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Code Editor : system_general_master_setup_08112017.php
<script> $(function() { $('#reload').click(function(){ var d = new Date(); $('img').attr('src', 'captcha.php?' + d.getTime()); }); }); </script> <div class="portlet box blue"> <div class="portlet-title"> <div class="caption"> <i class="fa fa-reorder"></i>Registration Form </div> </div> <div class="portlet-body form" > <div style='margin-left:6%;'> <div class="row"> <!-- BEGIN FORM--> <h3 class="form-section">Student Details</h3> <form class="form-horizontal" id='form_module_details_upload' enctype='multipart/form-data' method='POST'> <div class="col-md-7" > <input type='hidden' name= 'MAX_FILE_SIZE' value='10000000000' /> <div class="form-body"> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Select Quota</label> <div class="col-md-3"> <select class="form-control" id='T30' style='min-width:150px;' onchange ='CMS.loadscheme();' title='Tatkal'> <option value='General'>General</option> <option value='Tatkal'>Tatkal</option> </select> </div> </div> <p class="form-section" id = 'tatkalid'>Additional 3500 Rupees will be charged Under Tatkal quota. If Payment Status is Successful, Degree Certificate will be printed after 48 hrs (on Government working days) and Subject to the condition of availability of concerned records and Higher Authorities. University is not responsible in delay due to any technical reasons and hence in this case Tatkal amount will not be refunded.</p> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Register no. <span style='color:red;'>*</span></label> <div class="col-md-3"> <input type="text" name="registerno" id="T1" class="form-control" style="text-transform: uppercase;min-width:150px;" title='University Register no.' maxlength=10 onblur='CMS.Getstudentdetails(event,this.value)' > </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Candidate name</label> <div class="col-md-7"> <input type="text" name="candidate_name" id="T2" class="form-control" disabled maxlength=100 > </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >College</label> <div class="col-md-7"> <input type="text" name="college" id="T3" class="form-control" disabled maxlength=100 > </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Degree</label> <div class="col-md-7"> <input type="text" name="degree" id="T4" class="form-control" disabled maxlength=100 > </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Category</label> <div class="col-md-3"> <select class="form-control" id='T16' style='min-width:150px;' onchange='CMS.loadcnvcategoryfee(this.value)' title='Category'> <option value='00'>Select Category</option> <option value='SCST'>SC / ST</option> <option value='OTHERS'>OTHERS</option> </select> </div> </div> <!-- MY TASK BEGIN CONDENSED TABLE PORTLET--> <div class="span11" id='disp_scstatt' style='display:none;'><div class="portlet box blue"> <div class="portlet-title"> <i class="fa fa-cogs"></i> Upload Category Certificate </div> <div class="portlet-body"> <div class="scroller" data-height="380px"> <table id="upload_table" class="table table-bordered table-hover" cellpadding="0" cellspacing="0"> <thead> <tr> <th>#</th> <th><i class="icon-briefcase"></i> Document Type</th> <th>File </th> <th>Attachment</th> </tr> </thead> <tbody> <tr> <td style="width:30px">1</td> <td id="doc_upload_'.$int_code.'" style="width:300px">Category Certificate</td> <td style="width:300px"><div style="float:left;"><input type='hidden' id='categoryattpath' /><input type="file" name='categoryatt' id='categoryatt' /></div><div style="float:left;"><a class="btn btn-sm blue" href="#" onclick=CMS.UploadEmployeeDocuments('categoryatt')><i class="fa fa-upload"></i> Upload</a></div></td> <td style="width:100px" id="attach_td_cat"> </td> </tr> </tbody> </table> </div> </div> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" for="p_dob">D.O.B. <span style='color:red;'>*</span></label> <div class="col-md-3"> <div class="input-icon"> <i class="fa fa-calendar"></i> <input type="text" placeholder="Date of Birth" style='min-width:150px;' id="T14" title='Date of Birth' class="form-control"> </div> <div class="help-block"> (in dd/mm/yyyy format) </div> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Mobile no. <span style='color:red;'>*</span></label> <div class="col-md-3"> <input type="text" name="mobile no" id="T5" class="form-control" style='min-width:150px;' title='Mobile no.' onkeypress="return acceptNumbersOnlyForModule(event);" maxlength=10> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Confirm Mobile no. <span style='color:red;'>*</span></label> <div class="col-md-3"> <input type="text" name="confirm mobile" id="T6" class="form-control" style='min-width:150px;' title='Confirm Mobile no.' onkeypress="return acceptNumbersOnlyForModule(event);" maxlength=10> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Email Id. <span style='color:red;'>*</span></label> <div class="col-md-7"> <input type="text" name="email id" id="T7" class="form-control" style='min-width:150px;' style="text-transform: lowercase;" title='Email id.' maxlength=50> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Postal Address <span style='color:red;'>*</span></label> <div class="col-md-7"> <input type="text" name="address" id="T8" class="form-control" maxlength=50 title='Postal Address'><br> <input type="text" name="address" id="T9" class="form-control" style='margin-top:-18px;' maxlength=50><br> <!