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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>Application Form</title>
<style>
body {
font-family: Arial, sans-serif;
background-color: #1a1a1a;
color: white;
text-align: center;
}
.form-container {
width: 40%;
margin: 50px auto;
background-color: #2c3e50;
padding: 20px;
border-radius: 8px;
box-shadow: 0 0 10px rgba(0, 0, 0, 0.5);
}
.form-container h1 {
margin-bottom: 20px;
}
.form-group {
margin: 15px 0;
text-align: left;
}
.form-group label {
display: block;
margin-bottom: 5px;
}
.form-group input,
.form-group select {
width: 100%;
padding: 8px;
margin-bottom: 10px;
border: none;
border-radius: 5px;
}
.form-group input[type="radio"],
.form-group input[type="checkbox"] {
width: auto;
margin-right: 10px;
}
.button-group {
text-align: center;
}
.button-group button {
background-color: #e74c3c;
color: white;
padding: 10px 20px;
border: none;
border-radius: 5px;
cursor: pointer;
margin: 0 10px;
}
.button-group button:hover {
background-color: #c0392b;
}
</style>
</head>
<body>
<div class="form-container">
<h1>Application Form</h1>
<form>
<div class="form-group">
<label for="first-name">First Name:</label>
<input type="text" id="first-name" name="first-name" required>
</div>
<div class="form-group">
<label for="last-name">Last Name:</label>
<input type="text" id="last-name" name="last-name" required>
</div>
<div class="form-group">
<label for="dob">Date of Birth:</label>
<input type="date" id="dob" name="dob" required>
</div>
<div class="form-group">
<label for="age">Age:</label>
<input type="number" id="age" name="age" required>
</div>
<div class="form-group">
<label>Gender:</label>
<input type="radio" id="male" name="gender" value="male" required>
<label for="male">Male</label>
<input type="radio" id="female" name="gender" value="female" required>
<label for="female">Female</label>
</div>
<div class="form-group">
<label for="email">Email Address:</label>
<input type="email" id="email" name="email" required>
</div>
<div class="form-group">
<label>Positions Available:</label>
<input type="checkbox" id="junior" name="position" value="junior">
<label for="junior">Junior Developer</label>
<input type="checkbox" id="mid" name="position" value="mid">
<label for="mid">Mid-level Developer</label>
<input type="checkbox" id="senior" name="position" value="senior">
<label for="senior">Senior Developer</label>
</div>
<div class="form-group">
<label>Programming Languages:</label>
<input type="checkbox" id="java" name="language" value="java">
<label for="java">Java</label>
<input type="checkbox" id="javascript" name="language" value="javascript">
<label for="javascript">JavaScript</label>
<input type="checkbox" id="python" name="language" value="python">
<label for="python">Python</label>
</div>
<div class="form-group">
<label for="password">Password:</label>
<input type="password" id="password" name="password" required>
</div>
<div class="form-group">
<label for="confirm-password">Confirm Password:</label>
<input type="password" id="confirm-password" name="confirm-password" required>
</div>
<div class="button-group">
<button type="submit">Submit</button>
<button type="reset">Reset</button>
</div>
</form>
</div>
</body>
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