Your IP : 216.73.216.40
<? ob_start(); ?>
<?php
include "include/header.inc";
dbConnect();
$tbl = 'tbl_registration_mbams';
$id = $_REQUEST["id"];
if (!$id) $id = 0;
$regid = $_REQUEST["regid"];
$dob1 = $_REQUEST["dob1"];
$remoteip = $_SERVER["REMOTE_ADDR"];
if ($id && $_REQUEST["edit"] == 1) {
include "findindex.php";
} else if ($_POST["submit"] == "FIND") {
$id = substr($regid, strrpos($regid, "-")+1);
header("Location: reprintappform.php?regid=$regid&dob1=$dob1");
}
if ($_POST["submit"] == "SAVE") {
$msg = "";
$division = $_POST["division"];
if ($division =='MBA-IT') $regno='IIITA-MBA';
$fullname = $_POST["fullname"];
if (!$fullname) $msg = "Please enter your name";
$dob = $_POST["dd"].'/'.$_POST["mm"].'/'.$_POST["yy"];
//if (!$dob || $dob == '0000-00-00 00:00:00') $dob = date('y-m-d'); //date('Y-m-d');
$sysdate = date('y-m-d');
if ($dob == $sysdate || $dob == 'DD/MM/YYYY') $msg= "Please enter your correct date of birth";
$pob = $_POST["pob"];
if (!$pob) $msg = "Please enter your place of birth";
$gender = $_POST["gender"];
if (!$gender) $gender = 'Male';
$mstatus = $_POST["mstatus"];
$category = $_POST["category"];
if (!$category) $category = 'GE';
$community = $_POST["community"];
$nationality = $_POST["nationality"];
if (!$nationality) $msg = "Please enter your nationality";
$fathername = $_POST["fathername"];
if (!$fathername) $msg = "Please enter your father name";
$mothername = $_POST["mothername"];
if (!$mothername) $msg = "Please enter your mother name";
$address2 = $_POST["address2"];
if (!$address2) $msg = "Please enter your address";
$city2 = $_POST["city2"];
if (!$city2) $msg = "Please enter your city";
$pincode2 = $_POST["pincode2"];
if (!$pincode2) $msg = "Please enter pin code";
$state2 = $_POST["state2"];
$phone1 = $_POST["phone1"];
$phone2 = $_POST["phone2"];
$fax = $_POST["fax"];
$email1 = $_POST["email1"];
if (!$email1) $msg = "Please enter a valid email address";
$email2 = $_POST["email2"];
if (!$email2) $msg = "Please enter a valid email address";
$photo = $_FILES["photo"];
$txn_type = $_POST["txn_type"];
$txn_number = $_POST["txn_number"];
if (!$txn_number) $msg = "Please enter the DD/Cash Receipt No.";
$txn_amount = $_POST["txn_amount"];
if (!$txn_amount) $txn_amount = "500";
$txn_date = $_POST["depositdd"].'/'.$_POST["depositmm"].'/'.$_POST["deposityy"];
$txn_bankbranch = $_POST["txn_bankbranch"];
$ug_discipline = $_POST["ug_discipline"];
$ug_degree = $_POST["ug_degree"];
$ug_university = $_POST["ug_university"];
$ug_year = $_POST["ug_year"];
$ug_percentage = $_POST["ug_percentage"];
$ug_cpi = $_POST["ug_cpi"];
$ug_examdate = $_POST["ug_examdate"];
$ug_expectedby = $_POST["ug_expectedby"];
$im_discipline = $_POST["im_discipline"];
$im_degree = $_POST["im_degree"];
$im_university = $_POST["im_university"];
$im_year = $_POST["im_year"];
$im_percentage = $_POST["im_percentage"];
$im_cpi = $_POST["im_cpi"];
$hs_discipline = $_POST["hs_discipline"];
$hs_degree = $_POST["hs_degree"];
$hs_university = $_POST["hs_university"];
$hs_year = $_POST["hs_year"];
$hs_percentage = $_POST["hs_percentage"];
$hs_cpi = $_POST["hs_cpi"];
$ot_discipline = $_POST["ot_discipline"];
$ot_degree = $_POST["ot_degree"];
$ot_university = $_POST["ot_university"];
$ot_year = $_POST["ot_year"];
$ot_percentage = $_POST["ot_percentage"];
$ot_cpi = $_POST["ot_cpi"];
$cat_regno = $_POST["cat_regno"];
$cat_centercode = $_POST["cat_centercode"];
$cat_name = $_POST["cat_name"];
$cat_percentile = $_POST["cat_percentile"];
$cat_mmyy = $_POST["cat_mmyy"];
$we_datefrom1 = $_POST["we_datefrom1"];
$we_dateto1 = $_POST["we_dateto1"];
$we_employer1 = $_POST["we_employer1"];
$we_position1 = $_POST["we_officer1"];
$we_nature1 = $_POST["we_designation1"];
$we_datefrom2 = $_POST["we_datefrom2"];
