<html>
<head>
<meta http-equiv="Content-Language" content="it">
<meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
<title>Pendaftaran + Captcha</title>
</head>
<body>
<form method="POST" action="sendate1.php">
<p><font face="Calibri" style="font-size: 15pt">Kontak: </font></p>
<table border="0" width="46%" id="table2" style="font-family: Calibri; font-size: 12pt; font-style: oblique" height="57">
<tr>
<td width="149">
<p>Masukkan kode captcha*</td>
<td width="294">
<input type="text" name="captcha" size="38"></td>
<img src="captcha.php" name="captcha"></tr>
</table>
<table border="0" width="46%" id="table1" style="font-family: Calibri; font-size: 12pt; font-style: oblique" height="340">
<tr>
<td width="100">Nama : (depan&belakang)</td>
<td><input type="text" name="name" size="19">
<input type="text" name="lname" size="15"></td>
</tr>
<tr>
<td width="149">Password</td>
<td><input type="text" name="password" size="38"></td>
</tr>
<tr>
<td width="149">Email</td>
<td><input type="text" name="email" size="38"></td>
</tr>
<tr>
<td width="149">Alamat</td>
<td><input type="text" name="tel" size="38"></td>
</tr>
<tr>
<td width="149">Kota Asal :</td>
<td> <select name="motivo">
<option value="Informasi komersial">Jakarta</option>
<option value="Meminta Informasi">Bandung</option>
<option value="Membuat janji">Surabaya</option>
</select></td>
</tr>
<tr>
<td width="149">Tentang Anda:</td>
<td><textarea rows="5" name="mess" cols="29"></textarea></td>
</tr>
</table>
<p>
<INPUT type="submit" value="Kirim">
<a href="contattic.php" onclick="document.images["captcha"].reload();">REFRESH</a></p>
<p><font face="Calibri"><font style="font-size: 10pt">*</font>
<span style="font-size: 10pt">Captcha digunakan untuk memastikan bahwa pengirim
email bukanlah mesin. Jika kode captcha tidak dapat dilihat, silahkan klik REFRESH.</span></font></p>
</form>
</body>
</html>
Untuk SENDATE & CAPCTCHA IMAGE, Kita lanjut kan di laen ksempatan ok,..."Semangat"...!!! :)
Thanks a lot mas!!! kontak formnya!!
BalasHapusLumy buat belajar nih. he3!
yo'i....siap..!!! :}
BalasHapus