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signUp.html
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signUp.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0,shrink-to-fit=no">
<title>Registration Page</title>
<!-- CSS links -->
<link rel="stylesheet" type="text/css" href="css/bootstrap.min.css">
<link rel="stylesheet" type="text/css" href="css/style.css">
<script type="text/javascript" src="js/script.js"></script>
<script href="js/bootstrap.min.js"></script>
</head>
<body>
<nav class="navbar navbar-dark navbar-expand-lg fixed-top">
<div class="container">
<a class="navbar-brand" href="#"></a>
<button class="navbar-toggler" type="button" data-toggle="collapse" data-target="#Navbar">
<span class="navbar-toggler-icon"></span>
</button>
<div class="collapse navbar-collapse" id="Navbar">
<ul class="navbar-nav mr-0">
<li class="navbar-item active"><a class="nav-link" href="#">Home</a></li>
<li class="navbar-item "><a class="nav-link" href="#">Objective</a></li>
<li class="navbar-item"><a class="nav-link" href="#">Applicable Acts</a></li>
<li class="navbar-item"><a class="nav-link" href="#">EPFO/ESCI/CLC Return</a></li>
<li class="navbar-item"><a class="nav-link" href="#">State Integration</a></li>
<li class="navbar-item"><a class="nav-link" href="#">Services</a></li>
<li class="navbar-item"><a class="nav-link" href="#">Report</a></li>
</ul>
</div>
</div>
</nav>
<!--header-->
<!-- <header> -->
<div class="container">
<div class="row">
<div class="col-12 col-sm-8 offset-sm-3 col-md-5 offset-md-7">
<form action="" method="POST" name="loginForm" onsubmit="checkform(event.preventDefault())" >
<legend class="text-center" style="font-size:x-large;">Sign Up Form For Establishment Representative Owner</legend>
<div class="form-group row">
<label for="firstName" class="col-12 col-md-4 col-form-label">First Name</label>
<div class="col-12 col-md-8">
<input type="text" pattern="[A-Z]+[a-z]*" title="Use CamelCase e.g. Joe" class=" form-control" id="firstName" name="firstName" placeholder="First Name" required/>
</div>
</div>
<div class="form-group row">
<label for="middleName" class="col-12 col-md-4 col-form-label">Middle Name</label>
<div class="col-12 col-md-8">
<input type="text" pattern="[A-Z]+[a-z]*" title="Use CamelCase e.g. Joe" class=" form-control" id="middleName" name="middleName" placeholder="Middle Name"/>
</div>
</div>
<div class="form-group row">
<label for="lastName" class="col-12 col-md-4 col-form-label">Last Name</label>
<div class="col-12 col-md-8">
<input type="text" pattern="[A-Z]+[a-z]*" title="Use CamelCase e.g. Joe" class=" form-control" id="lastName" name="lastName" placeholder="Last Name" required/>
</div>
</div>
<div class="form-group row">
<label for="emailId" class="col-12 col-md-4 col-form-label">E-mail Id</label>
<div class="col-12 col-md-8">
<input type="email" class=" form-control" id="emailId" name="emailId" placeholder="[email protected]" required/>
</div>
</div>
<div class="form-group row">
<label for="contact" class="col-12 col-md-4 col-form-label">Contact No.</label>
<div class="col-12 col-md-8">
<input type="tel" minlength="10" maxlength="10" class="form-control" id="contact" name="contact" placeholder="9********0" required/>
</div>
</div>
<div class="form-group row">
<label for="verificationCode" class="col-12 col-md-4 col-form-label">Verify Code</label>
<div class="col-12 col-md-8">
<input class=" form-control" id="verificationCode" name="verificationCode" placeholder="Enter the characters shown" required/>
</div> <br/><br>
<div class="capbox ">
<div id="CaptchaDiv"></div>
<input type="hidden" id="txtCaptcha">
</div>
</div>
<div class="form-group row">
<div class="col-12 offset-4 ">
<button type="submit" class="btn btn-md btn-success">Sign Up</button>
<button type="reset" class="btn btn-md btn-primary">Reset</button>
</div>
</div>
</form>
</div>
</div>
</div>
<!-- </header> -->
<!-- Footer -->
<footer class="page-footer font-small pt-1">
<!-- Footer Elements -->
<div class="container">
<ul class="list-unstyled list-inline text-center">
<li class="list-inline-item">
<a class=" mx-1">Policies </a>
</li>
<li class="list-inline-item">
<a class="mx-1">FAQ</a>
</li>
<li class="list-inline-item">
<a class=" mx-1">Help</a>
</li>
<li class="list-inline-item">
<a class="mx-1">Contact Us</a>
</li>
<li class="list-inline-item">
<a class="mx-1">Policy</a>
</li>
<li class="list-inline-item">
<a class="mx-1">About Us</a>
</li>
</ul>
</div>
<!-- Copyright -->
<div class="footer-copyright text-center py-1">© 2020 Copyright:</div>
<!-- Copyright -->
</footer>
<!-- Footer -->
<script src="js/jquery.slim.min.js"></script>
<script src="js/popper.min.js"></script>
<script src="js/bootstrap.min.js"></script>
</body>
</html>