348 lines
10 KiB
HTML
348 lines
10 KiB
HTML
<table style="width:1000px; margin-left:auto;margin-right:auto; margin-bottom:5px;" cellpadding="0" cellspacing="0">
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<!--<tr><td colspan="12" >
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<div style="width:100%; margin-left:auto; margin-right:auto; ">
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<img style="width:100%; height:240px;" src="./hdrc.png" >
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</div></td></tr>
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-->
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<script>
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function appsub(x) {
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document.getElementById("applying_saub").value = x;
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}
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</script>
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<tr><td colspan="12" ALIGN=MIDDLE style="color:grey;font-size:30px;">
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PG Admission For the Session 2019-20
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</td></tr>
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</table>
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<div id="BDy" style="background-color:#D3E3F6; width:860px; margin: 0 auto; padding:20px;">
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<style>#tt > td{
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width:200px;
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}
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.dd2{
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width:120px;
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}
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.ip1{
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text-align:center;width:50px;padding:3px;border-radius:3px;
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}
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.F_txt{
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width:100%;padding:6px;border-radius:3px;font-size:1.2em;font-weight:bold;color:rgb(89, 85, 85);
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}
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.F{
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padding:3px;border-radius:3px; font-weight:bold;color:rgb(89, 85, 85);
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}
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</style>
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<form id="sree" method="post" action="" enctype="multipart/form-data">
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<input type="hidden" name="AdmF" value="Sub">
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<input type="hidden" name="S_ID" value="NA">
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<fieldset><legend>Personal Information</legend>
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<table ALIGN=LEFT style="width:100%;">
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<tr>
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<td>NAME:</td>
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<td > <input class="F_txt" type="text" name="S_NAME" required style="text-transform:uppercase; "> </td>
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</tr>
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<tr>
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<td>Mobile:</td>
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<td ><input class="F_txt" type="tel" maxlength="10" name="PHONE" required ></td>
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</tr>
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<tr>
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<td>E-mail :</td>
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<td > <input class="F_txt" type="email" name="E_MAIL" required style="text-transform:lowercase;" > </td>
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</tr>
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<tr>
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<td>FATHER :</td>
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<td ><input class="F_txt" style="text-transform:uppercase;" type="text" name="FATHER" required ></td>
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</tr>
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<tr>
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<td>GUARDIAN :</td>
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<td ><input class="F_txt" style="text-transform:uppercase;" type="text" name="GUARDIAN" required ></td>
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</tr>
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<tr>
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<td>ADDRESS :</td>
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<td><textarea class="F_txt" name="ADDRESS" style=" height:100px;" required>
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Vill=
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P.S.=
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Dist=
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PIN=
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</textarea></td>
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</tr>
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<tr>
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<td>DATE OF BIRTH :</td>
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<td>
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<table><tr><td><div> DATE </div> <select name="DOBD" style="width:60px;" class="inpt_01">
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<option value="01">01</option>
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<option value="02">02</option>
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<option value="03">03</option>
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<option value="04">04</option>
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<option value="05">05</option>
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<option value="06">06</option>
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<option value="07">07</option>
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<option value="08">08</option>
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<option value="09">09</option>
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<option value="10">10</option>
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<option value="11">11</option>
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<option value="12">12</option>
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<option value="13">13</option>
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<option value="14">14</option>
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<option value="15">15</option>
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<option value="16">16</option>
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<option value="17">17</option>
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<option value="18">18</option>
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<option value="19">19</option>
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<option value="20">20</option>
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<option value="21">21</option>
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<option value="22">22</option>
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<option value="23">23</option>
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<option value="24">24</option>
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<option value="25">25</option>
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<option value="26">26</option>
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<option value="27">27</option>
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<option value="28">28</option>
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<option value="29">29</option>
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<option value="30">30</option>
