No Description Available
Register Now Form
1058 06 October 2019
Abhishek Singh
~ onex0
This kind of registration and appointment booking form can be used on many places like on slider,banner and section.
No Description Available
0
This kind of registration and appointment booking form can be used on many places like on slider,banner and section.
//alert('welcome')
<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 & 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 & Communication Engineering">Electronics & 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>