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103.154.184.216 / www.astitvaad.com
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files >> /home/ceccomputer/public_html/online-form.php
<?php error_reporting(0); ?> <?php include("inc/top.php");?> <body> <!-- Main Wrapper Start --> <div class="main-wrapper"> <!-- navigation section --> <?php include("inc/navigation.php"); ?> <!-- end navigation section --> <!-- Breadcrumb --> <div class="breadcrumb-area" data-bgimage="images/header16.jpg" data-black-overlay="4"> <div class="container"> <div class="in-breadcrumb"> <div class="row"> <div class="col"> <h3> </h3> </div> </div> </div> </div> </div> <!--// Breadcrumb --> <?php include("inc/onlineForm.php"); ?> <main class="page-content"> <!-- About Us Area --> <div class="about-us-area section-ptb2"> <div class="container"> <div class="row"> <div class="col-lg-10 offset-lg-1"> <div class="about-us-contents table-responsive"> <h3><span>Online Form</span></h3> <?php if(isset($_REQUEST['success'])) { echo "<div class='alert alert-success alert-dismissible fade show'> <button type='button' class='close' data-dismiss='alert'>×</button> <strong>Success!</strong> You have been registered ! Thankyou for Applying Form. </div>"; } ?> <div class="billing-details-wrap"> <form action="" method="post" enctype="multipart/form-data" > <div class="row"> <div class="col-lg-4"> <p class="single-form-row"> <input type="text" name="name" placeholder="Name *" onKeyPress="return onlyAlphabets(event,this)" value="<?php if(isset($name)){echo $name;}?>" required> <input type="hidden" name="fid" value="<?php echo rand(100,10000);?>" /> </p> </div> <div class="col-lg-4"> <p class="single-form-row"> <input type="email" name="email" placeholder="Email (optional)" > </p> </div> <div class="col-lg-4"> <p class="single-form-row"> <input type="text" name="phone" maxlength="10" onkeypress="return numberonly(event);" placeholder="Mobile *" pattern="[6-9]{1}[0-9]{9}" title="Phone number with 6-9 and remaing 9 digit with 0-9" required> </p> </div> </div> <div class="row"> <div class="col-lg-4"> <p class="single-form-row"> <input type="text" onKeyPress="return onlyAlphabets(event,this)" name="father" placeholder="Father Name *" required> </p> </div> <div class="col-lg-4"> <p class="single-form-row"> <span class="img-set">D.O.B</span> <input type="date" name="dob" placeholder="Date of birth" required> </p> </div> <div class="col-lg-4"> <div class="single-form-row"> <div class="nice-select wide"> <input type="text" name="course" placeholder="course name" class="form-control"> </div> </div> </div> </div> <div class="row"> <div class="col-lg-4"> <div class="single-form-row"> <div class="nice-select wide"> <input name="address" type="text" class="form-control" placeholder="Address" > </div> </div> </div> <div class="col-lg-4"> <div class="single-form-row"> <input type="text" name="state" placeholder="State" required > </div> </div> <div class="col-lg-4"> <div class="single-form-row"> <div class="nice-select wide"> <select name="center"> <option value="0">Select Centre</option> <?php $c = "SELECT * FROM `centre` where status = 1"; $r = mysqli_query($con, $c); if(mysqli_num_rows($r) > 0) { while($ro = mysqli_fetch_array($r)) { echo "<option value='".$ro['centre_name']."'>".ucfirst($ro['centre_name'])."</option>"; } } else { echo "<option value='Gangtok'>No Records</option>"; } ?> <option value="other">Other</option> </select> </div> </div> </div> </div> <div class="row"> <div class="col-lg-4"> <div class="single-form-row"> <span class="img-set">Image size less than 100 kb</span> <input type="file" name="image" style="padding: 5px 12px !important" required> </div> </div> <div class="col-lg-4"> <div class="form-group"> <label for="gender">Gender </label> <label><input type="radio" name="gender" value="Male" checked=""> Male </label> <label><input type="radio" name="gender" value="Female"> Female </label> </div> </div> </div> <div class="table-responsive"> <table class="table table-bordered"> <thead> <tr class="bg-dark text-white text-center"> <th width="14%">Examination</th> <th width="14%">Subject</th> <th width="12%">Board</th> <th>Institute</th> <th width="10%">Score</th> <th width="6%">%age</th> <th width="10%">Div.