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Register Now Form

1249 06 October 2019
No Description Available
Abhishek Singh

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This kind of registration and appointment booking form can be used on many places like on slider,banner and section.
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FORM VALIDATIONS
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<section class="sliderbox" id="menu-homepage">
   <div class="container">
      <div class="row">
         <!-- slider -->
         <div class="col-sm-8 offset-sm-2">
            <div class="banner-content">
               <div class="text-center">
                  <h1><span>Insititute with</span> Best Placements</h1>
                  
                  <h4>Achieving the milestone in 5 years since Inception</h4>
               </div>
               <div class="fasttrackRegistrationForm">
                  <h2>Register Now!</h2>
                  <h5>Apply Today &amp; Be a Part of University with Best Placements</h5>
                  <div>
                     <form method="post" action="./mail/mailer.php">
                        <div class="row">
                           <div class="col-xs-12 col-sm-6">
                              <div class="fieldset">
                                 <input name="name" type="text" required="" id="txtName" placeholder="ENTER FULL NAME">
                                 <span id="RequiredFieldValidatorName" class="required" style="visibility:hidden;">*</span>
                              </div>
                           </div>
                           <div class="col-xs-12 col-sm-6">
                              <div class="fieldset">
                                 <input name="email" type="email" required="" placeholder="ENTER EMAIL ID">
                              </div>
                           </div>
                           <div class="col-xs-12 col-sm-6 mobileCity">
                              <div class="fieldset">
                                 <input name="phone" type="tel" maxlength="10" required="" pattern="[0-9]{10}" title="Enter 10 digits mobile number" placeholder="ENTER MOBILE">
                              </div>
                              <div class="fieldset">                                            
                                 <input type="text" name="city" required="" Placeholder="City">                                            
                              </div>
                           </div>
                           <div class="col-xs-12 col-sm-6 dobFrom">
                              <div class="clearfix">
                                 <div class="fieldset">
                                    <select name="day" required="">
                                       <option value="">DD</option>
                                       <option value="01">1</option>
                                       <option value="02">2</option>
                                       <option value="03">3</option>
                                       <option value="04">4</option>
                                       <option value="05">5</option>
                                       <option value="06">6</option>
                                       <option value="07">7</option>
                                       <option value="08">8</option>
                                       <option value="09">9</option>
                                       <option value="10">10</option>
                                       <option value="11">11</option>
                                       <option value="12">12</option>
                                       <option value="13">13</option>
                                       <option value="14">14</option>
                                       <option value="15">15</option>
                                       <option value="16">16</option>
                                       <option value="17">17</option>
                                       <option value="18">18</option>
                                       <option value="19">19</option>
                                       <option value="20">20</option>
                                       <option value="21">21</option>
                                       <option value="22">22</option>
                                       <option value="23">23</option>
                                       <option value="24">24</option>
                                       <option value="25">25</option>
                                       <option value="26">26</option>
                                       <option value="27">27</option>
                                       <option value="28">28</option>
                                       <option value="29">29</option>
                                       <option value="30">30</option>
                                       <option value="31">31</option>
                                    </select>
                                 </div>
                                 <div class="fieldset">
                                    <select name="month" required="">
                                       <option value="">MM</option>
                                       <option value="01">JANUARY</option>
                                       <option value="02">FEBRUARY</option>
                                       <option value="03">MARCH</option>
                                       <option value="04">APRIL</option>
                                       <option value="05">MAY</option>
                                       <option value="06">JUNE</option>
                                       <option value="07">JULY</option>
                                       <option value="08">AUGUST</option>
                                       <option value="09">SEPTEMBER</option>
                                       <option value="10">OCTOBER</option>
                                       <option value="11">NOVEMBER</option>
                                       <option value="12">DECEMBER</option>
                                    </select>
                                 </div>
                                 <div class="fieldset">
                                    <select name="year" required="">
                                       <option value="">YYYY</option>
                                       <option value="1980">1980</option>
                                       <option value="1981">1981</option>
                                       <option value="1982">1982</option>
                                       <option value="1983">1983</option>
                                       <option value="1984">1984</option>
                                       <option value="1985">1985</option>
                                       <option value="1986">1986</option>
                                       <option value="1987">1987</option>
                                       <option value="1988">1988</option>
                                       <option value="1989">1989</option>
                                       <option value="1990">1990</option>
                                       <option value="1991">1991</option>
                                       <option value="1992">1992</option>
                                       <option value="1993">1993</option>
                                       <option value="1994">1994</option>
                                       <option value="1995">1995</option>
                                       <option value="1996">1996</option>
                                       <option value="1997">1997</option>
                                       <option value="1998">1998</option>
                                       <option value="1999">1999</option>
                                       <option value="2000">2000</option>
                                       <option value="2001">2001</option>
                                       <option value="2002">2002</option>
                                       <option value="2003">2003</option>
                                       <option value="2004">2004</option>
                                       <option value="2005">2005</option>
                                       <option value="2006">2006</option>
                                       <option value="2007">2007</option>
                                       <option value="2008">2008</option>
                                       <option value="2009">2009</option>
                                       <option value="2010">2010</option>
                                       <option value="2011">2011</option>
                                       <option value="2012">2012</option>
                                       <option value="2013">2013</option>
                                       <option value="2014">2014</option>
                                       <option value="2015">2015</option>
                                       <option value="2016">2016</option>
                                       <option value="2017">2017</option>
                                       <option value="2018">2018</option>
                                       <option value="2019">2019</option>
                                       <option value="2020">2020</option>
                                       <option value="2021">2021</option>
                                       <option value="2022">2022</option>
                                       <option value="2023">2023</option>
                                       <option value="2024">2024</option>
                                       <option value="2025">2025</option>
                                       <option value="2026">2026</option>
                                       <option value="2027">2027</option>
                                       <option value="2028">2028</option>
                                       <option value="2029">2029</option>
                                       <option value="2030">2030</option>
                                    </select>
                                 </div>
                              </div>
                           </div>
                           <div class="col-xs-12">
                              <div class="fieldset">
                                 <select name="course" required="">
                                    <option value="">SELECT COURSE</option>
                                    <option value="Computer Science Engineering">Computer Science Engineering</option>
                                    <option value="Electronics &amp; Communication Engineering">Electronics &amp; Communication Engineerings</option>
                                    <option value="Civil Engineering">Civil Engineering</option>
                                    <option value="Mechanical Engineering">Mechanical Engineering</option>
                                    <option value="Electrical Engineering">Electrical Engineering</option>
                                    <option value="M.Tech (Computer Science)">M.Tech (Computer Science)</option>
                                    <option value="BBA">BBA</option>
                                    <option value="BCA">BCA</option>
                                 </select>
                              </div>
                           </div>
                           <div class="col-xs-12">
                       
                              <div class="fieldset">
                                 <input type="submit" name="register" value="Apply Now">
                                 <div id="ValidationSummary2" style="display:none;">
                                 </div>
                              </div>
                       
                           </div>
                        </div>
                     </form>
                  </div>
               </div>
               
            </div>
         </div>
      </div>
   </div>
</section>
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Register Now Form

Abhishek Singh

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