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Grains-Insurance.html
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Grains-Insurance.html
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<!DOCTYPE html>
<html style="font-size: 16px;" lang="en"><head>
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta charset="utf-8">
<meta name="keywords" content="">
<meta name="description" content="">
<title>Grains Insurance</title>
<link rel="stylesheet" href="nicepage.css" media="screen">
<link rel="stylesheet" href="Grains-Insurance.css" media="screen">
<script class="u-script" type="text/javascript" src="jquery.js" defer=""></script>
<script class="u-script" type="text/javascript" src="nicepage.js" defer=""></script>
<meta name="generator" content="Nicepage 5.6.2, nicepage.com">
<link id="u-theme-google-font" rel="stylesheet" href="https://fonts.googleapis.com/css?family=Montserrat:100,100i,200,200i,300,300i,400,400i,500,500i,600,600i,700,700i,800,800i,900,900i|Open+Sans:300,300i,400,400i,500,500i,600,600i,700,700i,800,800i">
<script type="application/ld+json">{
"@context": "http://schema.org",
"@type": "Organization",
"name": "Site1",
"logo": "images/PicsArt_03-01-08.13.45.png"
}</script>
<meta name="theme-color" content="#deca97">
<meta property="og:title" content="Grains Insurance">
<meta property="og:type" content="website">
<meta data-intl-tel-input-cdn-path="intlTelInput/"></head>
<body class="u-body u-xl-mode" data-lang="en"><header class="u-border-10 u-border-custom-color-4 u-border-no-left u-border-no-right u-border-no-top u-clearfix u-gradient u-header u-sticky u-header" id="sec-1a30" data-animation-name="" data-animation-duration="0" data-animation-delay="0" data-animation-direction=""><div class="u-clearfix u-sheet u-sheet-1">
<div class="u-layout-grid u-list u-list-1">
<div class="u-repeater u-repeater-1">
<div class="u-container-style u-list-item u-repeater-item u-list-item-1">
<div class="u-container-layout u-similar-container u-container-layout-1">
<a href="https://rcef.da.gov.ph/rsbsa/" class="u-image u-logo u-image-1" data-image-width="1376" data-image-height="1280" title="RSBSA">
<img src="images/PicsArt_03-01-08.13.45.png" class="u-logo-image u-logo-image-1">
</a>
</div>
</div>
<div class="u-container-align-center u-container-style u-list-item u-repeater-item u-list-item-2">
<div class="u-container-layout u-similar-container u-container-layout-2">
<a href="https://nicepage.com" class="u-image u-logo u-image-2" data-image-width="1024" data-image-height="1024">
<img src="images/PicsArt_03-01-05.09.12.png" class="u-logo-image u-logo-image-2">
</a>
</div>
</div>
<div class="u-container-align-center u-container-style u-list-item u-repeater-item u-list-item-3">
<div class="u-container-layout u-similar-container u-container-layout-3">
<a href="https://nicepage.com" class="u-image u-logo u-image-3" data-image-width="1024" data-image-height="1024">
<img src="images/PicsArt_03-01-11.56.39.png" class="u-logo-image u-logo-image-3">
</a>
</div>
</div>
<div class="u-container-align-center u-container-style u-list-item u-repeater-item u-list-item-4">
<div class="u-container-layout u-similar-container u-container-layout-4">
<a href="https://nicepage.com" class="u-image u-logo u-image-4" data-image-width="770" data-image-height="749">
<img src="images/PicsArt_03-01-12.00.461.png" class="u-logo-image u-logo-image-4">
</a>
</div>
</div>
</div>
</div>
<p class="u-align-center u-text u-text-default u-text-grey-5 u-text-1">RSBSA Insurance Online Application</p>
<nav class="u-menu u-menu-one-level u-offcanvas u-menu-1">
<div class="menu-collapse" style="font-size: 1rem; letter-spacing: 0px; font-weight: 500;">
<a class="u-button-style u-custom-active-border-color u-custom-active-color u-custom-border u-custom-border-color u-custom-borders u-custom-hover-border-color u-custom-hover-color u-custom-left-right-menu-spacing u-custom-padding-bottom u-custom-text-active-color u-custom-text-color u-custom-text-hover-color u-custom-top-bottom-menu-spacing u-nav-link u-text-active-palette-1-base u-text-hover-palette-2-base" href="#" style="padding: 4px 8px; font-size: calc(1em + 8px);">
<svg class="u-svg-link" viewBox="0 0 24 24"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#menu-hamburger"></use></svg>
