<head>
<title> Tabel Formulir Pendaftaran </title></head>
<body> <from name="Formulir 1" action="dudihermawan1610@gmail.com">
<table border="1" width="75%">
<tr> <td colspan="3" align="center"> <h2> <b> FORMULIR PENDAFTARAN SISWA BARU </H2></B> </TD></tr>
<tr><td width="20%"> Nama Depan
<td width="3%" align="center"> :
<td width="50%"> <input type="text" name="nama" size="100">
<tr><td width="20%"> Nama Belakang
<td width="3%" align="center"> :
<td width="50%"> <input type="text" name="nama" size="100">
<tr><td width="20%"> Tempat Lahir
<td width="3%" align="center"> :
<td width="50%"> <input type="text" name="nama" size="100">
<tr><td width="20%"> Tanggal Lahir
<td width="3%" align="center"> :
<td width="50%" align="center">
Tgl<select><option></option><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option>
<option>6</option><option>7</option><option>8</option><option>9</option><option>10</option><option>11</option><option>12</option><option>13</option>
<option>14</option><option>15</option><option>16</option><option>17</option><option>18</option><option>19</option><option>20</option><option>21</option>
<option>22</option><option>23</option><option>24</option><option>25</option><option>26</option><option>27</option><option>28</option><option>29</option>
<option>30</option><option>31</option></select> Bln <select><option></option><option>Januari</option><option>Februari</option><option>Maret</option><option>April</option>
<option>Mei</option><option>Juni</option><option>Juli</option><option>Agustus</option><option>September</option><option>Oktober</option><option>November</option>
<option>Desember</option></select> Tahun <select> <option>1996</option><option>1997</option><option>1998</option><option>1999</option><option>2000</option><option>2001</option> Thn </select></TR>
<tr><td>Jenis Kelamin </td>
<td align="center">:</td>
<td align="center"><input type="radio" name="nama" value="male">Laki-Laki<br><input type="radio" name="nama" value="female">Perempuan</td></tr>
<tr><td width="30%">Total Nilai UN</TD>
<td>:</td>
<td><input type="text" name="nilai" size="100"></td></tr>
<tr><td height="120" colspan="3" valign="middle" align="center">
<input type="Submit" name="Kirim" value="KIRIM">
<input type="Reset" name="Batal" value="BATAL"></td>
</body>
</table>
</html>
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