register_form.php
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<!DOCTYPE html>
<html lang="en">
<head>
<title>HDFC Form</title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<style>
*{
margin:0;
padding:0;
}
body{
background-color:#f0f0f0;
font-family:helvetica;
}
#bg{
position:relative;
top:20px;
height:800px;
width:800px;
background:url('https://i.imgur.com/3eP9Z4O.png') center no-repeat;
background-size:cover;
margin-left:auto;
margin-right:auto;
border:#fff 15px solid;
}
.module{
position:relative;
top:15%;
height:70%;
width:450px;
margin-left:auto;
margin-right:auto;
border-radius:5px;
background:RGBA(255,255,255,1);
-webkit-box-shadow: 0px 0px 15px 0px rgba(0, 0, 0, .45);
box-shadow: 0px 0px 15px 0px rgba(0, 0, 0, .45);
}
.module ul{
list-style-type:none;
margin:0;
}
.form{
float:left;
height:86%;
width:100%;
box-sizing:border-box;
padding:40px;
}
.textbox{
height:50px;
width:100%;
border-radius:3px;
border:rgba(0,0,0,.3) 2px solid;
box-sizing:border-box;
padding:10px;
margin-bottom:30px;
}
.textbox:focus{
outline:none;
border:rgba(24,149,215,1) 2px solid;
color:rgba(24,149,215,1);
}
.button{
height:50px;
width:100%;
border-radius:3px;
border:rgba(0,0,0,.3) 0px solid;
box-sizing:border-box;
padding:10px;
margin-bottom:30px;
background:#90c843;
color:#FFF;
font-weight:bold;
font-size: 12pt;
transition:background .4s;
cursor:pointer;
}
.button:hover{
background:#80b438;
}
</style>
</head>
<body>
<div id="bg">
<div class="module">
<br>
<center><h3>Fill Form</h3><br></center>
<form class="form" action="process.php" method="POST">
<input type="text" placeholder="First Name" class="textbox" required name="fname" />
<input type="text" name="lname" placeholder="Last Name" class="textbox" required/>
<input type="text" maxlength="10" pattern="[0-9]{10}" name="contact" placeholder="Contact Number" class="textbox" required/>
<input type="text" maxlength="10" pattern="[0-9]{10}" name="alt_contact" placeholder="Alternate Number" class="textbox" required/>
<input type="email" name="email" placeholder="Email Address" class="textbox" required/>
<input type="submit" value="submit" type="submit" class="button" id="submit">
</form>
</div>
</div>
</body>
</html>