<html>
<head>
<title>Kullanıcı Bilgileri</title>
</head>
<body>
<FORM METHOD="POST" ACTION="mailto:etogm@meb.gov.tr" TARGET="_blank">
<h3>Kullanıcı Bilgileri</h3>
<P>Adı:<INPUT TYPE="text" NAME="adı"></P>
<P>Soyadı:<INPUT TYPE="text" NAME="soyadı"></P>
<P>Cinsiyet: ERKEK<INPUT TYPE="radio" name="durum" value="1"> KADIN<INPUT TYPE="radio" name="durum" value="1"></P>
<form>
Doğum Yeri:
<select name="dogumyerı">
<option>Aksaray</option>
<option>Ankara</option>
<option>İstanbul</option>
<option>Koyna</option>
<option>İzmir</option>
</select>
</form>
<form>
Doğum Tarihi:
<select name="dogumtarihi">
<option>Gün</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>17</option>
</select>
<select name="dogumtarihi">
<option>Ay</option>
<option>Ocak</option>
<option>Şubat</option>
<option>Mart</option>
<option>Nisan</option>
<option>Mayıs</option>
<option>Eylül</option>
</select>
<select name="dogumtarihi">
<option>Yıl</option>
<option>2000</option>
<option>1999</option>
<option>1998</option>
<option>1997</option>
<option>1996</option>
</select>
</form>
<form>
<p>
<input type="submit" value="Kaydet"/>
<input type="reset" value="Temizle"/>
</p>
</form>
</form>
</body>
</html>