$we_dateto2 = $_POST["we_dateto2"];
$we_employer2 = $_POST["we_employer2"];
$we_position2 = $_POST["we_officer2"];
$we_nature2 = $_POST["we_designation2"];
$we_datefrom3 = $_POST["we_datefrom3"];
$we_dateto3 = $_POST["we_dateto3"];
$we_employer3 = $_POST["we_employer3"];
$we_position3 = $_POST["we_officer3"];
$we_nature3 = $_POST["we_designation3"];
//---------------------------------------------
if ($msg) {
echo "<center><font size=4px color='red'>$msg</font></center>";
} else {
$regid = "IIITA-";
/* if (mysql_num_rows(mysql_query("select * from $tbl where id=$id"))) {
mysql_query("update $tbl set fullname='$fullname',
dob='$dob', pob='$pob', gender='$gender', nationality='$nationality', fathername='$fathername',
address='$address', state='$state', pincode='$pincode', phone='$phone', fax='$fax', email='$email',
txntype='$txntype', txnnumber='$txnnumber', amount='$amount', depositdate='$depositdate', bankbranch='$bankbranch',
stream='$stream', bi='$bi', hci='$hci', ins='$ins', mi='$mi', ro='$ro', se='$se', wcc='$wcc', ce='$ce',
category='$category', ge_name='$ge_name', ge_discipline='$ge_discipline', ge_rank='$ge_rank', ge_year='$ge_year',
qd_university='$qd_university', qd_discipline='$qd_discipline', qd_degree='$qd_degree', qd_examdate='$qd_examdate',
qd_finalresultexpectedby='$qd_finalresultexpectedby', qd_minmarks='$qd_minmarks', qd_overallgrade='$qd_overallgrade',
we_datefrom1='$we_datefrom1', we_dateto1='$we_dateto1', we_employer1='$we_employer1', we_position1='$we_position1',
we_nature1='$we_nature1', we_datefrom2='$we_datefrom2', we_dateto2='$we_dateto2', we_employer2='$we_employer2',
we_position2='$we_position2', we_nature2='$we_nature2', we_datefrom3='$we_datefrom3', we_dateto3='$we_dateto3',
we_employer3='$we_employer3', we_position3='$we_position3', we_nature3='$we_nature3', app_status='$app_status',
date_modification=now(), remoteip='$remoteip' where id=$id");
} else {
echo "insert into $tbl(regid,division,fullname,dob,pob,gender,mstatus,nationality,category,
fathername,mothername,address2,city2,pincode2,state2,phone1,phone2,fax,email1,email2,
txn_type,txn_number,txn_amount,txn_date,txn_bankbranch,
ug_discipline,ug_degree,ug_university,ug_year,ug_percentage,ug_cpi,ug_examdate,ug_expectedby,
im_discipline,im_degree,im_university,im_year,im_percentage,im_cpi,
hs_discipline,hs_degree,hs_university,hs_year,hs_percentage,hs_cpi,
ot_discipline,ot_degree,ot_university,ot_year,ot_percentage,ot_cpi,
cat_regno,cat_centercode,cat_name,cat_percentile,cat_mmyy,
we_datefrom1,we_dateto1,we_employer1,we_officer1,we_designation1,
we_datefrom2,we_dateto2,we_employer2,we_officer2,we_designation2,
we_datefrom3,we_dateto3,we_employer3,we_officer3,we_designation3,
app_status,date_creation,date_modification,remoteip)
values('$regid','$division','$fullname','$dob','$pob','$gender','$mstatus','$nationality','$category',
'$fathername','$mothername','$address2','$city2','$pincode2','$state2',
'$phone1','$phone2','$fax','$email1','$email2',
'$txn_type','$txn_number','$txn_amount','$txn_date','$txn_bankbranch',
'$ug_discipline','$ug_degree','$ug_university','$ug_year','$ug_percentage','$ug_cpi','$ug_examdate','$ug_expectedby',
'$im_discipline','$im_degree','$im_university','$im_year','$im_percentage','$im_cpi',
'$hs_discipline','$hs_degree','$hs_university','$hs_year','$hs_percentage','$hs_cpi',
'$ot_discipline','$ot_degree','$ot_university','$ot_year','$ot_percentage','$ot_cpi',
'$cat_regno','$cat_centercode','$cat_name','$cat_percentile','$cat_mmyy',
'$we_datefrom1','$we_dateto1','$we_employer1','$we_officer1','$we_designation1',
'$we_datefrom2','$we_dateto2','$we_employer2','$we_officer2','$we_designation2',
'$we_datefrom3','$we_dateto3','$we_employer3','$we_officer3','$we_designation3',
