Html
- 1. <td>
<font size="5" face="tahoma">Hemen, Ücretsiz Üye Ol!</font>
</td>
<td></td>
<tr>
<td><font size="3" face="tahoma"
color="blue">Adınız:</font></td>
<td><input type="text" name="adiniz"></td>
</tr>
<tr>
<td><font size="3" face="tahoma"
color="blue">Soyadınız:</font></td>
<td><input type="text" name="Soyadiniz"></td>
</tr>
<tr>
<td><font size="3" face="tahoma" color="blue">E-Posta
- 2. • <tr>
<td><font size="3" face="tahoma" color="blue">E-Posta
Adresiniz(Tekrar):</font></td>
<td><input type="text" name="E-Posta1"></td>
</tr>
<tr>
<td><font size="3" face="tahoma" color="blue">ġifreniz:</font></td>
<td><input type="password" name="Sifreniz"></td>
</tr>
<tr>
<td><font size="3" face="tahoma"
color="blue">Cinsiyetiniz:</font></td>
<td><select name="Cinsiyet">
<option>ERKEK</option>
<option>KADIN</option>
</select>
</td>
</tr>
<tr>
<td><font size="3" face="tahoma" color="blue">Doğum
Tarihiniz:</font></td>
- 4. •
<tr>
<td><font size="3" face="tahoma" color="blue">YaĢadığınız ġehir:</font></td>
<td><select name="Sehir">
<option>ġehir</option>
<option>istanbul</option>
<option>izmir</option>
<option>tekirdağ</option>
<option>rize</option>
<option>gars</option>
<option>erzurum</option>
</select>
</td>
</tr>
<tr>
<td><font size="3" face="tahoma" color="blue">Güvenlik Kodu:</font></td>
<td><input type="password"</td>
</tr>
<tr>
<td></td>
<td><input type="checkbox" checked="on">üniaktivite haftalık bültenini e-posta adresini gönder.<a href="#">(Nedir?)</a></td>
</tr>
<tr>
<td></td>
<td><input type="checkbox" checked="on">üniaktivite duyuru ve kampanyalarını e-posta adresime gönder.<a href="#">(Nedir?)</a></td>
</tr>
<tr>
<td></td>
<td><input type="checkbox"><a href="#">Kullanım Ģartlarını</a>okudum,Ģartları kabul ediyorum.</td>
</tr>
<tr>
<td></td>
<td><input type="submit" value="Hesabımı OluĢtur"></td>
</tr>
<tr>
<td></td>
<td><font size="3" face="tahoma" color="blue">Mesajınız:</font></td>
</tr>
<tr>
<td></td>
<td><textarea name="mesaj" rows="10" cols="50"></textarea></td>
</tr>
<tr>
<td></td>
<td><input type="submit" value="GÖNDER"></td>
</tr>
</form>
</table>
</fieldset>
</body>
</html>