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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Form</title>
</head>
<body>
<center><h1><b>New Employee Details Form</b></h1></center>
<form>
<table cellpadding="10">
<tr><td><h3>Personal Details</h3></td></tr>
<tr><td rowspan="2"><label>Your Name</label></td>
<td>
<span>*</span>
<select name="title" id="title">
<option></option>
<option >a</option>
<option>b</option>
<option>c</option>
<option>d</option>
</select>
</td>
<td><span>*</span><input type="text" name="FirstName" id="firstName" required></td>
<td><input type="text" name="MiddleName" id="middlename"></td>
<td> <span>*</span><input type="text" name="surname" id="surname" required></td>
</tr>
<tr>
<td><label>Title</label></td>
<td><label>First Name</label></td>
<td><label>Middle Name</label></td>
<td><label>Surname</label></td>
</tr>
<tr>
<td><label>*Gender</label></td>
<td>
<input type="radio" value="Male" id="male" name="gender">
<label>Male</label>
<input type="radio" value="Female" id="female" name="gender">
<label>Female</label>
</td>
</tr>
<tr>
<td> <label>*Birth Date</label></td>
<td colspan="2"> <input type="datetime" name="Birthdate" id="BirthDate" size="30"></td>
</tr>
<tr>
<td rowspan="4"> <label>Address</label></td>
<td colspan="2"><input type="text" name="address" id="StreetAddress" size="30"></td>
<td colspan="2"> <input type="text" name="address" id="StreetAddressline2" size="30"></td>
</tr>
<tr>
<td colspan="2"><label>*Street Address</label></td>
<td><label>Street Address Line2</label></td>
</tr>
<tr>
<td><input type="text" name="address" id="suburb"></td>
<td><input type="text" name="state" id="state"></td>
<td><input type="text" name="postcode" id="postcode"></td>
</tr>
<tr>
<td><label>* Suburb</label></td>
<td><label>* State</label></td>
<td><label>* Postcode</label></td>
</tr>
<tr>
<td rowspan="3"><label>Contact</label></td>
<td><label>* Home Phone</label></td>
<td><label>* Mobile Phone</label></td>
<td><label>* Email Address</label></td>
</tr>
<tr>
<td> <input type="text" name="homephone" id="homephone"></td>
<td> <input type="text" name="Mobliephone" id="Mobliephone"></td>
<td> <input type="text" name="postcode" id="postcode"></td>
</tr>
<tr>
<td><label>*Are you an Australian?</label></td>
<td><input type="radio" name="Are you an Australian?" id="yes" value="yes"><label>Yes</label>
<input type="radio" name="Are you an Australian?" id="no" value="no"> <label>No</label>
</td>
</tr>
<tr>
<td><label>*Do you have a working visa?</label></td>
<td><input type="radio" name="Do you have a working visa?" id="yes" value="no"><label>Yes</label>
<input type="radio" name="Do you have a working visa?" id="no" value="no"><label>no</label>
</td>
</tr>
<tr>
<td><h3>Employment Details</h3></td>
</tr>
<tr>
<td><label for="">*Job Title</label></td>
<td colspan="2"><input type="text" name="job Title" id="jobtitle" size="35"></td>
</tr>
<tr>
<td> <label>*Commencement Date</label></td>
<td colspan="2"><input type="text" name="job Title" id="jobtitle" size="35"></td>
</tr>
<tr>
<td><label>*File Tax Number</label></td>
<td colspan="2"><input type="text" name="job Title" id="jobtitle" size="35"></td>
</tr>
<tr>
<td> <label>*Employment status</label></td>
<td><input type="radio" name="employmentstatus" id="fulltime" value="Full Time"><label>Full Time</label></td>
<td><input type="radio" name="employmentstatus" id="partname" value="Part Time"><label>PartTime</label></td>
<td><input type="radio" name="employmentstatu" id="Temporary" value="Temporary"><label>Temporary</label></td>
<td><input type="radio" name="employmentstatu" id="casual" value="casual"><label>casual</label></td>
</tr>
<tr>
<td><h3>Emergency Contact Details</h3></td>
</tr>
<tr>
<td rowspan="2"><label>Name</label></td>
<td>
<select name="title" id="title">
<option></option>
<option >a</option>
<option>b</option>
<option>c</option>
<option>d</option>
<option >e</option>
<option>f</option>
</select>
</td>
<td><input type="text" name="FirstName" id="firstName" required></td>
<td><input type="text" name="MiddleName" id="middlename"></td>
<td><input type="text" name="MiddleName" id="middlename" required></td>
</tr>
<tr>
<td><label>*Title</label></td>
<td><label>*First Name</label></td>
<td><label>Middle Name</label></td>
<td><label>*Surname</label></td>
</tr>
<tr>
<td><label>*Relationship</label></td>
<td colspan="2"><input type="text" name="Relationship" id="Relationship" size="30"></td>
</tr>
<tr>
<td rowspan="2"> <label>Contact</label></td>
<td><label>* Home Phone</label></td>
<td><label>* Mobile Phone</label></td>
<td><label>* Email Address</label></td>
</tr>
<tr>
<td> <input type="text" name="Contact" id="homephone"></td>
<td> <input type="text" name="Contact" id="Moblephone"></td>
<td> <input type="text" name="Contact" id="postcode"></td>
</tr>
<tr><td><h3>Banking Details</h3></td></tr>
<tr>
<td rowspan="2"><label>Bank</label></td>
<td colspan="2"><label>* Bank Name</label></td>
<td><label>* Bank Brach</label></td>
</tr>
<tr>
<td colspan="2"><input type="text" name="BankName" id="bankname" size="30"></td>
<td colspan="2"><input type="text" name="BankBranch" id="bankbranch" size="30"></td>
</tr>
<tr>
<td rowspan="2"><label>Account</label></td>
<td><label>* Account Name</label></td>
<td><label>* Account Number </label></td>
<td><label>* BSB Number</label></td>
</tr>
<tr>
<td><input type="text" name="AccountName" id="AccountName"></td>
<td><input type="number" name="AccountNumber" id="AccountNumber"></td>
<td><input type="number" name="BaseNumber" id="baseNumber"></td>
</tr>
<tr>
<td><label>*Employee signature</label></td>
<td><textarea name="Employee" id="Employee signature" rows="3" cols="20" ></textarea></td>
</tr>
<tr>
<td rowspan="2"><textarea name="print your name here" id="print your name here" cols="30" rows="1" placeholder="print your name here"></textarea></td>
</tr>
<tr>
<td rowspan="2"><textarea name="Enter date here" id="Enter date here" cols="30" rows="1" placeholder="Enter date here"></textarea></td>
</tr>
</table>
</form>
<button value="submit">Submit</button>
<p>*: Mandatory fields</p>
<center>
<p><u>create your own Borneosoft online forms</u></p>
<p><u>choose from our form Templates or Modify this form</u></p>
</center>
</body>
</html>