<link rel="stylesheet" href="css/font-awesome.css"/>
<div class="main">
<div class="container">
<form>
<div class="row">
<h4>Account Details</h4>
<div class="input-group input-group-icon">
<input type="text" placeholder="Full Name"/>
<div class="input-icon"><i class="fa fa-user"></i></div>
</div>
<div class="input-group input-group-icon">
<input type="email" placeholder="Email Adress"/>
<div class="input-icon"><i class="fa fa-envelope"></i></div>
</div>
<div class="input-group input-group-icon">
<input type="password" placeholder="Password"/>
<div class="input-icon"><i class="fa fa-key"></i></div>
</div>
</div>
<div class="row">
<div class="col-half">
<h4>Date of Birth</h4>
<div class="input-group">
<div class="col-third">
<input type="text" placeholder="DD"/>
</div>
<div class="col-third">
<input type="text" placeholder="MM"/>
</div>
<div class="col-third">
<input type="text" placeholder="YYYY"/>
</div>
</div>
</div>
<div class="col-half">
<h4>Gender</h4>
<div class="input-group">
<input type="radio" name="gender" value="male" id="gender-male"/>
<label for="gender-male">Male</label>
<input type="radio" name="gender" value="female" id="gender-female"/>
<label for="gender-female">Female</label>
</div>
</div>
</div>
<div class="row">
<h4>Payment Details</h4>
<div class="input-group">
<input type="radio" name="payment-method" value="card" id="payment-method-card" checked="true"/>
<label for="payment-method-card"><span><i class="fa fa-cc-visa"></i>Credit Card</span></label>
<input type="radio" name="payment-method" value="paypal" id="payment-method-paypal"/>
<label for="payment-method-paypal"> <span><i class="fa fa-cc-paypal"></i>Paypal</span></label>
</div>
<div class="input-group input-group-icon">
<input type="text" placeholder="Card Number"/>
<div class="input-icon"><i class="fa fa-credit-card"></i></div>
</div>
<div class="col-half">
<div class="input-group input-group-icon">
<input type="text" placeholder="Card CVC"/>
<div class="input-icon"><i class="fa fa-user"></i></div>
</div>
</div>
<div class="col-half">
<div class="input-group">
<select>
<option value="">Select</option>
<option value="01 Jan">01 Jan</option>
<option value="01 Feb">01 Feb</option>
<option value="01 Mar">01 Mar</option>
<option value="01 Apr">01 Apr</option>
<option value="01 May">01 May</option>
<option value="01 Jun">01 Jun</option>
<option value="01 Jul">01 Jul</option>
<option value="01 Aug">01 Aug</option>
<option value="01 Sep">01 Sep</option>
<option value="01 Oct">01 Oct</option>
<option value="01 Nov">01 Nov</option>
<option value="01 Dec">01 Dec</option>
</select>
<select>
<option value="">Select</option>
<option>2010</option>
<option>2011</option>
<option>2012</option>
<option>2013</option>
<option>2014</option>
<option>2015</option>
<option>2016</option>
<option>2017</option>
<option>2018</option>
<option>2019</option>
<option>2020</option>
<option>2021</option>
<option>2022</option>
<option>2023</option>
<option>2024</option>
<option>2025</option>
<option>2026</option>
<option>2027</option>
<option>2028</option>
<option>2029</option>
<option>2030</option>
</select>
</div>
</div>
</div>
<div class="row">
<h4>Terms and Conditions</h4>
<div class="input-group">
<input type="checkbox" id="terms"/>
<label for="terms">I accept the terms and conditions.</label>
</div>
</div>
<div class="row">
<input type="submit" class="submit_btn" name="submit" value="SUBMIT"/>
</div>
</form>
</div>
</div> /******************************
http://www.freetimelearning.com
http://www.freetimelearn.com
*******************************/
.main{ margin:10px auto 20px !important; width:600px;}
*,
*:before,
*:after {
box-sizing: border-box;
}
body {
padding: 16px;
font-family: Arial, Helvetica, sans-serif;
