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| source code form beasiswa dalam HTML |
<html>
<head>
<title>Form Beasiswa Sederhana</title>
<style type="text/css">
body { background : url(bg.gif) repeat-y top center #000; width : 800px; margin : 0 auto; padding : 10 px ;}
a:link { text-decoration:none; color:white; }
a:hover { color:black; background-color:#fff; font-style:italic;}
fieldest { border: 2px solid #333; width: 700px; background-color: transparent; margin:40px; }
legend { background: #222; border: 2px solid #333; padding: 5px; }
td { font-size: 12px; padding:5px; }
.ijo { margin: 0 auto;color:white; }
#label { font-style: italic; width:200px; }
</style>
</head>
<body>
<form action="form" method="post">
<fieldset>
<legend><a href="">Form Pengajuan Beasiswa</a></legend>
</br>
<table border="0" width="700px" class="ijo">
<tr>
<td id="label">NIM</td>
<td>:</td>
<td><input size="20" type="text" name="nim" value="" /></td>
</tr>
<tr>
<td id="label">NAMA</td>
<td>:</td>
<td><input size="45" type="text" name="nama" value="" /></td>
</tr>
<tr>
<td id="label">TTL</td>
<td>:</td>
<td><input size="20%" type="text" />
<select title="Date">
<option><Tanggal</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
<option>16</option>
<option>17</option>
<option>18</option>
<option>19</option>
<option>20</option>
<option>21</option>
<option>22</option>
<option>23</option>
<option>24</option>
<option>25</option>
<option>26</option>
<option>27</option>
<option>28</option>
<option>29</option>
<option>30</option>
<option>31</option>
</select>
<select>
<option>Bulan</option>
<option>Januari</option>
<option>Februari</option>
<option>Maret</option>
<option>April</option>
<option>Mei</option>
<option>Juni</option>
<option>Juli</option>
<option>Agustus</option>
<option>September</option>
<option>Oktober</option>
<option>November</option>
<option>Desember</option>
</select>
<select>
<option>Tahun</option>
<option>2015</option>
<option>2014</option>
<option>2013</option>
<option>2012</option>
<option>2011</option>
<option>2010</option>
<option>2009</option>
<option>2008</option>
<option>2007</option>
<option>2006</option>
<option>2005</option>
<option>2004</option>
<option>2003</option>
<option>2002</option>
<option>2001</option>
<option>2000</option>
<option>1999</option>
<option>1998</option>
<option>1997</option>
<option>1996</option>
<option>1995</option>
<option>1994</option>
<option>1993</option>
<option>1992</option>
<option>1990</option>
<option>1989</option>
<option>1988</option>
<option>1987</option>
<option>1986</option>
<option>1985</option>
<option>1984</option>
<select>
</td>
</tr>
<tr>
<td id="label">JENIS KELAMIN</td>
<td>:</td>
<td>
<input type="radio" name="Kelamin" value="Laki - laki" />Laki - laki
<input type="radio" name="Kelamin" value="Perempuan" />Perempuan
<td>
</tr>
<tr>
<td id="label">ALAMAT</td>
<td>:</td>
<td><input size="45" type="text" name="Alamat" value="" /></td>
</tr>
<tr>
<td id="label">PENGHASILAN ORTU</td>
<td>:</td>
<td>
<select>
<option>-</option>
<option>Dibawah 1 Juta</option>
<option>1 - 2 Juta</option>
<option>2 - 3 Juta</option>
<option>3 - 4 Juta</option>
<option>Di Atas 4 Juta</option>
</td>
</tr>
<tr>
<td width="20%" valign="top" id="label">KELUARGA YANG MASIH HIDUP</td>
<td valign="top">:</td>
<td>
<table width="100%" class="ijo">
<tr>
<td width="50%">
<input type="checkbox" name="Hobi" />BAPAK</br>
<input type="checkbox" name="Hobi" />IBU</br>
<input type="checkbox" name="Hobi" />KAKAK</br>
</td>
<td width="50%">
<input type="checkbox" name="Hobi" />ADIK</br>
<input type="checkbox" name="Hobi" />PAMAN</br>
<input type="checkbox" name="Hobi" />BIBI</br>
</td>
<tr>
</table>
</td>
</tr>
<tr>
<td valign="top" id="label">ALASAN</td>
<td valign="top">:</td>
<td>
<textarea cols="45" rows="">Alasan anda mengambil beasiswa...</textarea>
</td>
</tr>
<tr>
<td colspan="2"></td>
<td>
<input type="Submit" name="Submit" value="Submit"/>
<input type="reset" name="Reset" value="Reset" />
</td>
</tr>
</table>
</fieldset>
</form>
</body>
</html>
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