <input type="text" name="name" size="60" /></p>
- <input type="text" name="name" size="60" /></p>
- <p>Code<input type="text" name="code" size="10" onchange="return checkForNumber(this.value);"/></p>
- <p>Contact Number<br />
- <input type="text" name="area_code" size="3" maxlength="3" onchange="return checkForNumber(this.value);" />
- <input type="text" name="number" size="7" maxlength="7" onchange="return checkForNumber(this.value);" /></P>
- <p>Cellphone<br />
- <input type="text" name="cellnumber" size="10" maxlength="10" onchange="return checkForNumber(this.value);" /></p>
- <p>Email Address<br />
- <input type="text" name="email" size="50" /></P>
- <p><strong>Where did you here about us?</strong></p>
- <p><select name="aboutus">
- <option value="newspaper">Newspaper</option>
- <option value="internet">Internet</option>
- <option value="afriend">A Friend</option>
- <option value="brochure">Brochure</option>
- <option value="radio">Radio</option>
- <option value="flyer">Flyer</option>
- </select></P>
- </table></tr>
- </form>
- </body>
- </html>