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<?php include 'core/init.php'; mysqli_query($mysqli,"SET character_set_results = 'utf8', character_set_client = 'utf8', character_set_connection = 'utf8', character_set_database = 'utf8', character_set_server = 'utf8'"); mysqli_set_charset($mysqli,'utf8'); ?> <!DOCTYPE html> <html> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta http-equiv="X-UA-Compatible" content="ie=edge"> <link rel="stylesheet" type="text/css" href="https://stackpath.bootstrapcdn.com/bootstrap/4.3.1/css/bootstrap.min.css" integrity="sha384-ggOyR0iXCbMQv3Xipma34MD+dH/1fQ784/j6cY/iJTQUOhcWr7x9JvoRxT2MZw1T" crossorigin="anonymous"> <link rel="stylesheet" type="text/css" href="https://codepen.io/skjha5993/pen/bXqWpR.css"> <title>Registration Form</title> </head> <style> label { font-weight: 600; color: #555; } body { background: white; } .dashed{ border-bottom: 3px dashed black; /* color: #fff; background-color: #fff;/ /height: 300px; width: 50%;*/ } .div1{ width: 50px; height: 50px; border: 2px solid black; } .box{ border:1px solid black; width:900px; height:120px; } .box p{ font-size:20px; } .outer_box{ display: flex; justify-content: center; font-size:20px; } .box2{ border:1px solid black; width:500px; height:30px; } .box3{ border:1px solid black; width:500px; height:120px; } .image{ margin-bottom: 20px; } </style> <body> <div class="container" style="max-width: 960px;"> <form id="contactform" method="post"> <h2 class="text-center"></h2> <div class="row jumbotron"> <div class="main1"> <h1 style="text-align:center">ध्येय प्रकाशन अॅकॅ डमी महाराष्ट्रा सांचवित ; आय.एम.विनर राज्यस्तरीय प्रज्ञाशोध परीक्षा [I.A.W.E.]⊛ सन:- 2022 -2023 ⊛.</h1> <p></p> </div> <div class="row"> <div class="col-md-2"> <div class="logo1" style="width: 200px; height: 100px"> <img src="../img/dhyeyaprakashan.jpg" style="width: 250px"> </div> </div> <div class="col-md-6"> <div class="rank1"><b></b></div> </div> <div class="col-md-4 image"> <!--<label for="photo"><b>Photo</b></label>--> <input type="file" name="image0" id="image0" style="border: 1px solid #0000002e;padding: 40px 10px 40px 10px;width: 279px" > </div> <div class="col-sm-6 outer_box"> <div class="box2"> <p><b>Instructions for filling form:</b></p> </div> </div> <div class="col-sm-6 outer_box" style="margin-bottom: 20px"> <div class="box3"> <p><b>1) form fill in capital letters. 2) all fields are mandatory. 3) this form should not be crushed or folded.:</b></p> </div> </div> <!--<div class="col-sm-6 outer_box"> <!--<div class="box2"> <p><b>फॉमण भरण्यासाठी महत्त्वपूर्ण सूचना :</b></p> </div>--> <!--</div> <div class="col-sm-6 outer_box"> <div class="box3"> <p><b>१) फॉमण भरताना इांग्रजी कॅ वपटल अक्षराचा िापर करािा. २) फॉमण मधील सिण मावहती भरर्े अवनिायण आहे. ३)फॉमण मध्ये खाडाखोड करू नये, चुरगळू नये, वकां िा घडी घालू नये.</b></p> </div> </div>--> <div class="name_error"></div><div class="Standarad_error"></div><div class="mobile_error"></div><div class="medium_error"></div><div class="birth_error"></div><div class="school_name_error"></div><div class="school_addres_error"></div><div class="post_error"></div><div class="area_error"></div><div class="district_error"></div><div class="pincode_error"></div> <div class="col-sm-12 form-group"> <label for="name-f">Student Full Name</label> <input type="text" class="form-control" name="full_name" id="full_name" placeholder="Enter your first name."> </div> <div class="col-md-4 form-group"> <label for="name-l">Surname</label> </div> <div class="col-md-4 form-group"> <label for="name-l">First Name</label> </div> <div class="col-md-4 form-group"> <label for="name-l">Middle Name</label> </div> <!--<div class="col-sm-6 form-group"> <label for="email">Email</label> <input type="email" class="form-control" name="email" id="email" placeholder="Enter your email." required> </div>--> <div class="col-sm-6 form-group"> <label for="Date">Date Of Birth</label> <input type="Date" name="datepicker" class="form-control" id="datepicker" placeholder=""> </div> <div class="col-sm-6 form-group"> <label for="tel">Phone</label> <input type="tel" name="mobile" class="form-control" id="mobile" placeholder="Enter Your Contact Number."