PHP_en_15_1_3.php

<p>Register as new customer!</p>

<form method="post" action="output.php">
    <table>
        <tr>
            <td>Last name:</td>
            <td><input name="last_name" type="text" /></td>
        </tr>
        <tr>
            <td>First name:</td>
            <td><input name="first_name" type="text" /></td>
        </tr>
        <tr>
            <td>Street:</td>
            <td><input name="street" type="text" /></td>
        </tr>
        <tr>
            <td>Post Code:</td>
            <td><input name="post_code" type="text" /></td>
        </tr>
        <tr>
            <td>Place:</td>
            <td><input name="place" type="text" /></td>
        </tr>
        <tr>
            <td>E-Mail:</td>
            <td><input name="mail" type="text" /></td>
        </tr>
        <tr>
            <td>Phone:</td>
            <td><input name="phone" type="text" /></td>
        </tr>
        <tr>
            <td>Password:</td>
            <td><input name="password" type="password" /></td>
        </tr>
        <tr>
            <td colspan="2" align="center"><input type="submit" value="Register" /></td>
        </tr>
    </table>
</form>