</th> </tr> </thead> <tbody> <tr> <th class="text-center">10th</th> <td><input name="matric_subject" type="text" value="Matric" readonly style="width: 100%" disabled></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" maxlength="10" name="matric_board" placeholder="BSEB" required></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" maxlength="45" name="matric_institute" placeholder="school name" required></td> <td><input type="text" style="width: 100%" name="matric_score" maxlength="3" onkeypress="return numberonly(event);" placeholder="336" required></td> <td><input type="text" style="width: 100%" name="matric_percentage" maxlength="4" placeholder="68.2" onkeypress="return numberonly(event);" required></td> <td> <select name="matric_div" style="width: 100%"> <option value="0">Division</option> <option value="first">1st</option> <option value="second">2nd</option> <option value="third">3rd</option> </select> </td> </tr> <tr> <th class="text-center">12th</th> <td><select name="inter_subject" class="sub" style="width: 100%"> <option value="0">---Subject---</option> <option value="science">Science</option> <option value="arts">Arts</option> <option value="commerce">Commerce</option> </select> </td> <td><input type="text" style="width: 100%" name="inter_board" maxlength="10" onKeyPress="return onlyAlphabets(event,this)" placeholder="BESB"></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" name="inter_institute" maxlength="45" placeholder="school/college name"></td> <td><input type="text" style="width: 100%" name="inter_score" maxlength="3" onkeypress="return numberonly(event);" placeholder="336"></td> <td><input type="text" style="width: 100%" name="inter_percentage" maxlength="4" placeholder="68.2" onkeypress="return numberonly(event);"></td> <td> <select name="inter_div" style="width: 100%"> <option value="0">Division</option> <option value="first">1st</option> <option value="second">2nd</option> <option value="third">3rd</option> </select> </td> </tr> <tr> <th class="text-center">Graduation</th> <td><input type="text" style="width: 100%" name="gradu_subject" onKeyPress="return onlyAlphabets(event,this)" maxlength="10" placeholder="hindi,poly,bio"></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" name="gradu_board" maxlength="10" placeholder="pu/mu/du"></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" name="gradu_institute" maxlength="45" placeholder="college name"></td> <td><input type="text" style="width: 100%" name="gradu_score" maxlength="4" placeholder="336"></td> <td><input type="text" style="width: 100%" name="gradu_percentage" maxlength="4" onkeypress="return numberonly(event);" placeholder="68.2"></td> <td> <select name="gradu_div" style="width: 100%"> <option value="0">Division</option> <option value="first">1st</option> <option value="second">2nd</option> <option value="third">3rd</option> </select> </td> </tr> <tr> <th class="text-center">Other</th> <td><input type="text" style="width: 100%" name="others_subject" onKeyPress="return onlyAlphabets(event,this)" placeholder="" maxlength="10"></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" name="others_board" placeholder="" maxlength="10"></td> <td><input type="text" style="width: 100%" onKeyPress="return onlyAlphabets(event,this)" name="others_institute" placeholder="collge name" maxlength="45"></td> <td><input type="text" style="width: 100%" name="others_score" placeholder="555" onkeypress="return numberonly(event);" maxlength="4"></td> <td><input type="text" style="width: 100%" name="others_percentage" onkeypress="return numberonly(event);" placeholder="55.5" maxlength="4"></td> <td> <select name="others_div" style="width: 100%"> <option value="0">Division</option> <option value="first">1st</option> <option value="second">2nd</option> <option value="third">3rd</option> </select> </td> </tr> </tbody> </table> <label style="font-size:13px; line-height: 1.3"><input type="checkbox" checked> Declaration : I hereby certify that the above particulars are checked by me and found all particulars are correct. I understand that the legal action can be taken against me if these are found to be incorrect/false.