<html> <head> <title>The Request</title> <script type = "text/javascript"> <!-- // Form validation code will come here. //--> </script> </head> <body> <h1>The Request</h1> <form action = "/cgi-bin/test.cgi" name = "myForm" onsubmit = "return(validate());"> <table cellspacing = "2" cellpadding = "2" border = "1"> <tr> <td align = "right">Id</td> <td><input type = "number" name = "Id" /></td> </tr> <tr> <td align = "right">Course Number</td> <td><input type = "number" name = "CourseNumber" /></td> </tr> <tr> <td align = "right">Description</td> <td><input type = "text" name = "Description" /></td> </tr> <tr> <script> </script> <td align = "right">Distance Education</td> <td> <label><input id="my-checkbox" type="checkbox" value=+50 onclick="onToggle()"> </label></td> </tr> <tr> <td align = "right">Additional Marks</td> <td><input type = "number" name = "AddMarks" /></td> </tr> </table> </form> <p> <td align = "right">Number of Courses</td> <td><input type = "number" name = "NumberCourses" id = "NumCourses"/></td> <script type="text/javascript"> document.getElementById("NumCourses").value = 0 </script> <td align = "right">Total Cost</td> <td><input type="text" id="total" name ="total" value="0.0"></td> </script></p> <b>Reasons: </b><input type="radio" name="reason" value="Doctor"> Doctor's Note <input type="radio" name="reason" value="LackWork"> Lack of Work <input type="radio" name="reason" value="Compassion"> Some Compassion <p><td> <br> <input type = "submit" value = "Go For It" /> <input type = "reset" value = "Clear and Reset" /></td> <td align = "right"></td> <td> <select name = "Use"> <option value = "-40" selected>First Time User</option> <option value = "1">Frequent Flyer</option> <option value = "2">Buying a Degree</option> </select> </div> </p> <p><h4>Summary of Your Request(s)</h3> <p><textarea rows="6" cols="60"> </textarea></p> <p><h4>Danger Range</h3> <p><textarea rows="6" cols="60"> </textarea></p> <script> // on toggle method // to check status of checkbox function onToggle() { // check if checkbox is checked if (document.querySelector('#my-checkbox').checked) { // if checked console.log('checked'); } else { // if unchecked console.log('unchecked'); } }
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