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form.php
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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">
<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.0.2/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-EVSTQN3/azprG1Anm3QDgpJLIm9Nao0Yz1ztcQTwFspd3yD65VohhpuuCOmLASjC" crossorigin="anonymous">
<title>Form Pendaftaran</title>
</head>
<body>
<div class="container">
<div class="row">
<div class="col-lg-2">
</div>
<div class="col-lg-8 p-5 mt-5">
<form method="post" action="<?php echo($_SERVER["PHP_SELF"]);?>" >
<div class="title text-align-center justify-content-center">
<h1>Halo, Silahkan isi data diri kamu:D</h1>
</div>
<!-- Nama -->
<div class="mb-3">
<label for="nama" class="form-label">Nama</label>
<input type="text" class="form-control" name="nama" id="" aria-describedby="helpId" placeholder="Masukkan nama kamu"/>
<small id="helpId" class="form-text text-muted">Isi menggunakan nama lengkap</small>
</div>
<!-- Asal Sekolah -->
<div class="mb-3">
<label for="" class="form-label">Asal sekolah</label>
<input
type="text"
class="form-control"
name="asalsekolah"
id=""
aria-describedby="helpId"
placeholder="ex.SMAN 1 JEPANG"
/>
<small id="helpId" class="form-text text-muted"></small>
</div>
<!-- Jurusan -->
<div class="mb-3">
<label for="jurusan" class="form-label">Jurusan</label>
<select
class="form-select form-select-md"
name="jurusan"
id=""
>
<option selected>Pilih salah satu</option>
<option value="IPA">IPA</option>
<option value="IPS">IPS</option>
<option value="BINDO">Bahasa Indonesia</option>
</select>
</div>
<!-- Jenis Kelamin -->
<div class="mb-3">
<label for="" class="form-label">Jenis Kelamin</label>
<select
class="form-select form-select-md"
name="jenis_kelamin"
id=""
>
<option selected></option>
<option value="Laki-Laki">Laki-Laki</option>
<option value="Perempuan">Perempuan</option>
<!-- <option value="">Jakarta</option> -->
</select>
</div>
<!-- Nomor Telpon -->
<div class="mb-3">
<label for="" class="form-label">Nomor Telpon</label>
<input
type="tel"
class="form-control"
name="no_telepon"
id=""
aria-describedby="helpId"
placeholder="ex.0822XXXXXX"
/>
<small id="helpId" class="form-text text-muted">Pastikan nomor yang diisi terhubung dengan Whatsapp</small>
</div>
<!-- Tanggal Lahir -->
<div class="mb-3">
<label for="" class="form-label">Tanggal Lahir</label>
<input
type="date"
class="form-control"
name="tgl_lahir"
id=""
aria-describedby="helpId"
placeholder=""
/>
<small id="helpId" class="form-text text-muted">bulan/tanggal/tahun</small>
</div>
<!-- Nama Ayah -->
<div class="mb-3">
<label for="" class="form-label">Nama Ayah</label>
<input
type="text"
class="form-control"
name="nama_ayah"
id=""
aria-describedby="helpId"
placeholder=""
/>
<!-- <small id="helpId" class="form-text text-muted">Help text</small> -->
</div>
<!-- Nama Ibu -->
<div class="mb-3">
<label for="" class="form-label">Nama Ibu</label>
<input
type="text"
class="form-control"
name="nama_ibu"
id=""
aria-describedby="helpId"
placeholder=""
/>
<!-- <small id="helpId" class="form-text text-muted">Help text</small> -->
</div>
<!-- Nama Wali -->
<div class="mb-3">
<label for="" class="form-label">Nama Wali</label>
<input
type="text"
class="form-control"
name="nama_wali"
id=""
aria-describedby="helpId"
placeholder=""
/>
<!-- <small id="helpId" class="form-text text-muted">Help text</small> -->
</div>
<div class="mb-3">
<label for="" class="form-label">Nomor Telpon Ortu</label>
<input
type="text"
class="form-control"
name="no_tel_ortu"
id=""
aria-describedby="helpId"
placeholder=""
/>
<!-- <small id="helpId" class="form-text text-muted"></small> -->
</div>
<div class="mb-3">
<label for="" class="form-label">Nomor Telpon Wali</label>
<input
type="text"
class="form-control"
name="no_tel_wali"
id=""
aria-describedby="helpId"
placeholder=""
/>
<small id="helpId" class="form-text text-muted text-Danger">Boleh dikosongkan!</small>
</div>
<button type="submit" class="btn btn-primary" name="submit">Submit</button>
</form>
</div>
<div class="col-lg-2">
</div>
</div>
</div>
</body>
</html>
<script src="https://cdn.jsdelivr.net/npm/sweetalert2@11"></script>