purchase-form/purchaseForm.html at main · UMSIComplexWebDesign/purchase-form · GitHub

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  <!DOCTYPE html>
  <html lang="en">
  <head>
	  <meta charset="UTF-8">
	  <meta name="viewport" content="width=device-width, initial-scale=1.0">
	  <title>Sample Purchase Form</title>
	  <link rel="stylesheet" href="css/style.css">
	      <!-- HTML code from: http://24ways.org/2009/have-a-field-day-with-html5-forms/ -->

  </head>
  <body>

	  <h1>Sample Purchase Form</h1>

	  <form action="#" method="get" novalidate>
		  <!-- Your Details -->
		  	<fieldset>
			  <legend>Your Details</legend>
			  <ol>
				<li><label for="name">Name</label>
				<input id="name" name="name" type="text" placeholder="First and last name" required autofocus></li>

				<li><label for="email">Email</label>
				<input id="email" name="email" type="email" placeholder="example@domain.com" required></li>

				<li><label for="phone">Phone</label>
				<input id="phone" name="phone" type="tel" pattern="\d{3}-\d{3}-\d{4}" placeholder="123-456-7890" required></li>

				<li><label for="pass">Password</label>
				<input id="pass" name="password" type="password" required></li>
		  	  </ol>
			</fieldset>

		  <!-- Delivery Address -->
		  	<fieldset>
			  <legend>Delivery Address</legend>
			  <label for="street">Street Address</label>
			  <ol>
				<input id="street" name="street" type="text" placeholder="123 Main St" required></li>

				<li><label for="city">City</label>
				<input id="city" name="city" type="text" placeholder="Ann Arbor" required></li>

				<li><label for="state">State</label>
				<input id="state" name="state" type="text" placeholder="MI" maxlength="2" required></li>

				<li><label for="zip">Zip Code</label>
				<input id="zip" name="zip" type="text" pattern="\d{5}" placeholder="12345" required></li>

				<li><label for="country">Country</label>
				<input id="country" name="country" type="text" required></li>
			  </ol>
			</fieldset>

		  <!-- Card Details -->
		  <fieldset id = "cards">
			  <legend>Card Details</legend>
			  <ol>
				<li>

			  <!-- Card Type -->
			  <fieldset>
				  <legend>Card Type</legend>
				  <ol class = "cardtype">
					<input id="visa" name="cardtype" type="radio" >
						<label for="visa">VISA</label>
					<input id="amex" name="cardtype" type="radio">
						<label for="amex">AmEx</label>
					<input id="mastercard" name="cardtype" type="radio">
						<label for="mastercard">Mastercard</label>
				</ol>
				</fieldset></li>

			  <li><label for="cardnumber">Card Number</label>
			  <input id="cardnumber" name="cardnumber" type="text" inputmode="numeric" pattern="\d{13,19}" placeholder="1234 5678 9012 3456" required></li>

			  <li><label for="secure">Security Code</label>
			  <input id="secure" name="secure" type="text" inputmode="numeric" pattern="\d{3,4}" placeholder="3-4 digit code" required></li>

			  <li><label for="namecard">Name on Card</label>
			  <input id="namecard" name="namecard" type="text" placeholder="Exact name as on the card" required></li>
			</ol>
			</fieldset>

		  <!-- Submit Button -->
			  <button type="submit">Buy it!</button>
	  </form>

  </body>
  </html>