'Pending',now(),now(),'$remoteip')";
*/
//-----------------------------
mysql_query("insert into $tbl(regid,division,fullname,dob,pob,gender,mstatus,nationality,category,community,
fathername,mothername,address2,city2,pincode2,state2,phone1,phone2,fax,email1,email2,
txn_type,txn_number,txn_amount,txn_date,txn_bankbranch,
ug_discipline,ug_degree,ug_university,ug_year,ug_percentage,ug_cpi,ug_examdate,ug_expectedby,
im_discipline,im_degree,im_university,im_year,im_percentage,im_cpi,
hs_discipline,hs_degree,hs_university,hs_year,hs_percentage,hs_cpi,
ot_discipline,ot_degree,ot_university,ot_year,ot_percentage,ot_cpi,
cat_regno,cat_centercode,cat_name,cat_percentile,cat_mmyy,
we_datefrom1,we_dateto1,we_employer1,we_officer1,we_designation1,
we_datefrom2,we_dateto2,we_employer2,we_officer2,we_designation2,
we_datefrom3,we_dateto3,we_employer3,we_officer3,we_designation3,
app_status,date_creation,date_modification,remoteip)
values('$regid','$division','$fullname','$dob','$pob','$gender','$mstatus','$nationality','$category','$community',
'$fathername','$mothername','$address2','$city2','$pincode2','$state2',
'$phone1','$phone2','$fax','$email1','$email2',
'$txn_type','$txn_number','$txn_amount','$txn_date','$txn_bankbranch',
'$ug_discipline','$ug_degree','$ug_university','$ug_year','$ug_percentage','$ug_cpi','$ug_examdate','$ug_expectedby',
'$im_discipline','$im_degree','$im_university','$im_year','$im_percentage','$im_cpi',
'$hs_discipline','$hs_degree','$hs_university','$hs_year','$hs_percentage','$hs_cpi',
'$ot_discipline','$ot_degree','$ot_university','$ot_year','$ot_percentage','$ot_cpi',
'$cat_regno','$cat_centercode','$cat_name','$cat_percentile','$cat_mmyy',
'$we_datefrom1','$we_dateto1','$we_employer1','$we_officer1','$we_designation1',
'$we_datefrom2','$we_dateto2','$we_employer2','$we_officer2','$we_designation2',
'$we_datefrom3','$we_dateto3','$we_employer3','$we_officer3','$we_designation3',
'Pending',now(),now(),'$remoteip')");
$id = mysql_insert_id();
// }
if (mysql_errno() == 1062) {
echo "<h2 style='color: red'>Duplcate record found. Please check once.</h2>";
} else {
if ($photo && $id > 0) {
$photo = upload_file($id);
mysql_query("update $tbl set regid='$regid-$id',photo='$photo' where id=$id");
}
mysql_query("update $tbl set regid='$regid-$id' where id=$id");
header("Location: appform.php?id=$id");
}
}
}
echo "<input type='hidden' name='id' value='$id'>
<table width='100%'>
<tr><td>
<table>
<tr><td>Application For</td><td>
<select name='divs'>";
foreach ($divs as $div) {
echo "<option value='$div'";
if ($div == $division) echo " selected";
echo ">$div</option>";
}
echo "</select>
</td></tr>
<tr><td width=20%>Full Name </td><td width=80%> <input type='text' onkeypress='return isCharacterKey(event)' name='fullname' size='50' maxlength='50' value='$fullname'></td></tr>
<tr><td valign='top'>Category</td><td>";
if ($category == 'GE' ) {
echo "<input type='radio' name='category' value='GE' checked /> GE
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='GE' onclick='javascript:disablespn()' /> GE ";
}
if ($category == 'SC') {
echo "<input type='radio' name='category' value='SC' checked /> SC
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='SC' onclick='javascript:disablespn()' /> SC ";
}
if ($category == 'ST') {
echo "<input type='radio' name='category' value='ST' checked /> ST
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='ST' onclick='javascript:disablespn()' /> ST ";
}
if ($category == 'OBC' ) {
echo "<input type='radio' name='category' value='OBC' checked /> OBC
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='OBC' onclick='javascript:disablespn()' /> OBC ";
}
if ($category == 'PH') {
echo "<input type='radio' name='category' value='PH' checked /> PH
