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200 lines (166 loc) · 7.48 KB
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<!Doctype html>
<html>
<head>
<style>
div {
border-radius: 5px;
background-color: #F8F8F8;
width: auto;
padding: 25px;
}
h1 {
font-family: 'Raleway', Helvetica, Arial, sans-serif;
font-size: 56px;
line-height: 80px;
color: grey;
text-shadow: 2px 2px 4px #000000;
}
input[type=text]
{
width:200px;
height:20px;
background:white;
}
input[type=email]
{
background:white;
}
input[type=date]
{
background:white;
}
input[type=number]
{
background:white;
}
input:focus
{
background-color:white;
}
input[type=submit]
{
width:200px;
height:50px;
background-color: #2d3d5a;
color: white;
}
input[type=reset]
{
width:200px;
height:50px;
background-color: #2d3d5a;
color: white;
}
input[type=submit]:focus
{
width:200px;
height:50px;
border:none;
background-color:#2d3d5a;
border:solid steelblue;
color:steelblue;
}
input[type=submit]:hover
{
opacity: 0.8;
}
input[type=reset]:hover
{
opacity: 0.8;
}
.header
{
background-color: #2d3d5a;
padding: 20px;
text-align: center;
}
</style>
</head>
<body>
<div class="header">
<h1 style="color:white">Student Registration</h1><br>
</div><br>
<div>
<form name="myform" action="stud1.php" method="POST">
<fieldset>
<legend><b>PERSONAL INFORMATION:</b></legend>
<br>
<label for="mis" >Registration ID<b> :  </b></label>
<input type="text" id="mis" name="mis" style="width:250px;height:25px;" placeholder="ex: I2K15101912" required><br><br>
<label for="fname" >First Name<b> :  </b></label>
<input type="text" id="fname" name="firstname" style="width:250px;height:25px;"placeholder="First Name" required>
    
<label for="lname">Last Name<b> :  </b></label>
<input type="text" id="lname" name="lastname" style="width:250px;height:25px;" placeholder="Last Name" ><br><br>
<label for="email">Email <b> :  </b></label>
<input type="email" id="mail" name="email" style="width:250px;height:25px;" placeholder="ex : abc@gmail.com" required><br><br>
<label>Date of Birth<b> : </b></label>
<!--select required-->
<input type="date" name="bday" style="width:250px;height:25px;"><br><br>
<label for="mobile">Contact Number<b> :  </b></label>
<input type="number" name="phone" value="" size="45"max="9999999999" min="1000000000" style="width:250px;height:25px;" class="wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel" aria-required="true" placeholder="Phone"><br><br>
<label for="add"> Address <b> :  </b></label>
<input type="text" name="address" style="width:500px;height: 50px;" required ><br><br>
<label for="pincode" >Pincode<b> :  </b></label>
<input type="text" name="pin" style="width:250px;height:25px;" required><br><br>
<label for="city">City<b> :  </b></label>
<input type="text" name="city"style="width:250px;height:25px;" required ><br><br>
<label for="state">State <b> :  </b> </label>
<input type="text" name="state" style="width:250px;height:25px;" required><br><br>
<p>Gender <b> :  </b></p>
<input type="radio" name="gender" value="male">MALE<br>
<input type="radio" name="gender" value="female">FEMALE<br>
<input type="radio" name="gender" value="other">OTHER<br>
</fieldset><br><br><br>
<fieldset>
<legend><b>ACADEMIC DETAILS:</b></legend>
<label>Branch<b> : </b></label>
<select required name="br" style="width:250px;height:25px;" >
<option value="select">select</option>
<option value="COMP">COMPUTER</option>
<option value="IT">INFORMATION TECHNOLOGY</option>
<option value="ENTC">ELECTRONICS AND TELECOMMUNICATION</option>
</select><br><br>
<!--label for="agg" >Aggregate<b> :  </b></label>
<input type="number" name="agg" style="width:250px;height:25px;"><br><br-->
<label for="tenth" >Percentage(Class 10th)<b> :  </b></label>
<input type="number" name="tenth" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="twelfth" >Percentage(Class 12th)<b> :  </b></label>
<input type="number" name="twelfth" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="sem1" >Percentage(SEM1)<b> :  </b></label>
<input type="number" name="sem1" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="sem2" >Percentage(SEM2)<b> :  </b></label>
<input type="number" name="sem2" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="sem3" >Percentage(SEM3)<b> :  </b></label>
<input type="number" name="sem3" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="sem4" >Percentage(SEM4)<b> :  </b></label>
<input type="number" name="sem4" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="sem5" >Percentage(SEM5)<b> :  </b></label>
<input type="number" name="sem5" style="width:250px;height:25px;" min="0" max="100"><br><br>
<label for="sem6" >Percentage(SEM6)<b> :  </b></label>
<input type="number" name="sem6" style="width:250px;height:25px;" min="0" max="100"><br><br>
<!--label for="skills">Programming Skills<b> :  </b></label>
<input type="text" name=" skills"><br><br-->
<h4>What are your fields of interest?</h4>
<p><span class="wpcf7-form-control-wrap radio-98"><span class="wpcf7-form-control wpcf7-radio"><span class="wpcf7-list-item"><label><input type="checkbox" name="preference[]" value="App Development"> <span class="wpcf7-list-item-label"><font color="#4a148c">App Development</font></span></label></span><br><span class="wpcf7-list-item"><label><input type="checkbox" name="preference[]" value="Web Development"> <span class="wpcf7-list-item-label"><font color="#4a148c">Web Development</font></span></label></span><br><span class="wpcf7-form-control wpcf7-radio"><span class="wpcf7-list-item"><label><input type="checkbox" name="preference[]" value="Data Analytics"> <span class="wpcf7-list-item-label"><font color="#4a148c">Data Analytics</font></span></label></span><br>
<span class="wpcf7-form-control wpcf7-radio"><span class="wpcf7-list-item"><label><input type="checkbox" name="preference[]" value="Database Management"> <span class="wpcf7-list-item-label"><font color="#4a148c">Database Management</font></span></label></span></span></span></p>
<h4>What are your skills?</h4>
<p><span class="wpcf7-form-control-wrap checkbox-465"><span class="wpcf7-form-control wpcf7-checkbox"><span class="wpcf7-list-item"><label><input type="checkbox" name="skills[]" value="C/C++"> <span class="wpcf7-list-item-label"><font color="#4a148c">C/C++</font></span></label></span><br><span class="wpcf7-list-item"><label><input type="checkbox" name="skills[]" value="HTML"> <span class="wpcf7-list-item-label"><font color="#4a148c">HTML</font></span></label></span><br><span class="wpcf7-list-item"><label><input type="checkbox" name="skills[]" value="CSS"> <span class="wpcf7-list-item-label"><font color="#4a148c">CSS</font></span></label></span><br><span class="wpcf7-list-item"><label><input type="checkbox" name="skills[]" value="Java Script"> <span class="wpcf7-list-item-label"><font color="#4a148c">JavaScript</font></span></label></span></span></span></p>
<br>
</fieldset><br><br><br>
<fieldset>
<legend><b>Special Interests<b> / </b>Talents : </b></legend>
<label for="intrests">Interests<b> :  </b></label>
<input type="text" name="intrests" required><br><br>
<label for="achievements">Achievements (if any)<b> :  </b></label>
<input type="text" name="ach" style="width:250px;height:25px;" >
</fieldset><br><br><br>
<center>
<input type="submit" value="Submit">
<input type="reset" value="Reset">
</center>
</form>
</div>
</body>
</head>
</html>