Accessibility Form

gistfile1.html

<div class="form-wrapper">
	<form action="registered-confirmed.php" novalidate="novalidate" class="registerInterest">
		<div class="row account-info">
			<fieldset>
				<label for="Name">Name:</label>
				<input type="text" title="Name" id="Name" value="">
			</fieldset>
			<fieldset>
				<label for="Position">Position:</label>
				<input type="text" title="Position" id="Position" value="">
			</fieldset>
			<fieldset>
				<label for="Email">Email:</label>
				<input type="email" title="Email" id="Email" value="">
			</fieldset>
			<fieldset>
				<label for="Phone">Phone:</label>
				<input type="text" title="Phone" id="Phone" value="">
			</fieldset>
			<fieldset>
				<label for="Company">Company:</label>
				<input type="text" title="Company" id="Company" value="">
			</fieldset>
			<fieldset>
				<label for="Country">Country:</label>
				<input type="text" title="Country" id="Country" value="">
			</fieldset>
			<fieldset>
				<label>Interested in:</label>
			</fieldset>
			<fieldset>
				<input type="checkbox" value="Print" id="Print" name="Print">
				<label class="riLeft" for="Print">Print</label>
			</fieldset>
			<fieldset>
				<input type="checkbox" value="Single User" id="SingleUser" name="SingleUser">
				<label class="riLeft" for="SingleUser">Single User</label>
			</fieldset>
			<fieldset>
				<input type="checkbox" value="Multi-Users" id="MultiUser" name="MultiUser">
				<label class="riLeft" for="MultiUser">Multi-Users</label>
			</fieldset>
			<fieldset>
				<label for="Message">Message:</label>
				<textarea id="Message" name="Message"></textarea>
			</fieldset>
			<fieldset>
				<div class="captcha">
					<input id="returnUrl" name="returnUrl" type="hidden" value="/Projects/en-US/Documentation/captcha-demo">
					<img id="CaptchaImage" src="../assets/bp/images/generate.gif">
					<input id="CaptchaDeText" name="CaptchaDeText" type="hidden" value="4db24cbad9854075a251a9c24cf8af58">
					<p><a id="14e82652ba934411a4514d794998eed3" onclick="______48e4f67cc6dd4a1c97680190c0334a6f________()" style="">Try another</a></p>
					<label for="CaptchaInputText">Enter the text you see above:</label>
					<input id="CaptchaInputText" autocomplete="off" autocorrect="off" class="captchaField" data-val="true" data-val-required="Is required field" name="CaptchaInputText" type="text" value="">
					<span class="field-validation-valid" data-valmsg-for="CaptchaInputText" data-valmsg-replace="true"></span>
				</div>
			</fieldset>
			<div class="key">
				<p>* Indicates required field</p>
			</div>
		</div>

		<div class="row contact-options">
			<p>TSO may contact you to renew your subscription to the British Pharmacopoeia Online and keep you informed of products and services available from TSO that may be of interest to you.</p>
			<a href="http://www.pharmacopoeia.co.uk/2014/privacy.htm" target="_blank">Read the TSO Privacy Policy (new window)</a>
		</div>

		<div class="row">
			<input type="checkbox" id="terms">
			<label for="terms">Please tick if you do not wish your personal information to be used in this way. <br /> &nbsp;&nbsp;&nbsp;&nbsp;<a href="#0" target="_blank">Read the BP 2015 Terms and Conditions (new window)</a></label>
		</div>

		<div class="row">
			<input type="checkbox" id="terms">
			<label for="terms">I confirm that I have read and accept the BP 2015 Terms and Conditions</label>
		</div>

		<div class="row actions">
			<input title="Update details" type="submit" value="Submit details" class="enable">
		</div>

	</form>
</div>