Pursuit-Core-Web-HTML-Introduction-Lab/paymentForm.html at bd8f71b4e2f5a45dabfbe10bc621bec3fe71e0cb · joinpursuit/Pursuit-Core-Web-HTML-Introduction-Lab · GitHub

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
<!DOCTYPE html>
<html lang="en">
  <head>
    <meta charset="UTF-8" />
    <meta name="viewport" content="width=device-width, initial-scale=1.0" />
    <title>Payment Form</title>
  </head>
  <body>
    <h1>Payment Form</h1>
    <form action="">
      <p>Required fields are marked by <u>*</u></p>
      <h2>Contact Information</h2>
      <input type="radio" name="contact" checked id="" />Mr.
      <br />
      <input type="radio" name="contact" id="" />Ms.
      <br />
      <input type="radio" name="contact" id="" />Mrs.
      <br />
      <input type="radio" name="contact" id="" />Mx.
      <br />
      Name:* <input type="text" placeholder="Name" required="required" />
      <br />
      <br />
      Email:* <input type="email" placeholder="Email" required="required" />
      <h2>Payment Information</h2>
      Card Type:
      <select name="" id="">
        <option value="visa">Visa</option>
        <option value="mastercard">Mastercard</option>
        <option value="americanExpress">American Express</option>
        <option value="discover">Discover</option>
      </select>
      <br />
      <br />
      Card Number:*
      <input type="tel" placeholder="xxxx xxxx xxxx xxxx" required="required" />
      <br />
      <br />
      Expiration Date (MM/YY):*
      <input type="text" placeholder="mm/yy" required="required" />
      <br />
      <br />
      <input type="submit" value="Submit Payment" />
    </form>
  </body>
</html>