Registration Form

Please fill out the fields below to register for our web page. Press the Submit button at the end of the form when done.
Your Name:
Your Phone Number:
E-mail address:
Mailing address:
City, State, Zip:

 

  • Source 
    <HTML>
<HEAD><TITLE>Registration Form</TITLE>
<SCRIPT>
//global variable for error flag
var errfound = false;
//function to validate by length
function ValidLength(item, len) {
   return (item.length >= len);
}
//function to validate an email address
function ValidEmail(item) {
   if (!ValidLength(item, 5)) return false;
   if (item.indexOf ('@', 0) == -1) return false;
   return true;
}
// display an error alert
function error(elem, text) {
// abort if we already found an error
   if (errfound) return;
   window.alert(text);
   elem.select();
   elem.focus();
   errfound = true;
}
// main validation function
function Validate() {
   errfound = false;
   if (!ValidLength(document.regform.username.value,6))
      error(document.regform.username,"Invalid Name");
   if (!ValidLength(document.regform.phone.value,10))
      error(document.regform.phone,"Invalid phone number");
   if (!ValidEmail(document.regform.email.value))
      error(document.regform.email, "Invalid Email Address");
   if (!ValidLength(document.regform.address.value,10))
      error(document.regform.address, "Invalid Mailing Address");
   if (!ValidLength(document.regform.city.value,15))
      error(document.regform.city, "Invalid City/State/Zip");
   return !errfound; /* true if there are no errors */
}
</SCRIPT>
</HEAD>
<BODY>
<H1>Registration Form</H1>
<HR>
Please fill out the fields below to register for our web page. Press the
Submit button at the end of the form when done.
<HR>
<FORM NAME="regform" onSubmit="return Validate();"
ACTION="mailto:username@host" METHOD="post">
<B>Your Name:</B>
<INPUT TYPE="text" NAME="username" SIZE=20><BR>
<B>Your Phone Number: </B>
<INPUT TYPE="text" NAME="phone" SIZE=15><BR>
<B>E-mail address:</B>
<INPUT TYPE="text" NAME="email" SIZE=20><BR>
<B>Mailing address:</B>
<INPUT TYPE="text" NAME="address" SIZE=30><BR>
<B>City, State, Zip:</B>
<INPUT TYPE="text" NAME="city" SIZE=30>
<HR>
<INPUT TYPE="SUBMIT" NAME="submit" VALUE="Submit Registration">
<INPUT TYPE="RESET" VALUE="Start Over">
</FORM>
</BODY>
</HTML>