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physical_impairments.html
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physical_impairments.html
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<!doctype html>
<html lang="en">
<head>
<meta charset="utf-8">
<script src="./jquery-ui/external/jquery/jquery.js"></script>
<script src="./jquery.countdown.min.js"></script>
<style>
.form {
margin-bottom: 20px;
margin-top: 20px;
}
body{
text-align: left;
font-family: sans-serif;
font-weight: 100;
padding: 100px;
}
h1{
color: #396;
font-weight: 100;
font-size: 40px;
margin: 40px 0px 20px;
}
</style>
</head>
<body>
<h1>Give Us All Your INFO</h1>
<p> Time Remaining: <span id="clock"></span></p>
<form class="form" action="/" method="get">
<div>
<label>First Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Middle Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Last Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Maiden Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Mother's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Father's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Sibling's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Cat's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Dog's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Neighbor's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>First Love's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Pet Rock's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>2nd Teacher's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>First Car's Name</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Address</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Address 2</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Address 3</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Address 4</label>
<input type="text" name="fullname" />
</div>
<div>
<label>City</label>
<input type="text" name="fullname" />
</div>
<div>
<label>State</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Country</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Zip</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Gender</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Ethnicity</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Age</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Hair Color</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Eye Color</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Skin Color</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Height</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Weight</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Pant Size</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Shirt Size</label>
<input type="text" name="fullname" />
</div>
<div>
<label>Shoe Size</label>
<input type="text" name="fullname" />
</div>
<div>
<label>IQ</label>
<input type="text" name="fullname" />
</div>
</form>
<script>
let twominutes = new Date();
twominutes.setMinutes(twominutes.getMinutes() + 2);
$('#clock').countdown(twominutes, function(event) {
$(this).html(event.strftime('%M:%S'));
});
</script>
</body>
</html>