Untitled
unknown
plain_text
2 months ago
1.2 kB
7
Indexable
<!DOCTYPE html> <html lang="en"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title>Form 237B/c2 - Lemon Cheesecake Bars Request</title> </head> <body> <h1>Lemon Cheesecake Bars Request</h1> <form name="form237Bc2" action="/submit-request" method="POST"> <label for="name">Full Name:</label><br> <input type="text" id="name" name="name" required><br><br> <label for="email">Email Address:</label><br> <input type="email" id="email" name="email" required><br><br> <label for="quantity">Number of Lemon Cheesecake Bars:</label><br> <input type="number" id="quantity" name="quantity" min="1" required><br><br> <label for="delivery-date">Preferred Delivery Date:</label><br> <input type="date" id="delivery-date" name="delivery_date" required><br><br> <label for="special-request">Special Requests or Dietary Restrictions:</label><br> <textarea id="special-request" name="special_request" rows="4" cols="50"></textarea><br><br> <button type="submit">Submit Request</button> </form> </body> </html>
Editor is loading...
Leave a Comment