Support System.html

<!DOCTYPE html>


<html>
  
<lang="en">
<div="LTR">
  
<head>
  
      
<meta charset="utf-8">
   
<meta name="keywords" content="health, mental health">
<meta name="viewpoint" content="width= device width, initial-scale=1.0">
    
 <title>Support System</title>

    
<nav> </nav> <!-- add links to other websites --> 


</head>
 
   
<body>

   
<a href="https://www.GIMA.com" target="_blank"><b>GIMA</b> </a> 
<br><a href="home.html" target="_blank"><b>Home</b> </a> 
<br><br>


<form>
<!-- Text field -->
<b>Name:</b> <input type="text" name="Nickname" value="Please enter your nickname" size="40">
<br><br>

<!-- Radio buttons -->
<b>Age:</b>
<input type="radio" name="age"> < 20
<input type="radio" name="age"> 21 -- 30
<input type="radio" name="age"> 31 -- 40
<input type="radio" name="age"> 41+
<br><br>

<!-- Select list -->
<b>What means of interaction do you prefer?</b>
<select name="interaction">
<option name="anonymously">Anonymously
<option name="one-on-one">one-on-one
<option name="group chats">Group-chats
</select>
<br><br>

<!-- Check boxes -->
<b>How may we contact you for more information?</b><br>
<input type="checkbox" name="phone">Phone<br>
<input type="checkbox" name="mail">Mail<br>
<input type="checkbox" name="email">Email<br>
<input type="checkbox" name="no">Do not contact me<br>
<hr>

<b>Email or contact :</b> <input type="text" name="email" value="Please enter your email" size="40">
<br><br>

<b>Tell us about yourself</b>
<textarea> </textarea>

<br><br>

<b>Please enter your password</b>: <input type="password" />

<br><br>
<b>Confirm your password</b>: <input type="password" />

<p><input type="submit" value="Submit" />
<input type="reset" /></p>


</form>


    </body>


</html>