-- <input type="text" name="address" id="T10" class="form-control" style='margin-top:-18px;display:none;' maxlength=50><br> <input type="text" name="address" id="T11" class="form-control" style='margin-top:-18px;display:none;' maxlength=50><br> --> </div> </div> <div class="form-group" style='margin-top:-50px;'> <label class="col-md-3 control-label" style="text-align:left" >City<span style='color:red;'>*</span></label> <div class="col-md-7"> <input type="text" name="" id="T31" class="form-control" > <!--<select class="form-control" id='T15'></select> --> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >State<span style='color:red;'>*</span></label> <div class="col-md-7"> <input type="text" name="" id="T32" class="form-control" > <!--<select class="form-control" id='T15'></select> --> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Pincode<span style='color:red;'>*</span></label> <div class="col-md-7"> <input type="text" name="" id="T33" class="form-control" > <!--<select class="form-control" id='T15'></select> --> </div> </div> <p class="form-section">(Please ensure your correct postal address)</p> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Convocation<span style='color:red;'>*</span></label> <div class="col-md-7"> <input type="text" name="" id="T15" class="form-control" disabled > <!--<select class="form-control" id='T15'></select> --> </div> </div> <div class="form-group" style = "display:none"> <label class="col-md-4 control-label" style="text-align:left" >Need Certificate into home address by post ?<span style='color:red;'></span></label> <div class="col-md-3"> <input type = 'checkbox' id = 'T23' disabled checked onchange='CMS.loadpostofficeamount()' title='Receive Certificate' value = 'Post'> <!-- <select class="form-control" id='T23' style='min-width:150px;' title='Receive Certificate' onchange='CMS.loadpostofficeamount()'> <option value = 'center'>In Center</option> <option value = 'post'>By Post</option> </select>--> </div> </div> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Amount<span style='color:red;'>*</span></label> <div class="col-md-3"> <input type='hidden' value='' id='TH1' /> <input type="text" name="" value='0' id="T12" style='min-width:150px;' class="form-control" disabled maxlength=10> </div> </div> <p class="form-section">(Includes Additional 150 Rupees charged for home delivery)</p> <div class="form-group"> <label class="col-md-3 control-label" style="text-align:left" >Payment Type<span style='color:red;'>*</span></label> <div class="col-md-4"> <select class="form-control" id='T13' style='min-width:200px;' ></select> </div> </div> </div> </div> <div class="col-md-3"> <div class="form-group"> <img id='student_entry_photo' style="width:148px;z-index:1;height:187px; width:148px" onchange="DiaplayUserSelectedPhoto()" src="img/default_photo.jpg" class="img-responsive" > </div> <div class="form-group"> <label class="control-label" style="margin:0">Choose a file to upload <b>(Selfie Image Will Be Rejected)</b> <span style='color:red;'>*</span></label> <input type="file" name="student_entry_upload" id="student_entry_upload" onchange='DisplayUserSelectedPhoto();' style="padding:0;width:200px;" class="form-control"> </div> </div> </form> </div> <div class="form-body"> <div class="row"> <h3 class="form-section">Declaration</h3> <div class="col-md-12"> <div class="form-group"> <p>I HEREBY SOLEMNLY DECLARE AND PROMISE THAT IF ADMITTED TO THE DEGREE FOR WHICH I HAVE BEEN RECOMMENDED, I SHALL IN MY DAILY LIFE AND CONVERSATION, CONDUCT MYSELF, AS BEFITS A MEMBER OF THIS UNIVERSITY THAT I SHALL TO THE UTMOST OF MY CAPACITY AND OPPORTUNITY, SUPPORT THE CAUSE OF MORALITY AND SOUND LEARNING, AND THAT, AS FAR AS IN ME LIES, I SHALL UPHELD AND ADVANCE THE SOCIAL ORDER AND THE WELL BEING OF MY FELLOWMEN IN THE CASE OF PROFESSIONAL DEGREE, THE FOLLOWING SHALL BE ADDED TO THE ABOVE DECLARATION. I SHALL FAITHFULLY AND CAREFULLY FULFIL THE DUTIES OF THE PROFESSION TO WHICH I MAY BE ADMITTED BY VIRTUE OF MY DEGREE, THAT I SHALL ON ALL OCCASIONS MAINTAIN ITS PURITY AND REPUTATION AND I SHALL NEVER DEVIATE FROM THE STRAIGHT PATH OF THEIR HONOURABLE EXCERCISE BY MAKING MY KNOWLEDGE SUBSERVIENT TO UNWORTHY ENDS.</p> <div class="col-md-12"> <div class="col-md-offset-10 col-md-9" style="padding-left:50px;"> I agree to the Terms <input type = "checkbox" id = "student_declr" /> </div> </div> <br><br> <!-- <p style='text-align:center;'>Please enter the letters displayed in the image below. If the image is not clear, click on "Can't read the text? Get a new image"</p> <php @session_start(); $_SESSION = array(); $main_src ="captcha/simple-php-captcha.php"; include($main_src); $_SESSION['captcha'] = simple_php_captcha(); ?> <php echo '<img src="' . $_SESSION['captcha']['image_src'] . '" alt="CAPTCHA code">'; ?> </div> </div> </div> <div class="row"> <div class="col-md-2"> <div class="form-group"> <input type="text" id='passing_year' placeholder="enter letters displayed above" class="form-control"> </div> </div> </div> --> </div> </div> <div class="form-actions fluid"> <div class="row"> <div class="col-md-12"> <div class="col-md-offset-10 col-md-9" > <button class="btn purple" onclick='CMS.SendMailOtPToUser();' type="button"><i class="fa fa-check"></i> Submit</button> <button class="btn red" onclick='home();' type="button" ><i class="fa fa-times">Cancel</i></button> </div> </div> </div> </div> </div> </div> <!-- END Row-->
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