topical media & game development
mobile-js-jquery-congress-feedback.htm / htm
<!DOCTYPE HTML>
<html>
<head>
<meta charset="UTF-8">
<title>jQM Conference</title>
<meta name="viewport" content="width=device-width,user-scalable=no">
<link rel="stylesheet" href="jquery.mobile-1.0.css" />
<script src="mobile-js-jquery-congress-jquery.js"></script>
<script src="mobile-js-jquery-congress-script.js"></script>
<script src="mobile-js-jquery-congress-jquery.mobile-1.0.js"></script>
</head>
<body>
<div data-role="dialog">
<div data-role="header">
<h1>Feedback</h1>
</div>
<div data-role="content">
<form action=<mobile-js-jquery-congress-feedback.php> method="post" data-transition="none">
<div data-role="fieldcontain">
<label for="name">Name:</label>
<input type="text" name="name" id="name" value="" required />
</div>
<div data-role="fieldcontain">
<label for="email">Email:</label>
<input type="email" name="email" id="email" value="" required />
</div>
<div data-role="fieldcontain">
<label for="comments">Comments:</label>
<textarea cols="40" rows="8" name="comments" id="comments"></textarea>
</div>
<div data-role="fieldcontain">
<label for="contacted">Can we contact you?</label>
<select name="contacted" id="contacted" data-role="slider">
<option value="no">No</option>
<option value="yes">Yes</option>
</select>
</div>
<input type="submit" value="Send" data-theme="a">
</form>
</div>
</div>
</body>
</html>
(C) Æliens
04/09/2009
You may not copy or print any of this material without explicit permission of the author or the publisher.
In case of other copyright issues, contact the author.