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Code Editor : appForm.html
<div class="row" id="appForm"> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <div class="card"> <div class="header"> <h2> Application Form </h2> </div> <div class="body"> <div class="form-horizontal"> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Application Number">Register Number</label> </div> <div class="col-sm-4 col-md-2"> <div class="form-group"> <div class="form-line"> <input type="text" title="Reg. No." class="form-control" id="regno" maxlength= "10" placeholder="Register no." onblur="Getstudentdetails(event,this.value)"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Register Number">Candidate Name</label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" title="Candidate Name" class="form-control" id="formcandname" value="" disabled> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="college">College </label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" title="College" class="form-control" id="formcollege" disabled> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" title="Degree" for="Degree">Degree </label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" class="form-control" id="formdegree" disabled> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Category">Category </label> </div> <div class="col-sm-4 col-md-2"> <select id="formcategory" title="Category" class="form-control show-tick" style="margin-left: -15px"> </select> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Application For">Application For</label> </div> <div class="col-sm-2 col-md-4"> <select id="S2" title="service" class="form-control show-tick" style="margin-left: -15px" onchange="loadserviceslist(this.value)"> </select> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-8 col-md-8 col-sm-4 col-xs-5"> <fieldset class="scheduler-border"> <legend class="scheduler-border">Documents to be Submitted</legend> <div class="control-group"> <span id='T27'></span> </div> </fieldset> </div> </div> <div class="row clearfix" id = 'agencies' style = 'display:none;'> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Application For">Select Agencies</label> </div> <div class="col-sm-2 col-md-4"> <select class="form-control show-tick" onchange = 'getserviceagenciesfee($("#S2").val())' id="S8" title = "Select Agencies" style="margin-left: -15px"> <option value = ''>Select Agencies</option> <option>Government department / Agencies</option> <option>Foreign Agencies</option> </select> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-8 col-md-8 col-sm-4 col-xs-5"> <div id="cont_serviceslist"></div> </div> </div> <div class="row clearfix" id = 'transcript'> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="amount">Additional No. of transcript</label> </div> <div class="col-sm-4 col-md-2"> <div class="form-group"> <div class="form-line"> <input type="text" title="amount" class="form-control" id = 'tranno' value = '0' onchange = 'updatetotalservfee()'> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="amount">Total amount </label> </div> <div class="col-sm-4 col-md-2"> <div class="form-group"> <div class="form-line"> <input type="text" title="amount" class="form-control" id="amount" disabled> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Date of Birth "> Date of Birth</label> </div> <div class="col-sm-4 col-md-2 daterange"> <div class="form-group"> <div class="form-line"> <input type="text" title="Date of Birth" class="form-control date" id="formmdob" placeholder="dd/mm/yyyy"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Postal Address">Postal Address </label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group p-b-5"> <div class="form-line"> <input type="text" title="Address1" class="form-control" id="postal1"> </div> </div> <div class="form-group p-b-5"> <div class="form-line"> <input type="text" title="Address2" class="form-control" id="postal2"> </div> </div> <div class="form-group p-b-5"> <div class="form-line"> <input type="text" class="form-control" id="postal3"> </div> </div> <div class="form-group p-b-5"> <div class="form-line"> <input type="text" class="form-control" id="postal4"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Mobile No."> Mobile No.<span style='color:red;'>*</span></label> </div> <div class="col-sm-4 col-md-2"> <div class="form-group"> <div class="form-line"> <input type="text" title="Mobile No." maxlength="10" class="form-control" id="mobile" onkeypress="return acceptNumbersOnlyForModule(event);" placeholder="Mobile No."> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Email Id"> Email Id<span style='color:red;'>*</span></label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="email" title="email" class="form-control" id="email" placeholder="example@company.com"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="City"> City<span style='color:red;'>*</span></label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" title="City" class="form-control" id="city" placeholder="City"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="State"> State<span style='color:red;'>*</span></label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" title="State" class="form-control" id="state" placeholder="State"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Country"> Country<span style='color:red;'>*</span></label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" title="Country" class="form-control" id="country" placeholder="Country"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Pincode"> Pincode<span style='color:red;'>*</span></label> </div> <div class="col-sm-4 col-md-4"> <div class="form-group"> <div class="form-line"> <input type="text" title="Pincode" maxlength="6" class="form-control" id="pincode" onkeypress="return acceptNumbersOnlyForModule(event);" placeholder="Pincode"> </div> </div> </div> </div> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <label class="pull-left" for="Application For">Payment Mode <span style='color:red;'>*</span></label> </div> <div class="col-sm-2 col-md-4"> <select id="S3" title="Payment Mode" class="form-control show-tick" style="margin-left: -15px"> </select> </div> </div> <div class="row clearfix p-t-20"> <div class="col-lg-offset-7 col-md-offset-7 col-sm-offset-4 col-xs-offset-5"> <button type="button" class="btn btn-primary waves-effect m-l--5" onclick = "SaveApplicationDetails()">Submit</button> </div> </div> </div> </div> </div> </div> </div> <div class="row" id="appConfirm"> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <div class="card"> <div class="header"> <h2> Application confirm </h2> </div> <div class="body"> <div class="form-horizontal"> <div class="row clearfix"> <div class="col-md-offset-2 col-lg-6 col-md-6 col-sm-9 col-xs-9 form-control-label"> <h3> Application Registration completed successfully.</h3> </div> </div> <div class="row clearfix"> <div class="col-md-offset-3 col-lg-4 col-md-4 col-sm-4 col-xs-5 form-control-label"> <h3> Application No. : <span id="APT1"></span></h3> </div> </div> <div class="row clearfix"> <div class="col-md-offset-4 col-lg-2 col-md-2 col-sm-4 col-xs-5 form-control-label"> <div id="payment_link"></div> </div> </div> </div> </div> </div> </div> </div> <script type="text/javascript"> $('#transcript').hide(); $('#appConfirm').addClass("hidden"); var $demoMaskedInput = $('.daterange'); //Date $demoMaskedInput.find('.date').inputmask('dd/mm/yyyy', { placeholder: '__/__/____' }); </script>
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