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form.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset='UTF-8'>
<title>
Application Form
</title>
<style>
*{
background:yellow;
}
#right{
text-align: right;
}
legend{
font-weight: bolder;
}
table{
text-align:right;
}
</style>
<script type="text/javascript" src="js/validation.js"></script>
</head>
<body>
<form name='application' method='post'>
<fieldset style="margin-bottom:20px; width:60%">
<legend>Personal Details</legend>
<table>
<tr>
<td >First Name:</td>
<td style="float:left;"><input type='text' name='fname' placeholder="Enter First name"></td>
</tr>
<tr>
<td >Father's Name:</td>
<td style="float:left;"><input type='text' name='father_name_personal' placeholder="Enter Father's name"></td>
</tr>
<tr>
<td >Last Name:</td>
<td style="float:left;"><input type='text' name='lname' placeholder="Enter Last name"></td>
</tr>
<tr>
<td >Date of Birth:</td>
<td style="float:left;"><input type='text' name='DOB' placeholder='DD/MM/YY'></td>
</tr>
<tr>
<td>Gender:</td>
<td style="float:left;"><input type='radio' name='gender' id="male">Male
<input type='radio' name='gender' value="Female" id="female">Female</td>
</tr>
<tr>
<td>Address:</td>
<td style="float:left;"><textarea name='address' rows="5"
cols="30"></textarea></td>
</tr>
<tr>
<td>E-mail ID:</td>
<td style="float:left;"><input type='text' name='email'></td>
</tr>
<tr>
<td>Mobile No:</td>
<td style="float:left;">+91<input type='text' name='mobile' ></td>
</tr>
</table>
</fieldset>
<fieldset style="margin-bottom:30px; width:60%">
<legend>Credit Card Details</legend>
<table>
<tr>
<td>Bank Name:</td>
<td style="float:left;"><input type='text' name='bank_name'></td>
</tr>
<tr>
<td>Card Number:</td>
<td style="float:left;"><input type='text' name='card_no'></td>
</tr>
<tr>
<td>CVV:</td>
<td style="float:left;"><input type="password" name='cvv'></td>
</tr>
</table>
</fieldset>
<h3>Declaration:</h3>
<textarea readonly="readonly" rows="4" cols="60" style="margin-bottom:30px;" >
I hereby declare that information provided by me is genuine to my best knowledge.
</textarea>
<input type="submit" name="send info" value="Submit" onclick="validate();" style="margin-top:50px;">
</form>
</body>
</html>