<span style="font-size:24px;"><html>
<head>
<title>加盟申请表</title>
<style type="text/css">
body{font-size:14px;}
p{font-size:14px;}
.w{font-size:24px;}
.a{font-size:12px;color:blue;}
.b{font-size:16px;}
.c{color:red;}
.d{color:red;}
.red{color:red;}
</style>
</head>
<body>
<img src="image/apply_1.gif">
<table width="500"border="0">
<tr>
<td rowspan="2">
<img src="image/apply_2.gif"></td>
<td>
<h2 class="w">加盟注册表</h2>
</td>
</tr>
<tr>
<td class="a">注:打*为必填项</td>
</tr>
<tr>
<td><h3 class="b">代理申请基本信息</h3></td>
<td> </td>
</tr>
<tr>
<td>申请人姓名<strong class="red">*</strong></td>
<td><input name ="name" type="text"></td>
</tr>
<tr>
<td>籍贯<strong class="red">*</strong></td>
<td>
<select name="x">
<option value=" ">请选择...</option>
<option value="1">山东</option>
<option value="2">山西</option>
<option value="3">辽宁</option>
</select>省
<select name="y">
<option value=" ">请选择...</option>
<option value="4">临沂</option>
<option value="5">大同</option>
<option value="6">辽阳</option>
</select>区</td>
</tr>
<tr>
<td>身份证号<strong class="red">*</strong></td>
<td><input name ="name" type="text"></td>
</tr>
<tr>
<td>联系地址<strong class="red">*</strong></td>
<td><input name ="name" type="text"><td>
</tr>
<tr>
<td>电话<strong class="red">*</strong></td>
<td><input name ="name" type="text"></td>
</tr>
<tr>
<td>加盟地区<strong class="red">*</strong></td>
<td><input name ="name" type="text"></td>
</tr>
<tr>
<td>你是从哪里理解到我们的?</td>
<td><input type="checkbox"name="i"value="x">Baidu
<input type="checkbox"name="i"value="x">Goole
<input type="checkbox"name="i"value="x">电视广告
<input type="checkbox"name="i"value="x">报刊杂志
<input type="checkbox"name="i"value="x">路牌广告
<input type="checkbox"name="i"value="x">朋友介绍<br/>
<input type="checkbox"name="i"value="x"><p class="c">点击查看"Android"项目网上加盟免费声明
<a href=""target="_blank">[点击查看]</p> </td>
</tr>
<tr>
<td> </td>
<td><input type="submit" name="reset" value="提交"></td>
</tr>
</table>
</body>
</html></span>加盟申请表 HTM关键代码
最新推荐文章于 2021-06-09 12:06:30 发布
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