font-size: 15px;
color: #b9b9b9;
background-color: #F3F3F3;
}
h4 {
color: #7ed321;
}
input,
input[type="radio"] + label,
input[type="checkbox"] + label:before,
select option,
select {
width: 100%;
padding: 1em;
line-height: 1.4;
background-color: #f9f9f9;
border: 1px solid #e5e5e5;
border-radius: 3px;
-webkit-transition: 0.35s ease-in-out;
-moz-transition: 0.35s ease-in-out;
-o-transition: 0.35s ease-in-out;
transition: 0.35s ease-in-out;
transition: all 0.35s ease-in-out;
}
input:focus {
outline: 0;
border-color: #64ac15;
}
input:focus + .input-icon i {
color: #7ed321;
}
input:focus + .input-icon:after {
border-right-color: #7ed321;
}
input[type="radio"] {
display: none;
}
input[type="radio"] + label,
select {
display: inline-block;
width: 50%;
text-align: center;
float: left;
border-radius: 0;
}
input[type="radio"] + label:first-of-type {
border-top-left-radius: 3px;
border-bottom-left-radius: 3px;
}
input[type="radio"] + label:last-of-type {
border-top-right-radius: 3px;
border-bottom-right-radius: 3px;
}
input[type="radio"] + label i {
padding-right: 0.4em;
}
input[type="radio"]:checked + label,
input:checked + label:before,
select:focus,
select:active {
background-color: #7ed321;
color: #fff;
border-color: #64ac15;
}
input[type="checkbox"] {
display: none;
}
input[type="checkbox"] + label {
position: relative;
display: block;
padding-left: 1.6em;
}
input[type="checkbox"] + label:before {
position: absolute;
top: 0.2em;
left: 0;
display: block;
width: 1em;
height: 1em;
padding: 0;
content: "";
}
input[type="checkbox"] + label:after {
position: absolute;
top: 0.45em;
left: 0.2em;
font-size: 0.8em;
color: #fff;
opacity: 0;
font-family: FontAwesome;
content: "\f00c";
}
input:checked + label:after {
opacity: 1;
}
select {
height: 3.4em;
line-height: 2;
}
select:first-of-type {
border-top-left-radius: 3px;
border-bottom-left-radius: 3px;
}
select:last-of-type {
border-top-right-radius: 3px;
border-bottom-right-radius: 3px;
}
select:focus,
select:active {
outline: 0;
}
select option {
background-color: #7ed321;
color: #fff;
}
.input-group {
margin-bottom: 1em;
zoom: 1;
}
.input-group:before,
.input-group:after {
content: "";
display: table;
}
.input-group:after {
clear: both;
}
.input-group-icon {
position: relative;
}
.input-group-icon input {
padding-left: 4.4em;
}
.input-group-icon .input-icon {
position: absolute;
top: 0;
left: 0;
width: 3.4em;
height: 3.4em;
line-height: 3.4em;
text-align: center;
pointer-events: none;
}
.input-group-icon .input-icon:after {
position: absolute;
top: 0.6em;
bottom: 0.6em;
left: 3.4em;
display: block;
border-right: 1px solid #e5e5e5;
content: "";
-webkit-transition: 0.35s ease-in-out;
-moz-transition: 0.35s ease-in-out;
-o-transition: 0.35s ease-in-out;
transition: 0.35s ease-in-out;
transition: all 0.35s ease-in-out;
}
.input-group-icon .input-icon i {
-webkit-transition: 0.35s ease-in-out;
-moz-transition: 0.35s ease-in-out;
-o-transition: 0.35s ease-in-out;
transition: 0.35s ease-in-out;
transition: all 0.35s ease-in-out;
}
.container {
max-width: 38em;
padding: 1em 3em 2em 3em;
margin: 0em auto;
background-color: #fff;
border-radius: 4.2px;
box-shadow: 0px 3px 10px -2px rgba(0, 0, 0, 0.2);
}
.row {
zoom: 1;
}
.row:before,
.row:after {
content: "";
display: table;
}
.row:after {
clear: both;
}
.col-half {
padding-right: 10px;
float: left;
width: 50%;
}
.col-half:last-of-type {
padding-right: 0;
}
.col-third {
padding-right: 10px;
float: left;
width: 33.33333333%;
}
.col-third:last-of-type {
padding-right: 0;
}
@media only screen and (max-width: 540px) {
.col-half {
width: 100%;
padding-right: 0;
}
}
.submit_btn{ background:#7ed321; border-radius:3px; color:#FFF; cursor:pointer;} .submit_btn:hover{ background:#090;}