> </div> <div class="col-sm-12 form-group"> <label for="name-f">School Name</label> <input type="text" class="form-control" name="school_name" id="school_name" placeholder="Enter your school name."> </div> <div class="col-sm-6 form-group"> <label for="address-1">Standard:-</label> <!--<input type="text" class="form-control" name="Standarad" id="Standarad" placeholder="">--> <select class="form-control" name="Standarad" id="Standarad" aria-label="Default select example"> <option selected> Select Class</option> <option value="1th">1th</option> <option value="2th">2th</option> <option value="3th">3th</option> <option value="4th">4th</option> <option value="5th">5th</option> <option value="6th">6th</option> <option value="7th">7th</option> </select> </div> <div class="col-sm-6 form-group"> <label for="address-2">Medium</label> <select class="form-control" name="medium" id="medium" aria-label="Default select example"> <option selected> Select medium</option> <option value="Marathi">Marathi </option> <option value="English">English </option> <option value="Semi-English">Semi-English</option> </select> </div> <div class="col-sm-6 form-group"> <label for="address-1">School address</label> <input type="address" class="form-control" name="school_address" id="school_address" placeholder="Locality/House/Street no."> </div> <div class="col-sm-6 form-group"> <label for="address-2">Post:-</label> <input type="text" class="form-control" name="post" id="post" placeholder=""> </div> <div class="col-sm-4 form-group"> <label for="State">Taluka:-</label> <input type="text" class="form-control" name="area" id="area" placeholder="Enter your Taluka"> </div> <div class="col-sm-2 form-group"> <label for="zip">Postal-Code</label> <input type="zip" class="form-control" name="pincode" id="pincode" placeholder="Postal-Code."> </div> <div class="col-sm-6 form-group"> <label for="Country">District:-</label> <input type="zip" class="form-control" name="district" id="district" placeholder=""> </div> <div class="col-sm-6 form-group"> <label for="address-1">Parent address</label> <input type="address" class="form-control" name="parent_address" id="parent_address" placeholder="Locality/House/Street no."> </div> <div class="col-sm-6 form-group"> <label for="address-2">Post:-</label> <input type="text" class="form-control" name="parent_post" id="parent_post" placeholder=""> </div> <div class="col-sm-4 form-group"> <label for="State">Taluka:-</label> <input type="text" class="form-control" name="parent_area" id="parent_area" placeholder="Enter your Taluka"> </div> <div class="col-sm-2 form-group"> <label for="zip">Postal-Code</label> <input type="zip" class="form-control" name="parent_pincode" id="parent_pincode" placeholder="Postal-Code."> </div> <div class="col-sm-6 form-group"> <label for="Country">District:-</label> <input type="zip" class="form-control" name="parent_district" id="parent_district" placeholder=""> </div> <div class="col-sm-12"> <input type="checkbox" class="form-check d-inline" id="chb" required><label for="chb" class="form-check-label"> I accept all terms and conditions. </label> </div> </div> <div class="col-sm-12 form-group mb-0"> <button class="btn btn-primary float-right" type="submit">Submit</button> </div> <div class="col-sm-12 outer_box"> <div class="box"> <p><b>पालकाांचे प्रवतज्ञापत</b>्र:- मी या प्रवेश अर्ााच्या माध्यमातून माझ्या पाल्याचा आय. एम. ववनर राज्यस्तरीय प्रज्ञाशोध परीक्षेस त्याच्या उज्ज्वल प्रगतीसाठी व गुणवत्ता वाढीसाठी घेत आहे. या परीक्षेची पध्दत, अभ्यासक्रम, खूप छान आहे तो माझा पाल्यासाठी योग्य असून परीक्षेच्या सवा अटी मान्य आहेत.परीक्षेस पाल्याला बसवण्यासाठी कोणत्याही प्रकारचा दबाब, सक्ती के लीली नसून सह खुशीने अर्ा भरत आहे.</p> </div> </div> </form> </div> <!