Registration Form


::-webkit-calendar-picker-indicator { right: 1%; z-index: 2; opacity: 0; cursor: pointer; } input[type=checkbox] { display: none; } label.check { position: relative; display: inline-block; margin: 5px 20px 10px 0; cursor: pointer; } .question span { margin-left: 30px; } span.required { margin-left: 0; color: red; } label.check:before { content: “”; position: absolute; top: 2px; left: 0; width: 16px; height: 16px; border-radius: 2px; border: 1px solid #095484; } input[type=checkbox]:checked + .check:before { background: #095484; } label.check:after { content: “”; position: absolute; top: 6px; left: 4px; width: 8px; height: 4px; border: 3px solid #fff; border-top: none; border-right: none; transform: rotate(-45deg); opacity: 0; } input[type=checkbox]:checked + label:after { opacity: 1; } .btn-block { margin-top: 10px; text-align: center; } button { width: 150px; padding: 10px; border: none; border-radius: 5px; background: #095484; font-size: 16px; color: #fff; cursor: pointer; } button:hover { background: #0666a3; } @media (min-width: 568px) { .name-item, .city-item { display: flex; flex-wrap: wrap; justify-content: space-between; } .name-item input, .city-item input { width: calc(50% – 20px); } .city-item select { width: calc(50% – 8px); } }

Training Application Form

Applicant Details





Company name


Country Sudan </select> </div> </div> <h2>Course Details</h2> <div class=”item”> <p>Course Code</p> <input type=”text” name=”name”/> </div> <div class=”item”> <p>Location</p> <input type=”text” name=”name”/> </div> <div class=”item”> <p>Start Date</p> <input type=”date” name=”bdate”/> <i class=”fas fa-calendar-alt”></i> </div> <h2>Distributor Details</h2> <div class=”item”> <p>Contact Name</p> <input type=”text” name=”name”/> </div> <div class=”item”> <p>Distributor Name</p> <input type=”text” name=”name”/> </div> <div class=”item”> <p>Distributor Address</p> <input type=”text” name=”name” placeholder=”Street address” /> <input type=”text” name=”name” placeholder=”Street address line 2″ /> <div class=”city-item”> <input type=”text” name=”name” placeholder=”City” /> <input type=”text” name=”name” placeholder=”Region” /> <input type=”text” name=”name” placeholder=”Postal / Zip code” /> <select> <option value=””>Country</option> <option value=”1″>Russia</option> <option value=”2″>Germany</option> <option value=”3″>France</option> <option value=”4″>Armenia</option> <option value=”5″>USA</option> </select> </div> </div> <div class=”item”> <p>Phone</p> <input type=”text” name=”name”/> </div> <div class=”item”> <p>Fax</p> <input type=”text” name=”name”/> </div> <div class=”question”> <p>Privacy Policy<span class=”required”>*</span></p> <div class=”question-answer checkbox-item”> <div> <input type=”checkbox” value=”none” id=”check_1″ name=”check” required/> <label for=”check_1″ class=”check”><span>I agree to the <a href=””>privacy policy.</a></span></label> </div> </div> </div> <div class=”btn-block”> <button type=”submit” href=”/”>Send</button> </div> </form> </div>