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='PH' onclick='javascript:disablespn()' /> PH ";
}
if ($category == 'DPD' ) {
echo "<input type='radio' name='category' value='DPD' checked /> DPD
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='DPD' onclick='javascript:disablespn()' /> DPD ";
}
if ($category == 'SN' ) {
echo "<input type='radio' name='category' value='SN' checked /> SN
<body onLoad='enablespn()'>";
} else {
echo "<input type='radio' name='category' value='SN' onclick='javascript:enablespn()' /> SN ";
}
if ($category == 'NR' ) {
echo "<input type='radio' name='category' value='NR' checked /> NR
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='NR' onclick='javascript:disablespn()' /> NR ";
}
if ($category == 'FN' ) {
echo "<input type='radio' name='category' value='FN' checked /> FN
<body onLoad='disablespn()'>";
} else {
echo "<input type='radio' name='category' value='FN' onclick='javascript:disablespn()' /> FN ";
}
echo "<br>
[GE=General, SC=Schedule Cast, ST=Schedule Tribe, OBC=Other Backward Class, <br>
PH=Physically Handicapped, DPD=Armed Forces Personnel, SN=Sponsered, <br>
NR=Non Resident Indian, FN=Foreign National (including SAARC)]
</td></tr>
<tr><td>Community (only for OBC minority candidates)</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='community' size='50' maxlength='150' value='$community'></td></tr>
<tr><td>Father's Name</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='fathername' size='50' maxlength='150' value='$fathername'></td></tr>
<tr><td>Mother's Name</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='mothername' size='50' maxlength='150' value='$mothername'></td></tr>
<tr><td>Date of Birth</td><td>
<select name='dd'>";
foreach ($dates as $dt) {
echo "<option value='$dt'";
if ($dt == $dd) echo " selected";
echo ">$dt</option>";
}
echo "</select>
<select name='mm'>";
foreach ($months as $mt) {
echo "<option value='$mt'";
if ($mt == $mm) echo " selected";
echo ">$mt</option>";
}
echo "</select>
<select name='yy'>";
foreach ($years as $yr) {
echo "<option value='$yr'";
if ($yr == $yy) echo " selected";
echo ">$yr</option>";
}
echo "</select>
</td></tr>
<tr><td>Place of Birth </td><td> <input type='text' onkeypress='return isCharacterKey(event)' name='pob' size='50' maxlength='50' value='$pob'></td></tr>
<tr><td>Gender </td><td>";
$genders = array("Male","Female");
foreach ($genders as $gen) {
echo "<input type='radio' name='gender' value='$gen'";
if ($gen == $gender) echo " checked";
echo "> $gen ";
}
echo "
</td></tr>
<tr><td>Marital Status </td><td>";
$mstatuss = array("Unmarried","Married");
foreach ($mstatuss as $mstat) {
echo "<input type='radio' name='mstatus' value='$mstat'";
if ($mstat == $mstatus) echo " checked";
echo "> $mstat ";
}
echo "
<tr><td>Nationality</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='nationality' size='50' maxlength='150' value='INDIAN'></td></tr>
<tr><td>Address (Correspondance)</td><td><textarea name='address2' rows='3' cols='50' maxlength='150' value='$address2' >$address2</textarea></td></tr>
<tr><td>City</td><td> <input type='text' onkeypress='return isCharacterKey(event)' name='city2' size='38' maxlength='50' value='$city2'>
Pin Code <input type='text' onkeypress='return isNumberKey(event)' name='pincode2' size='10' maxlength='6' value='$pincode2'></td></tr>
<tr><td>State</td><td>
<select name='state2'>";
$states = array('Andaman Nicobar','Andhra Pradesh','Arunachal Pradesh','Assam','Bihar','Chandigarh',
'Chhattisgarh','Dadra & Nagar Haveli','Lakshadweep','Madhya Pradesh','Maharashtra','Manipur','Meghalaya','Mizoram',
'Nagaland','New Delhi','Orissa','Daman & Diu','Goa','Gujarat','Haryana','Himachal Pradesh','Jammu & Kashmir',