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<option value="31">31</option>
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</select></td>
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<td><div> MONTH </div> <select name="DOBM" style="width:60px;" class="inpt_01">
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<option value="01">01</option>
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<option value="02">02</option>
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<option value="03">03</option>
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<option value="04">04</option>
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<option value="05">05</option>
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<option value="06">06</option>
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<option value="07">07</option>
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<option value="08">08</option>
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<option value="09">09</option>
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<option value="10">10</option>
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<option value="11">11</option>
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<option value="12">12</option>
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</select></td>
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<td><div> YEAR </div>
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<select name="DOBY" style="width:100px;" class="inpt_01">
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<option value="2004">2004</option>
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<option value="2003">2003</option>
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<option value="2002">2002</option>
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<option value="2001">2001</option>
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<option value="2000">2000</option>
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<option value="1999">1999</option>
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<option value="1998">1998</option>
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<option value="1997">1997</option>
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<option value="1996">1996</option>
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<option value="1995">1995</option>
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<option value="1994">1994</option>
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<option value="1993">1993</option>
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<option value="1992">1992</option>
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<option value="1991">1991</option>
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<option value="1990">1990</option>
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<option value="1989">1989</option>
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<option value="1988">1988</option>
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<option value="1987">1987</option>
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<option value="1986">1986</option>
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<option value="1985">1985</option>
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<option value="1984">1984</option>
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<option value="1983">1983</option>
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<option value="1982">1982</option>
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<option value="1981">1981</option>
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<option value="1980">1980</option>
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</select></td></tr></table>
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</td>
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</tr>
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</table>
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<br>
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<table ALIGN=MIDDLE style="padding:19px;width:100%;">
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<tr><td>
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Gender :
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<select name="GENDER" class="F">
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<option value="Male">Male</option>
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<option value="Female">Female</option>
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<option value="Trans">Trans</option>
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</select>
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</td>
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<td>
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Religion :
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<select name="RELIGION" class="F">
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<option value="HINDU">HINDU</option>
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<option value="MUSLIM">MUSLIM</option>
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<option value="CHRISTIAN">CHRISTIAN</option>
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<option value="JAIN">JAIN</option>
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<option value="SIKH">SIKH</option>
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<option value="BUDDHIST">BUDDHIST</option>
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<option value="OTHERS">OTHERS</option></select>
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</td>
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<td>
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Caste :
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<select name="CASTE" class="F">
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<option value="GENL">GENERAL</option> <option value="SC">SC</option>
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<option value="OBC-A">OBC-A</option> <option value="OBC-B">OBC-B</option>
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<option value="ST">ST</option></select>
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</td>
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</tr>
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<tr><td>Disability
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<select name="PH" class="F">
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<option value="NO">No</option>
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<option value="PH_10">PH upto 10% </option>
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<option value="PH_20">PH upto 20% </option>
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<option value="PH_30">PH upto 30% </option>
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<option value="PH_40">PH upto 40% </option>
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<option value="PH_50">PH upto 50% </option>
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<option value="PH_60">PH upto 60% </option> </select>
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</td>
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<td>Blood Group :
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<select name="B_GROUP" class="F">
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<option value="A+"> A+ </option>
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<option value="A-"> A- </option>
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<option value="B+"> B+ </option>
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<option value="B-"> B- </option>
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<option value="AB+"> AB+ </option>
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<option value="AB-"> AB- </option>
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<option value="O+"> O+ </option>
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<option value="O-"> O- </option></select></td>
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</tr>
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</table>
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Whether Donated Blood :