</label> <span style="background: red;color: #fff;font-size: 13px;padding: 3px;">Before Submission form check very carefully</span> </div> <div class="order-button-payment"> <input type="submit" value="Submit" name="sendMyData"> </div> </form> </div> </div> </div> </div> </div> </div> <!--// About Us Area --> </div> <?php if(isset($_POST["sendMyData"])) { $fid=mysqli_real_escape_string($con,$_POST['fid']); $name1=mysqli_real_escape_string($con,$_POST['name']); $email=mysqli_real_escape_string($con,$_POST['email']); $phone=mysqli_real_escape_string($con,$_POST['phone']); $father=mysqli_real_escape_string($con,$_POST['father']); $dob=mysqli_real_escape_string($con,$_POST['dob']); $course=mysqli_real_escape_string($con,$_POST['course']); $address=mysqli_real_escape_string($con,$_POST['address']); $state=mysqli_real_escape_string($con,$_POST['state']); $center=mysqli_real_escape_string($con,$_POST['center']); $gender=mysqli_real_escape_string($con,$_POST['gender']); $matric_subject=mysqli_real_escape_string($con,$_POST['matric_subject']); $matric_board=mysqli_real_escape_string($con,$_POST['matric_board']); $matric_institute=mysqli_real_escape_string($con,$_POST['matric_institute']); $matric_score=mysqli_real_escape_string($con,$_POST['matric_score']); $matric_percentage=mysqli_real_escape_string($con,$_POST['matric_percentage']); $matric_div=mysqli_real_escape_string($con,$_POST['matric_div']); $inter_subject=mysqli_real_escape_string($con,$_POST['inter_subject']); $inter_board=mysqli_real_escape_string($con,$_POST['inter_board']); $inter_institute=mysqli_real_escape_string($con,$_POST['inter_institute']); $inter_score=mysqli_real_escape_string($con,$_POST['inter_score']); $inter_percentage=mysqli_real_escape_string($con,$_POST['inter_percentage']); $inter_div=mysqli_real_escape_string($con,$_POST['inter_div']); $gradu_subject=mysqli_real_escape_string($con,$_POST['gradu_subject']); $gradu_board=mysqli_real_escape_string($con,$_POST['gradu_board']); $gradu_institute=mysqli_real_escape_string($con,$_POST['gradu_institute']); $gradu_score=$_POST['gradu_score']; $gradu_percentage=mysqli_real_escape_string($con,$_POST['gradu_percentage']); $gradu_div=mysqli_real_escape_string($con,$_POST['gradu_div']); $others_subject=mysqli_real_escape_string($con,$_POST['others_subject']); $others_board=mysqli_real_escape_string($con,$_POST['others_board']); $others_institute=mysqli_real_escape_string($con,$_POST['others_institute']); $others_score=$_POST['others_score']; $others_percentage=mysqli_real_escape_string($con,$_POST['others_percentage']); $others_div=mysqli_real_escape_string($con,$_POST['others_div']); $name = $_FILES["image"]["name"]; $tmp = $_FILES["image"]["tmp_name"]; $upload_dir = "images/registration/"; //list($width, $height) = getimagesize($tmp); if($_FILES["image"]["size"] < 100000 ){ $pre = time(); $name = $pre. $_FILES['image']['name']; $image = $upload_dir.$name; move_uploaded_file($tmp, $image); $sql1="insert into online_registration(name,email,mobile,father_name,dob,sex,course,city,state,centre_name,image,matric_subject,matric_board,matric_ins,matric_score,matric_percent,matric_division, inter_subject,inter_board,inter_ins,inter_score,inter_percent,inter_division, grad_subject,grad_board,grad_ins,grad_score,grad_percent,grad_division, other_subject,other_board,other_ins,other_score,other_percent,other_division,dt)values ('$name1','$email','$phone','$father','$dob','$gender','$course','$address','$state','$center','$image','$matric_subject','$matric_board','$matric_institute','$matric_score','$matric_percentage','$matric_div', '$inter_subject','$inter_board','$inter_institute','$inter_score','$inter_percentage','$inter_div', '$gradu_subject','$gradu_board','$gradu_institute','$gradu_score','$gradu_percentage','$gradu_div', '$others_subject','$others_board','$others_institute','$others_score','$others_percentage','$others_div',now())"; $rs1=mysqli_query($con,$sql1); } else{ ?> <script> alert('please upload image size less than 100 kb!'); </script> <?php } if($rs1){ ?> <script> alert(' Thanks insert successfully !'); window.location.href="index.php"; </script> <?php } } ?> <!-- footer --> <?php include("inc/footer.php"); ?> <!-- end footer -->