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register_eb.html
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register_eb.html
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<!DOCTYPE html>
<html lang="en">
<head>
<title>Register</title>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="icon" type="image/icon" href="images/logo_white.png">
<link href="fonts/mdi-font/css/material-design-iconic-font.min.css" rel="stylesheet" media="all">
<link rel="stylesheet" type="text/css" href="css/bootstrap1.min.css">
<link rel="stylesheet" type="text/css" href="css/select2.min.css">
<link rel="stylesheet" type="text/css" href="css/util.css">
<link rel="stylesheet" type="text/css" href="css/main.css">
<link rel="stylesheet" type="text/css" href="css/daterangepicker.css">
</head>
<body style="background-color: #212d74">
<div class="bg-contact2">
<div class="container-contact2">
<div class="wrap-contact2">
<form class="contact2-form validate-form">
<span class="contact2-form-title">
Register as EB
</span>
<div class="form-row no-gutters">
<div class="form-group col-md-4">
<div class="wrap-input2 validate-input " data-validate="Name is required" style="">
<input class="input2" type="text" name="name">
<span class="focus-input2" data-placeholder="First Name"></span>
</div>
</div>
<div class="form-group col-md-4">
<div class="wrap-input2" style="">
<input class="input2" type="text" name="name">
<span class="focus-input2" data-placeholder="Middle Name"></span>
</div>
</div>
<div class="form-group col-md-4">
<div class=" wrap-input2 validate-input " data-validate="Name is required" style="">
<input class="input2" type="text" name="name">
<span class="focus-input2" data-placeholder="Last Name"></span>
</div>
</div>
</div>
<div class="wrap-input2 validate-input" data-validate="Gender is Required">
<div class="input-group">
<div class="rs-select2 js-select-simple select--no-search input-2">
<select name="gender" style="width:100%">
<option disabled="disabled" selected="selected">Gender</option>
<option>Male</option>
<option>Female</option>
<option>Other</option>
</select>
<div class="select-dropdown"></div>
</div>
</div>
</div>
<div class="wrap-input2 validate-input dob" data-validate="Birth Date is Required" data-provide="datepicker">
<div class="input-group">
<input class="input--style-1 js-datepicker input-2" type="text" name="birthday"placeholder="date of birth" style="width:100%;background:transparent;color:#000">
<i class="zmdi zmdi-calendar-note input-icon js-btn-calendar"></i>
</div>
</div>
<div class="wrap-input2 validate-input" data-validate = "Valid email is required: ex@abc.xyz">
<input class="input2" type="text" name="email">
<span class="focus-input2" data-placeholder="EMAIL"></span>
</div>
<div class="wrap-input2 validate-input" data-validate = "Phone Number Required">
<input class="input2" type="text" name="contact">
<span class="focus-input2" data-placeholder="Contact Number"></span>
</div>
<h2 style="margin:20px 0px">Address</h2>
<div class="wrap-input2 validate-input" data-validate = "Address is required">
<input class="input2" type="text" name="Address1">
<span class="focus-input2" data-placeholder="Address Line 1"></span>
</div>
<div class="wrap-input2 validate-input" data-validate = "Address is required">
<input class="input2" type="text" name="Address1">
<span class="focus-input2" data-placeholder="Address Line 2"></span>
</div>
<div class="form-row">
<div class="form-group col-md-4">
<div class="wrap-input2 validate-input " data-validate="State is required" style="">
<input class="input2" type="text" name="State">
<span class="focus-input2" data-placeholder="State"></span>
</div>
</div>
<div class="form-group col-md-4">
<div class="wrap-input2" style="">
<input class="input2" type="text" name="City">
<span class="focus-input2" data-placeholder="City"></span>
</div>
</div>
<div class="form-group col-md-4">
<div class=" wrap-input2 validate-input " data-validate="Pincode is required" style="">
<input class="input2" type="text" name="pincode">
<span class="focus-input2" data-placeholder="Pincode"></span>
</div>
</div>
</div>
<h2 style="margin:20px 0px">Educational Details</h2>
<div class=" wrap-input2 validate-input " data-validate="Required" style="">
<input class="input2" type="text" name="College">
<span class="focus-input2" data-placeholder="Institue Name"></span>
</div>
<div class="form-row">
<div class="form-group col-sm-6">
<div class=" wrap-input2 validate-input " data-validate="Required" style="">
<input class="input2" type="text" name="Course">
<span class="focus-input2" data-placeholder="Course Name"></span>
</div>
</div>
<div class="form-group col-sm-6">
<div class=" wrap-input2 validate-input " data-validate="Required" style="">
<input class="input2" type="text" name="Semester">
<span class="focus-input2" data-placeholder="Semester"></span>
</div>
</div>
</div>
<div class=" wrap-input2 validate-input " data-validate="Required" style="">
<label style="font-size:16px">Upload your Resume</label>
<input class="input2 filec" type="file" name="Semester" value="Upload your Resume" accept=".pdf"placeholder="Resume" style="background:transparent;border:none;">
<span class="focus-input2" data-placeholder=""></span>
</div>
<h2 style="margin:20px 0px">NITS MUN</h2>
<div class="form-row">
<div class="col-6">
<div class="wrap-input2 validate-input" data-validate="position is Required">
<div class="input-group">
<div class="rs-select2 js-select-simple select--no-search input-2">
<select name="position" style="width:100%">
<option disabled="disabled" selected="selected">Position</option>
<option>Chair</option>
<option>Vice Chair</option>
</select>
<div class="select-dropdown"></div>
</div>
</div>
</div>
</div>
<div class="col-6">
<div class="wrap-input2 validate-input" data-validate="Committee is Required">
<div class="input-group">
<div class="rs-select2 js-select-simple select--no-search input-2">
<select name="committee" style="width:100%">
<option disabled="disabled" selected="selected">Committee</option>
<option>1st committe</option>
<option>Female</option>
<option>Other</option>
</select>
<div class="select-dropdown"></div>
</div>
</div>
</div>
</div></div>
<div class="container-contact2-form-btn" style="margin-top:30px">
<div class="wrap-contact2-form-btn">
<div class="contact2-form-bgbtn"></div>
<button class="contact2-form-btn">
Register
</button>
</div>
</div>
</form>
</div>
</div>
</div>
<script src="js/register.js"></script>
<script src="js/jquery-3.3.1.min.js"></script>
<script src="js/bootstrap.js"></script>
<script src="js/select2.min.js"></script>
<script src="js/moment.min.js"></script>
<script src="js/daterangepicker.js"></script>
<script src="js/global.js"></script>
<script async src="https://www.googletagmanager.com/gtag/js?id=UA-23581568-13"></script>
<script>
window.dataLayer = window.dataLayer || [];
function gtag(){dataLayer.push(arguments);}
gtag('js', new Date());
gtag('config', 'UA-23581568-13');
</script>
</script>
</body>
</html>