<!DOCTYPE html>
<!-- Copyright 2016 The Chromium Authors. All rights reserved.
Use of this source code is governed by a BSD-style license that can be
found in the LICENSE file. -->
<h3>Profile form</h3>
<form name="profile_form" id="profile_form" action="destination.html" method="post">
  Name: <input type="text" name="name" id="name" /><br />
  Address: <input type="text" name="address" id="address" /><br />
  City: <input type="text" name="city" id="city" /><br />
  State: <select name="state" id="state">
    <option value="CA">CA</option>
    <option value="MA">MA</option>
    <option value="NY">NY</option>
    <option value="MD">MD</option>
    <option value="OR">OR</option>
    <option value="OH">OH</option>
    <option value="IL">IL</option>
    <option value="DC">DC</option>
  </select> <br />
  Zip: <input name="zip" id="zip"> <br />
  <input id="submit_profile" type="submit" value="Submit Profile" />
</form>