'Jharkhand','Karnataka','Kerala','Puducherry','Punjab','Rajasthan','Sikkim','Tamil Nadu','Tripura',
'Uttar Pradesh','Uttarakhand','West Bengal');
foreach ($states as $stat) {
echo "<option value='$stat'";
if ($stat == $state2) echo " selected";
echo ">$stat</option>";
}
echo "</select>
</td></tr>
</td></tr><tr><td>Contact No. </td><td> Primary <input type='text' onkeypress='return isNumberKey(event)' name='phone1' size='20' maxlength='20' value='$phone1'>
Secondry <input type='text' onkeypress='return isNumberKey(event)' name='phone2' size='20' maxlength='20' value='$phone2'>
</td></tr><tr><td>Fax No. </td><td> <input type='text' onkeypress='return isNumberKey(event)' name='fax' size='50' maxlength='50' value='$fax'>
</td></tr><tr><td>Email Address (Primary)</td><td> <input type='text' name='email1' size='50' maxlength='50' value='$email1'>
</td></tr><tr><td>Email Address (Secondry)</td><td> <input type='text' name='email2' size='50' maxlength='50' value='$email2'>
</td></tr><tr><td colspan='2'>(Institute is not responsible for any false contact or incomplete contact. E-mail address should be filled neatly and clearly)
</td></tr>
</table>
</td><td valign=top>
";
if (!$photo){
echo "<img src='images/user_thumb_large.jpg' height=100 width=100 /><br>";}
else{
echo "<img src='photos/$id.jpg' height=120 width=120 /><br>";}
echo "Upload your photograph <sup>*</sup> (.jpg file only)<br>
<input type='file' name='photo' size='30' value='$photo' /> <br><br>
<hr>
<!-- ------------------------------------------------------------------ -->
<table>
<tr><td colspan=2><!-- img src='images/new-blinking1.gif' / --><blink><b>To Reprint your submitted application find it by</blink></b></td></tr>
<tr><td>Application No.</td>
<td><input type='text' name='regid' size='15' maxlength='35' value='$regid'></td>
</tr>
<tr><td>Date of Birth (DD/MM/YYYY)</td>
<td><input type='text' onkeypress='return isDateKey(event)' name='dob1' size='15' maxlength='35' value='$dob1'>
<input type='submit' name='submit' value='FIND'></td>
</tr>
</table>
<!-- ------------------------------------------------------------------ -->
<hr>
<b>Click here to download <br>
<!-- 1. <a href='include/phd-advertisement-2013.pdf'>PhD Rolling Admission Advertisement</a><br>
2. <a href='include/phd-reference-2013.pdf'>Reference Letter</a><br> -->
<hr>
</td></tr>
<tr><td colspan=2><hr>
<b>Application Fee (for downloaded/photocopy/online generated form only)</b> <br>Pl. make sure that DD issued are 'MICR' type only and made in favour of <b>'IIIT ALLAHABAD'</b> payable at <b>ALLAHABAD</b><br>
</td></tr>
<tr><td>
<table>
<tr><td><input type='radio' name='txn_type' value='DD' checked /> DD
Amount Rs.</td><td>
<select name='txn_amount'>",
$amounts = array('1200','600');
foreach ($amounts as $amt){
echo "<option value='$amt'";
if ($amt == $txn_amount) echo " selected";
echo ">$amt</option>";
}
echo "</select>
DD No. <input type='text' onkeypress='return isNumberKey(event)' name='txn_number' size='15' maxlength='25' value='$txn_number'>
Dated
<select name='depositdd'>";
foreach ($dates as $dt) {
echo "<option value='$dt'";
if ($dt == $depositdd) echo " selected";
echo ">$dt</option>";
}
echo "</select>
<select name='depositmm'>";
foreach ($dmonths as $mt) {
echo "<option value='$mt'";
if ($mt == $depositmm) echo " selected";
echo ">$mt</option>";
}
echo "</select>
<select name='deposityy'>";
foreach ($dyears as $yr) {
echo "<option value='$yr'";
if ($yr == $deposityy) echo " selected";
echo ">$yr</option>";
}
echo "</select>
</td></tr>
<tr><td>Bank & Branch Name</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='txn_bankbranch' size='100' maxlength='150' value='$txn_bankbranch'></td></tr>
</table>
</td></tr>
<tr><td>
<tr><td colspan='2'><hr>