-- latest jquery--> <script src="assets/js/jquery-3.5.1.min.js"></script> <!-- Add To Home js --> <script src="assets/js/pwa.js"></script> <!-- Bootstrap js --> <script src="assets/js/bootstrap/bootstrap.bundle.min.js"></script> <!-- feather icon js --> <script src="assets/js/feather/feather.min.js"></script> <!-- lazyload js --> <script src="assets/js/lazysizes.min.js"></script> <!-- Slick js --> <script src="assets/js/slick/slick.js"></script> <script src="assets/js/slick/slick-animation.min.js"></script> <script src="assets/js/slick/custom_slick.js"></script> <!-- Notify js --> <script src="assets/js/bootstrap/bootstrap-notify.min.js"></script> <!-- script js --> <script src="assets/js/theme-setting.js"></script> <script src="assets/js/script.js"></script> </body> </html> <script> $('form#contactform').submit(function(e) { e.preventDefault(); var name = $('#full_name').val(); var Standarad = $('#Standarad').val(); var medium = $('#medium').val(); var birth = $('#datepicker').val(); var mobile = $('#mobile').val(); var school_name = $('#school_name').val(); var school_address = $('#school_address').val(); var post = $('#post').val(); var area = $('#area').val(); var district = $('#district').val(); var pincode = $('#pincode').val(); var parent_address = $('#parent_address').val(); var parent_post = $('#parent_post').val(); var parent_area = $('#parent_area').val(); var parent_pincode = $('#parent_pincode').val(); var parent_district = $('#parent_district').val(); var image = $('#image0').val(); if(name == ''){ $(".name_error").html('<div class="alert alert-danger">Required fields cant be empty..</div>').delay(3000).show().fadeOut("slow"); return false; } if(Standarad == ''){ $(".Standarad_error").html('<div class="alert alert-danger">Standarad Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if(medium == ''){ $(".medium_error").html('<div class="alert alert-danger">Medium Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if(birth == ''){ $(".birth_error").html('<div class="alert alert-danger">Birth Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if (mobile.length != 10){ $(".mobile_error").html('<div class="alert alert-danger">Check Your Mobile No </div>').delay(3000).show().fadeOut("slow"); return false; } if(school_name == ''){ $(".school_name_error").html('<div class="alert alert-danger">schoolname Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if(school_address == ''){ $(".school_addres_error").html('<div class="alert alert-danger">schooladdress Must be Field </div>').delay(3000).show().fadeOut("slow"); return false; } if(post == ''){ $(".post_error").html('<div class="alert alert-danger">post Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if(area == ''){ $(".area_error").html('<div class="alert alert-danger">area Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if(district == ''){ $(".district_error").html('<div class="alert alert-danger">district Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } if(pincode == ''){ $(".pincode_error").html('<div class="alert alert-danger">pincode Must be Enter </div>').delay(3000).show().fadeOut("slow"); return false; } else { $.ajax({ url: 'ajax/forms.php', dataType:"text", type: 'POST', data: $("form#contactform").serialize(), success: function (response) { $("#contactres").html(response).delay(5000).show().fadeOut("slow"); setTimeout(function(){ $("#full_name").val(''); $("#Standarad").val(''); $("#medium").val(''); $("#datepicker").val(''); $("#mobile").val(''); $("#school_name").val(''); $("#school_address").val(''); $("#post").val(''); $("#area").val(''); $("#district").val(''); $("#pincode").val(''); $('#parent_address').val(); $('#parent_post').val(); $('#parent_area').val(); $('#parent_pincode').val(); $('#parent_district').val(); $('#image0').val(); }, 5000); }, error:function (xhr, ajaxOptions, thrownError){ alert(thrownError); } }); return false; } }); </script>

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