UMPAN BALIK
<HTML>
<HEAD>
<TITLE>Feedback Form</TITLE>
</HEAD>
<BODY>
<H1>Feedback Form</H1>
<FORM action="mailto:simon.long@cit.ie" method="post" enctype="text/plain">
First Name : <INPUT type="text" name="firstname" placeholder="Enter name here">
Second Name : <INPUT type="text" name="secondname" placeholder="Enter surname here">
<BR>
<BR>
<!--It's important that both of these radio button have the same name so they behave as one component (i.e. Only one can be selected at a time)-->
<INPUT type="radio" name="gender" value="male">Male<BR>
<INPUT type="radio" name="gender" value="female">Female
<BR>
<BR>
<!--This uses the new HTML "email" INPUT type which will automatically validates the email address when the SUBMIT button is clicked-->
email: <INPUT type="email" name="mail" placeholder="e-mail address">
<BR>
<BR>
Comment :<BR>
<TEXTAREA rows="6" cols="50" name="commentfield"></TEXTAREA>
<BR>
<SELECT name="countychooser">
<OPTION value="cork">Cork</OPTION>
<OPTION value="dublin">Dublin</OPTION>
<OPTION value="galway">Galway</OPTION>
<OPTION value="kerry">Kerry</OPTION>
</SELECT>
<BR>
<BR>
<INPUT TYPE="submit" value="Send Feedback">
<INPUT TYPE="reset" value="Reset">
</FORM>
</BODY>
</HTML>