huahuibao/app/teach/views/main/sign.php

<div class="signup" style="margin-top:60px;">
    <div class="mui-modal-com">
        <div>
            <img class="signup-img" src="/images/glhs/signup.png">
            <div class="signUp_box_wrap">
                <div class="signUp_box">
                    <div class="title">你正在报名 专业花店创业全能班</div>
                    <div class="title1">预付定金300元即可报名，前20名线上报名获赠价值300元的课程一份</div>
                    <div class="tip">请填写资料，以便学校联系你</div>
                    <form >
                        <div class="input-list">
                            <span>姓&emsp;名：</span>
                            <input type="text" />
                        </div>
                        <div class="input-list">
                            <span>手机号：</span>
                            <input type="text" />
                        </div>
                        <div class="sex-box">
                            <span class="name">性别：</span>
                            <div class="sex">
                                <input class="sex" type="radio" name="sex" value="男" checked="checked" />
                                <span>男</span>
                            </div>
                            <div class="sex">
                                <input class="sex" type="radio" name="sex" value="女" />
                                <span>女</span>
                            </div>
                        </div>
                        <input class="btn_submit" type="submit" value="提交" />
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>