Your IP : 216.73.216.40
<html>
<head>
<style type="text/css">
.font
{
text-align: center;
color:#CC0000;
font-size: 130%;
font-family:Huxtable
}
.tab{
border-style:solid;
border-width:1px;
border-color:#ffffff;
}
body
{
background-image:url('fade.jpg');
background-repeat:repeat-x;
}
.repx{
background-repeat:repeat-x;
}
</style>
<title>REGISTER PAGE</title>
</head>
<body>
<table border="0" width="100%" align="center">
<tr>
<p align="center" >
<td align="center" class="repx">
<!--<h1 style="font-family:Cordia New;color:white;font-size:70px;color:#CECACA">Science Conclave 2010<br></h1>-->
<h1 style="font-family:Fixed Miriam Transparent;color:white;font-size:45px;color:#000000"><br>Science Conclave 2010<br></h1>
</p>
</td>
</tr>
</table>
<table cellpadding="30" width="35%" class="tab" background="flower.jpg" align="center">
<tr>
<td width="33%" align="center"><br><br>
<font size=4 face="LuzSans-Medium"> Register Here:</font><br><br>
<form method="post" action="upload.php" enctype="multipart/form-data">
<table>
<tr><td>
Email address:</td><td><input type="text" name="user_email" size="40"></td></tr>
<tr><td>
Photograph:</td><td><input type="file" name="form_data" size="40"></td></tr>
<tr><td>
Name:</td><td><input type="text" name="user_name" size="40"></td></tr>
<tr><td>
Father's Name:</td><td><input type="text" name="user_fname" size="40"></td></tr>
<tr><td>
Date of Birth (dd-mm-yyyy):</td><td><input type="text" name="user_dob" size="40"></td></tr>
<tr><td>
Gender:</td><td><input type="radio" name="user_sex" value="male"> Male <input type="radio" name="user_sex" value="female">Female</td></tr>
<tr><td>
Address for correspondence:</td><td><textarea name="user_add" rows="5" cols="31"></textarea></td></tr>
<tr><td>
Phone number(std code-no):</td><td><input type="text" name="user_ph" size="15"></td></tr>
<tr><td colspan=2 align="center"><br><br>
<p><input type="submit" name="submit" value="submit">
</td></tr>
</table>
</form>
</body>
</html>