<b>CAT/CMAT/GMAT/XAT/ATMA/MAT Details</b> (For MBA Applicants only)<br>
<table>
<tr><td>A.) Registration No. (MBA-IT Only)</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='cat_regno' size='25' maxlength='50' value='$cat_regno'></td><td></td></tr>
<tr><td>B.) Center Code (As in the Admit Card)</td><td><input type='text' onkeypress='return isCharacterKey(event)' name='cat_centercode' size='20' maxlength='20' value='$cat_centercode'> </td><td></td></tr>
<tr><td colspan='3'>C.) <b>CAT/CMAT/XAT/ATMA/MAT exam details/GMAT Score details for NRI/Foreign Nationals Program</b><br></td></tr>
<tr><td>Exam Name</td>
<td>Percentile Score</td>
<td>Exam Month & Year</td>
</tr>
<tr><td><input type='text' name='cat_name' size='25' maxlength='25' value='$cat_name'></td>
<td><input type='text' name='cat_percentile' size='25' maxlength='25' value='$cat_percentile'></td>
<td><input type='text' name='cat_mmyy' size='25' maxlength='25' value='$cat_mmyy'></td>
</tr>
</table>
</td></tr>
<tr><td colspan=2>
<hr>
<b>Details of Qualifying Examination (#) passed or appearing.</b>
</td></tr>
<tr><td colspan=2>
<table>
<tr><td>Name of the Qualifying <br>Examination<br> Passed/Appearing</td>
<td>University/Institute/Board</td>
<td>Discipline</td>
<td>Degree/Programme</td>
<td>Year of Passing/Appearing</td>
<td>Min. Pass Marks, % or Grade Average </td>
<td>Overall % or Grade Average <br>(if degree completed)</td>
<td>Exam Date<br> (in case of final year)</td>
<td>Final Result Expected<br> by (If Appearing)</td></tr>
<tr><td><b>Under Graduate</b></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='ug_university' size='25' maxlength='50' value='$ug_university'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='ug_discipline' size='20' maxlength='20' value='$ug_discipline'> </td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='ug_degree' size='20' maxlength='20' value='$ug_degree'> </td>
<td><input type='text' onkeypress='return isNumberKey(event)' name='ug_year' size='25' maxlength='50' value='$ug_year'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='ug_percentage' size='5' maxlength='5' value='$ug_percentage'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='ug_cpi' size='5' maxlength='5' value='$ug_cpi'></td>
<td rowspan='5' valign='top'><input type='text' name='ug_examdate' size='20' maxlength='50' value='$pg_appearing'></td>
<td rowspan='5' valign='top'><input type='text' name='ug_expectedby' size='20' maxlength='50' value='$pg_appearing'></td>
</tr>
<tr><td><b>Class XII</b></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='im_university' size='25' maxlength='50' value='$im_university'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='im_discipline' size='20' maxlength='20' value='$im_discipline'> </td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='im_degree' size='20' maxlength='20' value='$im_degree'> </td>
<td><input type='text' onkeypress='return isNumberKey(event)' name='im_year' size='25' maxlength='50' value='$im_year'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='im_percentage' size='5' maxlength='5' value='$im_percentage'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='im_cpi' size='5' maxlength='5' value='$im_cpi'></td>
</tr>
<tr><td><b>Class X</b></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='hs_university' size='25' maxlength='50' value='$hs_university'></td>
<td><input type='text' onkeypess='return isCharacterKey(event)' name='hs_discipline' size='20' maxlength='20' value='$hs_discipline'> </td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='hs_degree' size='20' maxlength='20' value='$hs_degree'> </td>
