weekendproject/sample5.html at main · Arjavaneesh/weekendproject · GitHub

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<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Fees Payment Details</title>
    <style>
        body {
            font-family: Arial, sans-serif;
            background-color: #f4f4f4;
            margin: 0;
            padding: 20px;
        }
        .container {
            background-color: #fff;
            padding: 20px;
            border-radius: 8px;
            box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);
            max-width: 500px;
            margin: 0 auto;
        }
        h1 {
            text-align: center;
            color: #333;
        }
        .form-group {
            margin-bottom: 15px;
        }
        .form-group label {
            display: block;
            margin-bottom: 5px;
            color: #333;
        }
        .form-group input, .form-group select {
            width: 100%;
            padding: 10px;
            border: 1px solid #ccc;
            border-radius: 4px;
        }
        .submit-btn {
            display: block;
            width: 100%;
            padding: 10px;
            background-color: #4CAF50;
            color: white;
            border: none;
            border-radius: 5px;
            cursor: pointer;
            font-size: 16px;
        }
        .submit-btn:hover {
            background-color: #45a049;
        }
    </style>
</head>
<body>

<div class="container">
    <h1>Fees Payment Details</h1>
    <form action="#" method="post" id="feesPaymentForm">
        <div class="form-group">
            <label for="name">Full Name</label>
            <input type="text" id="name" name="name" required>
        </div>

        <div class="form-group">
            <label for="amount">Amount ($)</label>
            <input type="number" id="amount" name="amount" step="0.01" required>
        </div>

        <div class="form-group">
            <label for="payment-method">Payment Method</label>
            <select id="payment-method" name="payment-method" required>
                <option value="">Select a method</option>
                <option value="credit-card">Credit Card</option>
                <option value="debit-card">Debit Card</option>
                <option value="bank-transfer">Bank Transfer</option>
                <option value="paypal">PayPal</option>
            </select>
        </div>

        <div class="form-group">
            <label for="transaction-reference">Transaction Reference</label>
            <input type="text" id="transaction-reference" name="transaction-reference" required>
        </div>

        <button type="submit" class="submit-btn">Submit Payment</button>
    </form>
</div>

</body>
</html>