Template:Join

From WikiMSK

<_form action="email" id="joinform" messageonsuccess="Thank you for your message." recaptcha-v3-action="joinform" restrictions="lifted"> <_email template="MediaWiki:FlexForm_join_template"></_email> <_label for="name">Full Name</_label> <_input type="text" id="name" name="name" required="required" placeholder="Your full name.."/> <_label for="email">Email</_label> <_input type="text" id="email" name="email" required="required" placeholder="Your email.."/> <_label for="email">Registration Number</_label> <_input type="text" id="registration" name="registration" required="required" placeholder="Your registration number.."/> <_label class="left" for="specialty">What is your specialty?</_label> <_input type="text" id="specialty" name="specialty" required="required" placeholder="Your specialty.."/>

Are you an NZCMM or AAMM member?

 <_input type="radio" id="no" name="nzcmm" value="no" class="radio-button"/>
 <_label for="huey" class="radio-label">No</_label>
 <_input type="radio" id="yes" name="nzcmm" value="yes" class="radio-button"/>
 <_label for="dewey" class="radio-label">Yes</_label>

<_label for="message" style="margin-top:1.25em;">Message</_label> <_input type="textarea" rows="10" id="message" name="message" required="required" placeholder="Your message.."/> <_input type="submit" value="Submit"/> </_form>