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admin_signup_form.php
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<!DOCTYPE html>
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta charset="utf-8" />
<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1" />
<title>AGRO-KRISHI</title>
<link href="css/bootstrap.css" rel="stylesheet" />
<link href="css/font-awesome.css" rel="stylesheet" />
<link href="css/style.css" rel="stylesheet" />
<link href='http://fonts.googleapis.com/css?family=Open+Sans' rel='stylesheet' type='text/css' />
</head>
<body>
<?php include('includes/header.php');?>
<div class="container">
<h4 class="header-line"><h3>ADMIN'S SIGNUP FORM</h3></h4>
</div>
<div class="form-area3">
<div class="row">
<div class="col-md-6 col-sm-6 col-xs-12 col-md-offset-3" >
<h3 align="center">SIGNUP FORM</h3>
</div>
<div class="panel-body">
<form name="signup" method="post" action='admin_signup_form_backend.php' onsubmit="return valid();">
<div class="form-group">
<br/><br/>
<label><p>Username</p></label>
<input class="form-control" type="text" name="name" />
<br>
<div class="form-group">
<label><p>Adhaar no</p></label>
<input class="form-control" type="text" name="adhaar" placeholder="xxxx-xxxx-xxxx-xxxx"/>
</div>
<div class="form-group">
<label><p>Password</p></label>
<input class="form-control" type="password" name="password" />
</div>
<div class="form-group">
<label><p>Confirm Password</p> </label>
<input class="form-control" type="password" name="confirmpassword" autocomplete="off" required />
</div>
<div class="form-group">
<label><p>Security Question </p> </label>
<select class="form-control" name='security_question'>
<option default>Select Your security questions</option>
<option value="ques1">your best friend</option>
<option value="ques2">your first job</option>
<option value="ques3">your favourite holiday destination</option>
<option value="ques4">favorite dinner</option>
</select>
</div>
<div class="form-group">
<label><p>Answers</p></label>
<input class="form-control" type="text" name="security_question_answer" />
</div>
<br/>
<button type="submit" name="signup" class="btn btn-danger" id="submit">SIGNUP</button>
</div>
</form>
<script src="assets/js/jquery-1.10.2.js"></script>
<script src="assets/js/bootstrap.js"></script>
<script src="assets/js/custom.js"></script>
</body>
</html>