Berikut adalah contoh Codingnya:
<html>
<head><title>Form Pendaftaran</title></head>
<body>
<table border="4" bgcolor="A9C5EB" align="center" height="500" width="400" cellpadding="20">
<tr>
<td>
<b><font color="black" size="10"> Mendaftar </font></b>
<p> Gratis, untuk pelajar </p>
<input type="text" Name="nama" size="20" placeholder="Nama Depan">
<input type="text" Name="nama" size="20" placeholder="Nama Belakang"><br><br>
<input type="text" Name="email" size="46" placeholder="Email Anda"><br><br>
<input type="text" Name="remail" size="46" placeholder="Masukan Ulang Email"><br><br>
<input type="password" Name="sandi" size="46" placeholder="Kata Sandi Baru"><br>
<p><b> Tanggal Lahir </b></p>
<select name="Tanggal">
<option>-Tanggal-</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
<option value="32">32</option>
</select>
<select name="Bulan">
<option>-Bulan-</option>
<option value="1">Januari</option>
<option value="2">Februari</option>
<option value="3">Maret</option>
<option value="4">April</option>
<option value="5">Mei</option>
<option value="6">Juni</option>
<option value="7">Juli</option>
<option value="8">Agustus</option>
<option value="9">September</option>
<option value="10">Oktober</option>
<option value="11">November</option>
<option value="12">Desember</option>
</select>
<select name="Tahun">
<option>-Tahun-</option>
<option value="1980">1980</option>
<option value="1981">1981</option>
<option value="1982">1982</option>
<option value="1983">1983</option>
<option value="1984">1984</option>
<option value="1985">1985</option>
<option value="1986">1986</option>
<option value="1987">1987</option>
<option value="1988">1988</option>
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
<option value="1997">1997</option>
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
<option value="2001">2001</option>
<option value="2002">2002</option>
<option value="2003">2003</option>
<option value="2004">2004</option>
<option value="2005">2005</option>
<option value="2006">2006</option>
<option value="2007">2007</option>
<option value="2008">2008</option>
<option value="2009">2009</option>
<option value="2010">2010</option>
<option value="2011">2011</option>
<option value="2012">2012</option>
<option value="2013">2013</option>
<option value="2014">2014</option>
<option value="2015">2015</option>
</select><br><br>
<input type="radio" name="Kelamin" value="L">Laki Laki
<input type="radio" name="Kelamin" value="P">Perempuan
<br><br>
<input value="Kirim" style="background-color: 4985D0; height: 50; width: 150;"type="submit">
</td>
</tr>
</body>
</html>
Berikut adalah hasilnya :
