Your IP : 216.73.216.40


Current Path : /var/www/html/venkat/blockchain/
Upload File :
Current File : /var/www/html/venkat/blockchain/register.php

<?php
include("inde.php"); 
?>
	 <div align = "center"> <br><form method = "post" action = "submit.php">
	   <table>
		

		<colspan = "3"> <td> <b> Fill your Details </b> </td> </tr>
                <tr> <td> <br> <font face = "verdana">  Participation Category </td> <td> <br> : </td>
                     <td> <br> <select name = "category">
                                <option value = "iitk"> IIT-K participant </option> 
                                <option value = "iiita"> IIIT-A participant </option>  
                                <option value = "outsidestudent"> Outside student </option>             
                                <option value = "others"> Others </option>
                           </select>  
                       </td>
                </tr>
		<tr> <td> <br> <font face = "verdana">  Interested to participate in poster presentation</td> <td> <br> : </td>
                     <td> <br> <select name = "poster">
                                <option value = "yes"> Yes</option> 
                                <option value = "no"> No </option>  
                           </select>  
                       </td>
                </tr>
		<tr>
		<td> <br> <font face = "verdana"> Enter Code <img src="session.php" > </td>  <td> <br>  : </td> <td> <br> <input type="text" name="vercode" /> <a href = "register.php">Refresh</a> </td> </tr> <tr>
		<td> <br> <font face = "verdana"> Your Name </td> <td> <br> : </td> <td> <br>  <input type = "text" name = "name" maxlength = "45"> </td> </tr> <tr>
	        <td> <br> <font face = "verdana">  E-Mail Id</td> <td> <br> : </td> <td> <br>  <input type = "email" name = "email" maxlength = "40"> </td> 
		</tr>
		<tr colspan = "3">
	   		<td> <br> <input type = "submit" value = "Submit"> </td>
		</tr>
	    </table>
	    </form> 
	   </div>
<?php
include("bottom.php");
?>