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<input type="radio" name="B_DONATE" value="Yes">YES
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<input type="radio" name="B_DONATE" value="NO">NO
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<br><br>
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</fieldset>
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<fieldset><legend>Educational Information</legend>
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<table>
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<tr>
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<td>University :</td>
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<td><select name="UNIVERSITY" class="F">
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<option value="West Bengal State University">West Bengal State University</option>
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<option value="Vidya Sagar University">Vidya Sagar University</option>
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<option value="Rabindra Bharati University">Rabindra Bharati University</option>
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<option value="Presidency University">Presidency University</option>
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<option value="North Benagal University">North Benagal University</option>
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<option value="Netaji Shubhash Open University">Netaji Shubhash Open University</option>
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<option value="Kalyani University">Kalyani University</option>
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<option value="Jadavpur University">Jadavpur University</option>
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<option value="Diamond Harbour Women s University">Diamond Harbour Women s University</option>
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<option value="Calcutta University">Calcutta University</option>
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<option value="Aliah University">Aliah University</option>
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<option value="Others">Others</option>
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</select></td>
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</tr>
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<tr>
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<td>College NAME :</td>
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<td><input type="text" style="text-transform:uppercase;width:300px; " class="F" name="COLLEGE" required></td>
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</tr>
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<tr>
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<td> YEAR OF PASSING :</td>
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<td><select name="YOP" onchange="yop(this.value)" class="F">
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<option value="2017">2017</option>
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<option value="2016">2016</option>
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<option value="2015">2015</option>
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<option value="2014">2014</option>
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<option value="2013">2013</option>
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</select></td>
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</tr>
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</table>
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<table id="tt" style="margin-left:10px;padding:10px;">
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<tr >
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<td></td>
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<td>Subject Name</td>
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<td >Full Marks</td>
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<td>Pass Marks</td>
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<td>Marks Obtained</td>
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</tr>
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<tr>
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<td> Hons :</td>
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<td class="dd2"><select name="H_NM" style="width:90px;" onchange="appsub(this.value)" > <option value=""> Select </option> <option value="Bengali">Bengali</option><option value="Chemistry">Chemistry</option> </select></td>
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<td class="dd2"><input type="tel" class="ip1" name="H_FM" id="t1" maxlength="3" required></td>
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<td class="dd2"><input type="tel" class="ip1" name="H_PM" id="t2" maxlength="3" required></td>
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<td class="dd2"><input type="tel" class="ip1" name="H_MO" id="t3" maxlength="3" required></td>
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</tr>
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<tr>
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<td> GEN 1 :</td>
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<td><input type="TEXT" style="width:90px;" class="ip1" id="p1" name="G1_NM" maxlength="3" required></td>
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<td><input type="tel" class="ip1" id="p1" name="G1_FM" maxlength="3" required></td>
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<td><input type="tel" class="ip1" id="p2" name="G1_PM" maxlength="3" required></td>
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<td><input type="tel" class="ip1" id="p3" name="G1_MO" maxlength="3" required></td>
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</tr>
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<tr>
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<td>Gen 2 :</td>
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<td><input type="TEXT" style="width:90px;" class="ip1" name="G2_NM" maxlength="3" onchange="passd(this.value)" required></td>
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<td><input type="tel" class="ip1" name="G2_FM" maxlength="3" onchange="passd(this.value)" required></td>
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<td><input type="tel" class="ip1" name="G2_PM" maxlength="3" onchange="passd(this.value)" required></td>
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<td><input type="tel" class="ip1" name="G2_MO" maxlength="3" onchange="pass(this.value)" required></td>
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</tr>
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</table>
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* Percentage will be calculated by the system !
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</fieldset><br><br>
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<br><br>
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<div style="float:left;" >Applying For <input type="text" id="applying_saub" required disabled style="font-size:1.3em; "> </div>
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<br><br><br>
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<fieldset id="dd"><legend>File Upload... </legend> <!-- File Upload... -->
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<div> SELECT YOUR IMAGE TO UPLOAD </div> <input type="file" name="Photo" required >
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<div> SELECT YOUR SIGNATURE TO UPLOAD </div> <input type="file" name="sign" required >
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<div> SELECT YOUR Part III marksheet </div> <input type="file" name="mark" required >
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</fieldset>
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<br>
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<center> <input type="submit" style="width:250px; height:30px;" value="Submit" > </center>
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</form>
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<br><br><br>
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</div>
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