<svg class="u-svg-content" version="1.1" id="menu-hamburger" viewBox="0 0 16 16" x="0px" y="0px" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"><g><rect y="1" width="16" height="2"></rect><rect y="7" width="16" height="2"></rect><rect y="13" width="16" height="2"></rect>
</g></svg>
</a>
</div>
<div class="u-custom-menu u-nav-container">
<ul class="u-nav u-spacing-2 u-unstyled u-nav-1"><li class="u-nav-item"><a class="u-active-grey-5 u-border-active-palette-1-base u-border-hover-palette-1-base u-border-no-left u-border-no-right u-border-no-top u-button-style u-hover-grey-10 u-nav-link u-text-active-grey-90 u-text-grey-90 u-text-hover-grey-90" href="Home.html" style="padding: 10px 20px;">Home</a>
</li><li class="u-nav-item"><a class="u-active-grey-5 u-border-active-palette-1-base u-border-hover-palette-1-base u-border-no-left u-border-no-right u-border-no-top u-button-style u-hover-grey-10 u-nav-link u-text-active-grey-90 u-text-grey-90 u-text-hover-grey-90" href="#" style="padding: 10px 20px;">About</a>
</li><li class="u-nav-item"><a class="u-active-grey-5 u-border-active-palette-1-base u-border-hover-palette-1-base u-border-no-left u-border-no-right u-border-no-top u-button-style u-hover-grey-10 u-nav-link u-text-active-grey-90 u-text-grey-90 u-text-hover-grey-90" href="Home.html#sec-ab97" style="padding: 10px 20px;">Contact</a>
</li></ul>
</div>
<div class="u-custom-menu u-nav-container-collapse">
<div class="u-black u-container-style u-inner-container-layout u-opacity u-opacity-95 u-sidenav">
<div class="u-inner-container-layout u-sidenav-overflow">
<div class="u-menu-close"></div>
<ul class="u-align-center u-nav u-popupmenu-items u-unstyled u-nav-2"><li class="u-nav-item"><a class="u-button-style u-nav-link" href="Home.html">Home</a>
</li><li class="u-nav-item"><a class="u-button-style u-nav-link" href="#">About</a>
</li><li class="u-nav-item"><a class="u-button-style u-nav-link" href="Home.html#sec-ab97">Contact</a>
</li></ul>
</div>
</div>
<div class="u-black u-menu-overlay u-opacity u-opacity-70"></div>
</div>
</nav>
</div></header>
<section class="u-clearfix u-image u-section-1" id="sec-a00b" data-image-width="744" data-image-height="558">
<div class="u-clearfix u-sheet u-sheet-1">
<div class="u-clearfix u-custom-html u-expanded-width u-custom-html-1">
<style> form {
max-width: 600px;
margin: 10 auto;
padding: 20px;
background-color: #f9f9f9;
border: 1px solid #ddd;
border-radius: 5px;
}
label {
display: block;
margin-bottom: 10px;
font-weight: bold;
color: black;
}
input[type="text"],
input[type="email"],
input[type="tel"],
select {
width: 100%;
padding: 10px;
margin-bottom: 20px;
border: 1px solid #ccc;
border-radius: 3px;
font-size: 16px;
}
input[type="submit"] {
background-color: #4CAF50;
color: white;
padding: 12px 20px;
border: none;
border-radius: 4px;
cursor: pointer;
font-size: 16px;
}
input[type="submit"]:hover {
background-color: #45a049;
}
/* Styles for responsiveness */
@media screen and (max-width: 600px) {
form {
max-width: 100%;
}
} </style>
<form>
<label for="fullname">Full Name:</label>
<input type="text" id="fullname" name="fullname" required="">
<label for="email">Email Address:</label>
<input type="email" id="email" name="email" required="">
<label for="phone">Phone Number:</label>
<input type="tel" id="phone" name="phone" required="">
<label for="gender">Gender:</label>
<select id="gender" name="gender">
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
<label for="birthdate">Date of Birth:</label>
<input type="date" id="birthdate" name="birthdate" required="">
<input type="submit" value="Submit">
</form>
</div>
</div>
</section>
<footer class="u-align-center u-clearfix u-footer u-grey-80 u-footer" id="sec-0bc3"><div class="u-clearfix u-sheet u-sheet-1">
<p class="u-small-text u-text u-text-variant u-text-1">Sample text. Click to select the Text Element.</p>
</div></footer>
<section class="u-backlink u-clearfix u-grey-80">
<a class="u-link" href="https://nicepage.com/website-design" target="_blank">
<span>Website Design</span>
</a>
<p class="u-text">
<span>created with</span>
</p>
<a class="u-link" href="https://nicepage.com/html-website-builder" target="_blank">
<span>HTML Designer</span>
</a>.
</section>
</body></html>