<td><input type='text' onkeypress='return isNumberKey(event)' name='hs_year' size='25' maxlength='50' value='$hs_year'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='hs_percentage' size='5' maxlength='5' value='$hs_percentage'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='hs_cpi' size='5' maxlength='5' value='$hs_cpi'></td>
</tr>
<tr><td><b>Others</b></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='ot_university' size='25' maxlength='50' value='$ot_university'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='ot_discipline' size='20' maxlength='20' value='$ot_discipline'> </td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='ot_degree' size='20' maxlength='20' value='$ot_degree'> </td>
<td><input type='text' onkeypress='return isNumberKey(event)' name='ot_year' size='25' maxlength='50' value='$ot_year'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='ot_percentage' size='5' maxlength='5' value='$ot_percentage'></td>
<td><input type='text' onkeypress='return isDecimalKey(event)' name='ot_cpi' size='5' maxlength='5' value='$ot_cpi'></td>
</tr>
</table>
</td></tr>
</table>
</td></tr>
<tr><td colspan=2>
<hr>
<b>Work Experience (if applicable, latest three only with documentry proof)</b>
</td></tr><tr><td colspan=2>
<table>
<tr><td>Company Name with Full Address,<br> E-mail & Contact No.</td>
<td>Reporting Officer/Employer, <br>along with Phone No. & Email ID</td>
<td>Designation</td>
<td colspan=2 align='center'>Dates (From -To)<font size=-1> (DD/MM/YYYY)<font></td>
</tr>
<tr><td>1 <input type='text' onkeypress='return isCharacterKey(event)' name='we_employer1' size='30' maxlength='50' value='$we_employer1'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='we_officer1' size='30' maxlength='50' value='$we_position1'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='we_designation1' size='25' maxlength='50' value='$we_nature1'></td>
<td><input type='text' onkeypress='return isDateKey(event)' name='we_datefrom1' size='20' maxlength='20' value='$we_datefrom1'></td>
<td><input type='text' onkeypress='return isDateKey(event)' name='we_dateto1' size='20' maxlength='20' value='$we_dateto1'></td>
</tr>
<tr><td>2 <input type='text' onkeypress='return isCharacterKey(event)' name='we_employer2' size='30' maxlength='50' value='$we_employer2'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='we_officer2' size='30' maxlength='50' value='$we_position2'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='we_designation2' size='25' maxlength='50' value='$we_nature2'></td>
<td><input type='text' onkeypress='return isDateKey(event)' name='we_datefrom2' size='20' maxlength='20' value='$we_datefrom2'></td>
<td><input type='text' onkeypress='return isDateKey(event)' name='we_dateto2' size='20' maxlength='20' value='$we_dateto2'></td>
</tr>
<tr><td>3 <input type='text' onkeypress='return isCharacterKey(event)' name='we_employer3' size='30' maxlength='50' value='$we_employer3'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='we_officer3' size='30' maxlength='50' value='$we_position3'></td>
<td><input type='text' onkeypress='return isCharacterKey(event)' name='we_designation3' size='25' maxlength='50' value='$we_nature3'></td>
<td><input type='text' onkeypress='return isDateKey(event)' name='we_datefrom3' size='20' maxlength='20' value='$we_datefrom3'></td>
<td><input type='text' onkeypress='return isDateKey(event)' name='we_dateto3' size='20' maxlength='20' value='$we_dateto3'></td>
</tr>
</table>
</td></tr>
<tr><td><br><br>
<input type='submit' name='submit' value='SAVE'>";
echo "</td></tr></table>
";
?>
<br>
* Photograph file must be uploaded along with online application form.<br>
# Attach self attested copies of certificates, marks sheet etc. with printed filled in application form and send to the institute via post.<br>
<?php
include "include/footer.inc";
?>
<? ob_flush(); ?>