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<h1>Application form</h1> <form action="" method="post" name="form1" id="form1"> <p>1. Personal Details</p> <p>Name: <input type="text" id="textfield"></p> <p>Student Number: <input type="text" id="textfield3"></p> <p>Date of Birth: <input type="text" tabindex="-1" id="textfield2"></p> <p><label for="textfield4">Family Name: <input type="text" id="textfield4"></p> <p>Given Names: <input type="text" tabindex="4" id="textfield5"></p> <p><label for="homeaddress">Home Address:</label> <input type="text"></p> <p>Post code: <select id="postcode"> <option value="0">Select</option> <option value="3000">3000</option> <option value="3010">3010</option> <option value="3183">3183</option> </select> </p> <fieldset> <legend>2. Emergency Contact</legend> <p>Name: <input type="text" id="textfield13"></p> <p>Address: <input type="text" id="textfield14"></p> <p>Post Code <input type="text" id="textfield15"></p> <p>Telephone: <input type="text" id="textfield16"></p> </fieldset> <p>3. Citizenship</p> <p><input type="radio">Australian</p> <p><input type="radio">New Zealand</p> <p><input type="submit" value="Submit" id="button" name="button"></p> </form>
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