chrome/test/data/autofill/heuristics/input/15_crbug_53075.html

   1 <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
   2  "http://www.w3.org/TR/html4/loose.dtd">
   3 <!-- www.ukbathroomcreations.com/customer_login/register/ -->
   4 <html>
   5 <head>
   6  <meta http-equiv="Content-Type" content="text/html; charset=utf-8">
   7 <meta name="google-site-verification" content="ezxF_-OmrwaU2Qu5wTV0YHNCHP8DHFlmiyWvYKQuBFk" >
   8  <title>Customer Login | UK Bathroom Creations</title>
   9  <meta name="title" content="">
  10  <meta name="keywords" content="">
  11  <meta name="description" content="">
  12  <meta name="copyright" content="UK Bathroom Creations">
  13  <meta name="robots" content="">
  14  <meta name="distribution" content="global">
  15  <meta name="revisit-after" content=" days">
  16  <meta name="google-site-verification" content="R12-HUrA-gzWvs5XPLyZlXzInnjhWjeosQ-6b3apjBE" />
  17 </head>
  18
  19 <body>
  20   <form action='/inc/modules/authentication/process_registration.php' method='post'>
  21     <input type='hidden' name='fromRegForm' value=true><div class='reg_box'>
  22     <span class='cn'>Company Details</span><ol><li><div style='width:200px;float:left;'>Company Name:</div>
  23     <input type='text' name='ecomms_company_name' value=""></li></ol></div><div class='reg_box'>
  24     <span class='cn'>Personal Details</span><ol><li class='red'>&nbsp;</li><li><div style='width:200px;float:left;'>Title:</div><select name='ecomms_title'><option value=""></option><option value="Mr" >Mr</option><option value="Mrs" >Mrs</option><option value="Miss" >Miss</option><option value="Ms" >Ms</option><option value="Dr" >Dr</option><option value="Other" >Other</option></select>
  25     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>First Name:</div>
  26     <input type='text' name='ecomms_first_name' value="">
  27     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Last Name:</div>
  28     <input type='text' name='ecomms_last_name' value="">
  29     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Telephone:</div>
  30     <input type='text' name='ecomms_telephone' value="">
  31     <span style='color:green'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Mobile:</div>
  32     <input type='text' name='ecomms_mobile' value="">
  33     <span style='color:green'>&nbsp;*</span></li></ol></div><br ><div class='reg_box'>
  34     <span class='cn'>Account Login Details</span><ol><li>Be sure to use a correct email address as we will send you an email to activate your account</li><li class='red'>Sorry your password is too short please specify a password longer than 8 characters&nbsp;</li><li><div style='width:200px;float:left;'>Email Address:</div>
  35     <input type=text name='ecomms_email' value="x@foo.com">
  36     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Password:</div>
  37     <input type='password' name='ecomms_password' value="abcdef">
  38     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Confirm password:</div>
  39     <input type='password' name='ecomms_password_confirm' value="abcdef">
  40     <span class='red'>&nbsp;*</span></li></ol></div><br ><div class='reg_box'>
  41     <span class='cn'>Address Details</span><ol><li class='red'>&nbsp;</li><li><div style='width:200px;float:left;'>Address1:</div>
  42     <input type='text' name='ecomms_address1' value="">
  43     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Address2:</div>
  44     <input type='text' name='ecomms_address2' value=""></li><li><div style='width:200px;float:left;'>Town / City:</div>
  45     <input type='text' name='ecomms_town' value="">
  46     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>County:</div>
  47     <input type='text' name='ecomms_county' value="">
  48     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Postcode:</div>
  49     <input type='text' name='ecomms_postcode' value="">
  50     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Country:</div><select name='ecomms_country'><option value='224' >United Kingdom</option></select><li>
  51     <input type='checkbox' value='1' name='delivery_address' onclick="if(this.checked==true){document.getElementById('del').style.display='inline';} else {document.getElementById('del').style.display='none';}" > specify a different delivery address</li></ol></div><br ><div class='reg_box' style='display:none;width:702px;' id='del'>
  52     <span class='cn'>Delivery Address Details (if different from above)</span><ol><li class='red'>&nbsp;</li><li><div style='width:200px;float:left;'>Title:</div><select name='del_title'><option value=""></option><option value="Mr" >Mr</option><option value="Mrs" >Mrs</option><option value="Miss" >Miss</option><option value="Ms" >Ms</option><option value="Dr" >Dr</option><option value="Other" >Other</option></select>
  53     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>First Name:</div>
  54     <input type='text' name='del_first_name' value="">
  55     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Last Name:</div>
  56     <input type='text' name='del_last_name' value="">
  57     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Telephone:</div>
  58     <input type='text' name='del_telephone' value="">
  59     <span style='color:green'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Mobile:</div>
  60     <input type='text' name='del_mobile' value="">
  61     <span style='color:green'>&nbsp;*</span></li><li>&nbsp;</li><li><div style='width:200px;float:left;'>Address1:</div>
  62     <input type='text' name='del_address1' value="">
  63     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Address2:</div>
  64     <input type='text' name='del_address2' value=""></li><li><div style='width:200px;float:left;'>Town / City:</div>
  65     <input type='text' name='del_town' value="">
  66     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>County:</div>
  67     <input type='text' name='del_county' value="">
  68     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Postcode:</div>
  69     <input type='text' name='del_postcode' value="">
  70     <span class='red'>&nbsp;*</span></li><li><div style='width:200px;float:left;'>Country:</div><select name='ecomms_del_country'><option value='224' >United Kingdom</option></select></ol></div><div class='reg_box'><ol><li>
  71     <input type='submit' value='Register'></li></ol></div>
  72   </form>
  73 </body>
  74 </html>