<html>
<head>
<title>CURRICULUM VITAE GHOFARI</title>
</head>
<body>
<h1>Curriculum Vitae</h1>
<body bgcolor=red>
<h2>DATA PRIBADI</h2>
<form action="#" method="get">
<table width="579" height="294" border="1">
<tr>
<td width="185">Nama</td>
<td width="23">:</td>
<td width="349"><input type=text name=Nama width="380"/></td>
</tr>
<tr>
<td width="185">Tempat / Tanggal Lahir</td>
<td>:</td>
<td width="349"><input type=text name=tempat /><select name=tempat>
<option value=1>01
<option value=2>02
<option value=3>03
<option value=4>04
<option value=5>05
<option value=6>06
<option value=7>07
<option value=8>08
<option value=9>09
<option value=10>10
<option value=11>11
<option value=12>12
<option value=13>13
<option value=14>14
<option value=15>15
<option value=16>16
<option value=17>17
<option value=18>18
<option value=19>19
<option value=20>20
<option value=21>21
<option value=22>22
<option value=23>23
<option value=24>24
<option value=25>25
<option value=26>26
<option value=27>27
<option value=28>28
<option value=29>29
<option value=30>30
<option value=31>31
</select>
<select name=bln>
<option value=1>01
<option value=1>02
<option value=3>03
<option value=4>04
<option value=5>05
<option value=6>06
<option value=7>07
<option value=8>08
<option value=9>09
<option value=10>10
<option value=11>11
<option value=12>12
</select>
<select name=tahun>
<option value=1985>1985
<option value=1986>1986
<option value=1987>1987
<option value=1988>1988
<option value=1989>1989
<option value=1990>1990
<option value=1991>1991
<option value=1992>1992
<option value=1993>1993
<option value=1994>1994
<option value=1995>1995
<option value=1996>1996
<option value=1997>1997
<option value=1998>1998
<option value=1999>1999
<option value=2000>2000
</select></td>
</tr>
<tr>
<td width="185">Jenis Kelamin </td>
<td>:</td>
<td width="349"><input type=radio name=gender value=pria>Laki-laki
<input type=radio name=gender value=Wanita>Perempuan</td>
</tr>
<tr>
<td width="185">Agama</td>
<td>:</td>
<td width="349"><input type=radio name=agama value=Islam>Islam
<input type=radio name=agama value=Katholik>Katholik
<input type=radio name=gender value=Kristen>Kristen
<input type=radio name=agama value=Hindu>Hindu
<input type=radio name=agama value=Budha>Budha </td>
</tr>
<tr>
<td width="185">Alamat</td>
<td>:</td>
<td width="349"><textarea name=Alamat cols=60 rows=4></textarea></td>
</tr>
<tr>
<td width="185">No.HP</td>
<td>:</td>
<td width="349"><input type="text" name="No.HP" width="380"/></td>
</tr>
<tr>
<td width="185">Email</td>
<td>:</td>
<td width="349"><input type="text" name="Email" width="380"/></td>
</tr>
</table>
</body>
</html>
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