<head><center>Imam Fathanah, Danang Sulistyono, Indra Wijaya</center>
<title>Tugas Kelompok
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<td colspan="2" style="text-align:center">Form Pendaftaran Mahasisawa Baru </center><br><center>2016</center></td>
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<td class="kanan"><br>
Nama <br><br>
Alamat <br><br><br><br><br><br>
Agama <br><br><br>
Jenis Kelamin <br><br>
Hobi <br><br>
</td>
<td>
<br>
<input type="text" name="nama"><br>
<br><textarea name=textbox rows=5 cols=50></textarea> <br><br>
<name="agama">
<input type="radio" name="ag" value="is">Islam  
<input type="radio" name="kr">Kristen 
<input type="radio" name="hd">Hindhu <br>
<input type="radio" name="ag" value="kt">Katolik
<input type="radio" name="bd">Budha  
<input type="radio" name="kh">Konghucu <br><br>
<select name="Jenis Kelamin"<p>
<option value="Pilih">Pilih</option>
<option value="Laki-Laki">Laki-Laki</option>
<option value="Perempuan">Perempuan</option></P>
</select><br><br>
<name="hobi">
<input type="checkbox" name="hb" value="mb">Membaca
<input type="checkbox" name="mn">Menulis
<input type="checkbox" name="Mc">Memancing<br>
<input type="checkbox" name="Mc">Lainnya <br>
<input type="submit" value="simpan"> <input type="submit" value="batal">
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