<!DOCTYPE html>
<html lang="en">
<head>
<title>Form Submission</title>
<style>
.form-container {
text-align: left;
max-width: 600px;
margin: 50px auto;
padding: 20px;
border: 1px solid #ccc;
box-shadow: 0 0 50px rgba(0, 0, 0, 0.3);
}
form {
padding: 20px;
}
label {
display: block;
margin-bottom: 8px;
}
input[type="text"], input[type="email"], input[type="date"], textarea, div {
width: 100%;
padding: 10px;
margin-bottom: 20px;
border: 1px solid #cccccc;
}
.button {
padding: 10px 15px;
color: white;
background-color: #67595E;
border: none;
cursor: pointer;
}
.button:hover {
background-color: #0056b3;
}
</style>
</head>
<body>
<div class="form-container">
<h2>Satisfaction Survey</h2>
<form method=GET action="http://workshop.sps.nyu.edu/~sultans/util/form/formProc.cgi">
<!-- Name -->
<label for="name">Full Name:</label>
<input type="text" id="name" name="name" required>
<!-- Address -->
<label for="address">Address:</label>
<textarea name="address" style="height:50px" required></textarea>
<!-- Email -->
<label for="email">Email Address:</label>
<input type="email" id="email" name="email" required>
<!-- Date of Birth -->
<label for="dob">Date of Birth:</label>
<input type="date" id="dob" name="dob" required>
<!-- Gender -->
<label for="sex1">Gender:</label>
<div id="gender">
<input type="radio" id="sex1" name="sex" value="M" required>Male
<input type="radio" id="sex2" name="sex" value="F" required>Female
</div>
<!-- Skills -->
<label for="status1">Marital Status:</label>
<div id="status">
<input type="checkbox" id="status1" name="status">Single
<input type="checkbox" id="status2" name="status">Married
<input type="checkbox" id="status3" name="status">With Children
</div>
<!-- Satisfaction ratio -->
<label for="phone">Your Satisfaction Range</label>
<div id="satisfaction">
0
<input type="range" id="satisfy" name="satisfy" required>
100%
</div>
<!--
<input type="hidden" name="_EMAIL" value="your_email@address">
<input type="hidden" name="_FILE" value="your_file_name">
<input type="hidden" name="_REDIRECT" value="http://your_hostname/~your_userid/Thankyou.html">
-->
<input type="submit" value="Submit" class='button'>
</form>
</div>
</body>
</html>