<font size=4 color=red><u><marquee>PENDAFTARAN JADI MURID BARU</font></marquee>
<font size=10 color=#8A2BE2><u>SEKOLAH MENENGAH KEJURUAN</font>
</table></tr></td>
<br><font size=6>caranya....!!!
<br><b font size="5"align="center">Biodata calon siswa...!!!</br>


Nama :<input type="text" name="nama"><br>
Alamat:<input type="text" name="alamat"><br>
Kelahiran:<input type="text"name="tempat"><br>
TTL:
<select name="tanggal">
<option value="01"selected>01
<option value="02">02
<option value="03">03
<option value="04">04
<option value="05">05
<option value="06">06
<option value="07">07
<option value="08">08
<option value="09">09
<option value="10">10
<option value="11">11
<option value="12">12
<option value="13">13
<option value="14">14
<option value="15">15
<option value="16">16
<option value="17">17
<option value="18">18
<option value="19">19
<option value="20">20
<option value="21">21
<option value="22">22
<option value="23">23
<option value="24">24
<option value="25">25
<option value="26">26
<option value="27">27
<option value="28">28
<option value="29">29
<option value="30">30
<option value="31">31
</selected>
<br>

<tr>
<td align="right" valign="top"> bulan:</td>
<td colspan=4><select name="bulan">
<option selected value="januari">januari
<option value="pebruari">pebruari
<option value="maret">maret
<option value="april">april
<option value="mei">mei
<option value="juni">juni
<option value="juli">juli
<option value="agustus">agustus
<option value="september">september
<option value="oktober">oktober
<option value="november">november
<option value="desember">desember
</selected>
<br>
<tr>
<td align="right" valign="top"size="2">tahun</td>
<input type="text" nama="tahun"><br>


<tr>
<td align="right" valign="top">provinsi</td>
<td colspan=4><select name="province">
<option selected value="Jawa Barat>Jawa Barat
<option value="Jawa Tengah">Jawa Tengah
<option value="Jawa Timur">Jawa Timur
<option value="Sumatra Selatan">Sumatra Selatan
<option value="Sumatra Utara">Sumatra Utara
<option value="Kalimantan Utara">Kalimantan Utara
<option value="Kalimantan Selatan">Kalimantan Selatan
<option value="Papua">Papua
</select></td>
</tr><br>

no.telpon :<input type="text" nama="no.telpon"><br>







Alasan :
<br><textarea name="alasan" rows=4 cols=50></textarea><br>




<tr>
<td align="right" valign="top"> tujuan :</td><br>
<td colspan=2><input type=checkbox name= send mu about size=15>coba-coba
<br><input type=checkbox name= send mu about size=15>ingin bekerja
<br><input type=checkbox name= send mu about size=15>cari teman
<br><input type=checkbox name= send mu about size=15>ingin capai cita2
<br><input type=checkbox name= send mu about size=15>iseng</td>
</tr><br>




<tr><td>file</td>
<input type=file size=40></textarea></tr></td><br>

<tr><td>password</td><td>
<input type="password"name=password></tr></td><br>
<tr><td>confirm password</td><td>
<input type="password"name=password></tr></td><br>

catatan:
<br><textarea name="alasan" rows=5 cols=40></textarea><br>




persetujuan...<br>
<tr>
<td>
<input type=submit name=kirim value=kirim>
<input type=reset name=batal value=batalkan>
<input type=button name=kembali value=kembali>
</tr></td>



<img src="n.jpg" width="80" height="100">


</font>
</body>
</form>