Test for Manuel Lemos' PHP form class with paged layout
Form class with paged layout test
E
-mail address
:
Credit card
n
umber
:
[Optional]
Credit card t
y
pe
:
Unknown
Master Card
Visa
American Express
Diners Club
Carte Blanche
Discover
enRoute
JCB
P
ersonal name
:
A
ge
:
W
eight
:
H
o
me page
:
Agree with the
t
erms
:
Acce
s
s name
:
Passwor
d
:
C
onfirm password
:
Password
r
eminder
:
I
nterests
:
Arts
Business
Computers
Education
Entertainment
Health
News
Politics
Sports
Science
Other
When approved, receive notification by:
E-
m
ail
:
P
h
one
:
Subscription type:
Adm
i
nistrator
:
U
ser
:
G
uest
:
Toggle
b
utton
: