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form1.html
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<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta http-equiv="X-UA-Compatible" content="ie=edge">
<link rel="stylesheet" type="text/css" href="bootstrap.css">
<script src="script.js"></script>
<link rel="icon" href="https://raw.githubusercontent.com/Saikishor164/ProFormaForm/main/logo-2.ico" type="image/x-icon">
<title>Registration Form 1 </title>
</head>
<body>
<h2 class="toph2">-</h2>
<h2 class="text-center">Profoma to be submitted for the establishment of</h2>
<h2 class="text-center">P.A Inamdar Computer Lab </h2>
<h2 class="text-center">Proforma No.1 </h2>
<h2 class="toph2">-</h2>
<div class="container">
<p style="color:rgb(255, 0, 0);"><b>* All the Fields are Required</b></p>
<!-- <form id="form1" action="form1.php" method="post"> -->
<form id="form1" action="form1.php" method="post">
<div class="row jumbotron">
<!-- Educational Trust: -->
<!-- <div class="col-sm-12 form-group">
<label for="educationalname">Name of the Educational Trust:</label>
<input type="text" class="form-control" name="educationalname" id="educationalname" placeholder="Enter your Educational Trust name." required>
</div> -->
<div class="col-sm-12 form-group">
<fieldset required>
<label for="eduname">Name of the Educational Trust:</label>
<select class="form-control" name="Dedutrustname" id="eduname" required>
<option value="anyOne"> Select Any One</option>
<!-- A -->
<option value="1">A.P.J. Abdul Kalam Centrey</option>
<option value="2">Adhya Educational Society</option>
<option value="3">Agaram Foundation</option>
<option value="4">Agastya International Foundation</option>
<option value="5">Ahmedabad Education Society</option>
<option value="6">Akanksha Foundation</option>
<option value="7">Akshaya Patra Foundation</option>
<option value="8">Al-Ameen Educational Society</option>
<option value="9">All Bengal Teachers Association</option>
<option value="10">All India Society for Electronics and Computer Technology</option>
<option value="11">Amrita Vidyalayam</option>
<option value="12">Andhra Pradesh United Teachers Federation</option>
<option value="13">Army Welfare Education Society</option>
<option value="14">Association of Indian Universities</option>
<option value="15">Association of Pharmaceutical Teachers of India</option>
<option value="16">Atal Bihari Vajpayee Institute of Mountaineering and Allied Sports</option>
<!-- B -->
<option value="17">Balodyan</option>
<option value="18">Bapuji Educational Association</option>
<option value="19">Bharat Lok Shiksha Parishad</option>
<option value="20">Bharat Stree Mahamandal</option>
<option value="21">Bharatiya Vidya Bhavan</option>
<option value="22">BHUMI (organisation)</option>
<option value="23">Bhupal Noble's College</option>
<option value="24">Bihar Combined Entrance Competitive Examination Board</option>
<option value="25">Brainworks Learning Systems</option>
<!-- C -->
<option value="26">Central Institute of Educational Technology</option>
<option value="27">Central Institute of Road Transport</option>
<option value="28">Central Khalsa Orphanage</option>
<option value="29">Central Tibetan School Administration</option>
<option value="30">Centre for Cultural Resources and Training</option>
<option value="31">Centre for Education Policy of India</option>
<option value="32">Centre For Learning Resources</option>
<option value="33">CFA Council of India</option>
<option value="34">Charotar education society</option>
<option value="35">Children's LoveCastles Trust</option>
<option value="36">Chinmaya Vidyalayas</option>
<option value="37">Coalition to Uproot Ragging from Education</option>
<option value="38">Council for the Indian School Certificate Examinations</option>
<option value="39">CPA Council of India</option>
<!-- D -->
<option value="40">D.A.V. College Managing Committee</option>
<option value="41">Dakshin Gujarat Adivasi Sevamandal</option>
<option value="42">Dawn (Bengali educational society)</option>
<option value="43">Delhi Directorate of Education</option></option>
<option value="44">Delhi Public School Society</option>
<option value="45">District Educational Office</option>
<option value="46">District Institute of Education and Training</option>
<!-- E -->
<option value="47">EdCIL</option></option>
<option value="48">Educate Girls</option>
<option value="49">Education Council of India</option>
<option value="50">Ekal Vidyalaya</option>
<option value="51">Eklavya foundation</option>
<option value="52">Elpro International School</option>
<option value="53">Jat Education Society Rohtak</option>
<option value="54">ES Tibet</option>
<option value="55">EVidyaloka</option>
<!-- F -->
<option value="56">Foundation For Excellence</option>
<option value="57">Friends of Tribals Society</option>
<!-- G -->
<option value="58">GetVidya</option>
<option value="59">Goa Vidyaprasarak Mandal</option>
<option value="60">Gokhale Education Society's R. H. Sapat College of Engineering, Management Studies and Research</option>
<option value="61">Gujarat Vidhya Sabha</option>
<!-- H -->
<option value="62">Haryana Urdu Akademi</option>
<option value="63">Himalayan Mountaineering Institute</option>
<option value="64">Hitkarini Sabha</option>
<option value="65">Homi Bhabha Centre for Science Education</option>
<option value="66">Hyderabad (Sind) National Collegiate Board</option>
<!-- I -->
<option value="67">Ibn Sina Academy of Medieval Medicine and Sciences</option>
<option value="68">Increasing Diversity by Increasing Access</option>
<option value="69">Islamic Welfare Society</option>
<option value="70">Indian Association of Physics Teachers</option>
<option value="71">Indian Council of Education</option>
<option value="72">Indian Public Schools' Conference</option>
<option value="73">Indian Society for Technical Education</option>
<option value="74">Institute of Human Resources Development</option>
<option value="75">Islamic Fiqh Academy (India)</option>
<!-- J -->
<option value="76">Jagadguru Kripalu Parishat</option>
<option value="77">Jamia-e-Imania</option>
<!-- k -->
<option value="78">K.P.M. Trus</option>
<option value="79">Kalvialaya</option>
<option value="80">Kanoria foundation</option>
<option value="81">Karnatak Lingayat Education Society</option>
<option value="82">Katha (NGO)</option>
<option value="83">Kerala Mathematical Association</option>
<option value="84">Kerala Sasthra Sahithya Parishad</option>
<option value="85">Kunpan Cultural School</option>
<!-- l -->
<option value="86">Lakshmipat Singhania Academy</option>
<option value="87">LHA Charitable Trust</option>
<option value="88">Lighthouse Learning</option>
<!-- M -->
<option value="89">Maharashtra Knowledge Corporation</option>
<option value="90">Mahatma Gandhi Institute of Education for Peace and Sustainable Development</option>
<option value="91">Mahila Rashtriya Sangha</option>
<option value="92">Malabar Education Movement</option>
<option value="93">Mamidipudi Venkatarangaiya Foundation</option>
<option value="94">Markazul Maarif</option>
<option value="95">Maulana Azad Education Foundation</option>
<option value="96">Mizoram College Teachers' Association</option>
<option value="97">MKM Educational Trust</option>
<option value="98">Moinee Foundation</option>
<option value="99">Mowbrays Educational Society</option>
<option value="100">Muktangan</option>
<!-- N -->
<option value="101">Nadar Mahajana Sangam</option>
<option value="102">Nalanda Educational Institutions</option>
<option value="103">Narayana Group of Educational Institutions</option>
<option value="104">National Commission for Minority Educational Institutions</option>
<option value="105">National Council for Teacher Education</option>
<option value="106">National Council of Educational Research and Training</option>
<option value="107 ">National Institute of Mountaineering and Allied Sports</option>
<option value="108">National Institute of Securities Markets</option>
<option value="109">National Skill Development Agency</option>
<option value="110">Navodaya Vidyalaya Samiti</option>
<option value="111">Nettur Technical Training Foundation</option>
<option value="112">North East National Board of School Education</option>
<option value="113">Northwest College for Advanced Learning</option>
<option value="114">NTR Trust</option>
<option value="115">Nutan Vidyalaya Education Society</option>
<!-- O -->
<option value="116">Our Children Foundation</option>
<!-- P -->
<option value="117">Parikrma Humanity Foundation</option>
<option value="118">Parisar Asha</option>
<option value="119">Pratham</option>
<option value="120">Project Nanhi Kali</option>
<option value="121">PSG Group</option>
<option value="122">Punjab State Board of Technical Education and Industrial Training</option>
<!-- R -->
<option value="123">Rai Foundation</option>
<option value="124">Rajalakshmi Institutions</option>
<option value="125">Rashtreeya Sikshana Samithi Trust</option>
<option value="126">Read India</option>
<option value="127">RGNIYD Regional Centre (Chandigarh)</option>
<option value="128">Rural Development Foundation, India</option>
<option value="129">Ryan International Group of Institutions</option>
<!-- S -->
<option value="130">Sálim Ali Centre for Ornithology and Natural History</option>
<option value="131">Schools of Equality</option>
<option value="132">Science City Chennai</option>
<option value="133">Science Olympiad Foundation</option>
<option value="134">Sherab Gatsel Lobling School</option>
<option value="135">Shri Gangajali Education Society</option>
<option value="136">Society Against Violence in Education</option>
<option value="137">Sonam Gyatso Mountaineering Institute</option>
<option value="138">St. Soldier Educational Society</option>
<option value="139">State Board of Technical Education, Bihar</option>
<option value="140">Sugar Technologists Association of India</option>
<option value="141">SWAYAM</option>
<option value="142">Symbiosis Society</option>
<!-- T -->
<option value="143">TalentSprint</option>
<option value="144">Teach For India</option>
<option value="145">TES India</option>
<option value="146">Tibetan Children's Villages</option>
<!-- U -->
<option value="147">United States-India Educational Foundation</option>
<option value="148">UPAY</option>
<option value="149">Uplift Humanity India</option>
<!-- V -->
<option value="150">VIBGYOR Group of Schools</option>
<option value="151">Vidya Bharati</option>
<option value="152">Vignan Educational Foundation</option>
<option value="153">Vivekananda Educational Society</option>
<option value="154">Vivekananda Kendra</option>
<option value="155">Vivekananda Vidyaniketan Educational Institutions</option>
<!-- Y -->
<option value="156">Young Lamas Home School</option>
<option value="157">The YP Foundation</option>
<option value="158">Yuva Unstoppable</option>
</select>
<!-- text box -->
<label for="edunameother">Others:</label>
<input type="text" class="form-control" name="educationalname" id="edunameother" placeholder="Enter your Educational Trust name." >
</fieldset>
</div>
<div class="col-sm-12 form-group">
<label for="eduaddress">Full Address:</label>
<input type="text" class="form-control" name="educationaladdress" id="eduaddress" placeholder="Enter your Education full Address" required>
</div>
<div class="col-sm-10 form-group">
<label for="location">Location:</label>
<input type="text" id="location" class="form-control" name="location" readonly>
</div>
<div class="col-sm-2 form-group"><br>
<button style="margin-top:10px;" class="btn btn-success" type="button" onclick="getLocation()">Get location</button>
</div>
<!-- <div class="col-sm-6 form-group">
<label for="educationalcontact">Mobile No.1 </label>
<input type="phone" name="educationalcontact" class="form-control" id="educationalcontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" pattern="[1-9]{10}" required>
</div>
<div class="col-sm-6 form-group">
<label for="educationalmobile">Mobile No.2 </label>
<input type="educationalmobile" name="cnf-phone" class="form-control" id="educationalmobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="educationalemail">Email</label>
<input type="email" class="form-control" name="educationalemail" id="educationalemail" placeholder="Enter your email of education Trust" required> -->
<div class="col-sm-6 form-group">
<label for="educontact">Contact No. </label>
<input type="phone" name="educationalcontact" class="form-control" id="educontact" placeholder="XXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="edumobile">Mobile No.2 </label>
<input type="phone" name="educationalmobile" class="form-control" id="edumobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="eduemail">Email</label>
<input type="email" class="form-control" name="educationalemail" id="eduemail" placeholder="Enter your email of education Trust" required>
</div>
<!-- Educational Trust: -->
<br><br>
<!-- President/Chairman: -->
<div class="col-sm-12 form-group">
<label for="presidentname">Name of the President/Chairman:</label>
<input type="text" class="form-control" name="presidentname" id="presidentname" placeholder="Enter your president/Chairman " required>
</div>
<div class="col-sm-6 form-group">
<label for="presidentcontact">Contact No. </label>
<input type="phone" name="presidentcontact" class="form-control" id="presidentcontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="Presidentmobile">Mobile No. </label>
<input type="phone" name="Presidentmobile" class="form-control" id="Presidentmobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="presidentemail">Email</label>
<input type="email" class="form-control" name="presidentemail" id="presidentemail" placeholder="Enter your email of president/Chairman" required>
</div>
<!-- <label for="prename">Name of the President/Chairman:</label>
<input type="text" class="form-control" name="presidentname" id="prename" placeholder="Enter your president/Chairman " required>
</div>
<div class="col-sm-6 form-group">
<label for="precontact">Mobile No.1 </label>
<input type="phone" name="presidentcontact" class="form-control" id="precontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="premobile">Mobile No.2 </label>
<input type="phone" name="Presidentmobile" class="form-control" id="premobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="preemail">Email</label>
<input type="email" class="form-control" name="presidentemail" id="preemail" placeholder="Enter your email of president/Chairman" required>
</div> -->
<!-- President/Chairman: -->
<br><br>
<!-- Hon.Secretary: -->
<div class="col-sm-12 form-group">
<label for="secretaryname">Name of the Hon.Secretary:</label>
<input type="text" class="form-control" name="secretaryname" id="secretaryname" placeholder="Enter your Hon.Secretary: " required>
</div>
<div class="col-sm-6 form-group">
<label for="secretarycontact">Contact No. </label>
<input type="phone" name="secretarycontact" class="form-control" id="secretarycontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="secretarymobile">Mobile No. </label>
<input type="phone" name="secretarymobile" class="form-control" id="secretarymobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="secretaryemail">Email</label>
<input type="email" class="form-control" name="secretaryemail" id="secretaryemail" placeholder="Enter your email of Hon.Secretary:" required>
</div>
<!-- <label for="secrname">Name of the Hon.Secretary:</label>
<input type="text" class="form-control" name="secretaryname" id="secrname" placeholder="Enter your Hon.Secretary: " required>
</div>
<div class="col-sm-6 form-group">
<label for="secrcontact">Mobile No.1 </label>
<input type="phone" name="secretarycontact" class="form-control" id="secrcontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="secrmobile">Mobile No.2 </label>
<input type="phone" name="secretarymobile" class="form-control" id="secrmobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="secremail">Email</label>
<input type="email" class="form-control" name="secretaryemail" id="secremail" placeholder="Enter your email of Hon.Secretary:" required>
</div> -->
<!-- Hon.Secretary: -->
<br><br>
<!-- Coordinator Wiht PAI-ICT Academy Pune-->
<div class="col-sm-12 form-group">
<label for="coordinatorname">Name of the Coordinator With PAI-ICT Academy Pune</label>
<input type="text" class="form-control" name="coordinatorname" id="coordinatorname" placeholder="Enter your Coordinator With PAI-ICT Academy Pune " required>
</div>
<div class="col-sm-6 form-group">
<label for="coordinatorcontact">Contact No. </label>
<input type="phone" name="coordinatorcontact" class="form-control" id="coordinatorcontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="coordinatormobile">Mobile No. </label>
<input type="phone" name="coordinatormobile" class="form-control" id="coordinatormobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="coordinatoremail">Email</label>
<input type="email" class="form-control" name="coordinatoremail" id="coordinatoremail" placeholder="Enter your Coordinator With PAI-ICT Academy Pune" required>
</div>
<!-- <label for="coorname">Name of the Coordinator With PAI-ICT Academy Pune</label>
<input type="text" class="form-control" name="coordinatorname" id="coorname" placeholder="Enter your Coordinator Wiht PAI-ICT Academy Pune " required>
</div>
<div class="col-sm-6 form-group">
<label for="coorcontact">Mobile No.1 </label>
<input type="phone" name="coordinatorcontact" class="form-control" id="coorcontact" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="coormobile">Mobile No.2 </label>
<input type="phone" name="coordinatormobile" class="form-control" id="coormobile" placeholder="XXXXXXXXXX" minlength="10" maxlength="10" required>
</div>
<div class="col-sm-12 form-group">
<label for="cooremail">Email</label>
<input type="email" class="form-control" name="coordinatoremail" id="cooremail" placeholder="Enter your Coordinator Wiht PAI-ICT Academy Pune" required>
</div> -->
<!-- Coordinator With PAI-ICT Academy Pune -->
<br> <hr>
<!-- <div class="col-sm-6 form-group">
<label for="address-2">Address Line-2</label>
<input type="address" class="form-control" name="address" id="address-2" placeholder="Village/City Name." required>
</div>
<div class="col-sm-4 form-group">
<label for="State">State</label>
<input type="address" class="form-control" name="State" id="State" placeholder="Enter your state name." required>
</div>
<div class="col-sm-2 form-group">
<label for="zip">Postal-Code</label>
<input type="zip" class="form-control" name="Zip" id="zip" placeholder="Postal-Code." required>
</div>
<div class="col-sm-6 form-group">
<label for="Country">Country</label>
<select class="form-control custom-select browser-default">
<option value="Australia">Australia</option>
<option value="Hong Kong">Hong Kong</option>
<option value="India">India</option>
<option value="Maldives">Maldives</option>
<option value="Norway">Norway</option>
<option value="Switzerland">Switzerland</option>
<option value="Thailand">Thailand</option>
<option value="Turkey">Turkey</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
</select>
</div>
<div class="col-sm-6 form-group">
<label for="Date">Date Of Birth</label>
<input type="Date" name="dob" class="form-control" id="Date" placeholder="" required>
</div>
<div class="col-sm-6 form-group">
<label for="sex">Gender</label>
<select id="sex" class="form-control browser-default custom-select">
<option value="male">Male</option>
<option value="female">Female</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-6 form-group">
<label for="tel">Phone</label>
<input type="tel" name="phone" class="form-control" id="tel" placeholder="Enter Your Contact Number." minlength="10" maxlength="10" required>
</div>
<div class="col-sm-6 form-group">
<label for="pass">phone</label>
<input type="phone" name="phone" class="form-control" id="pass" placeholder="Enter your phone." required>
</div>
<div class="col-sm-6 form-group">
<label for="pass2">Confirm phone</label>
<input type="phone" name="cnf-phone" class="form-control" id="pass2" placeholder="Re-enter your phone." required>
</div>
<div class="col-sm-12">
<input type="checkbox" class="form-check d-inline" id="chb" required><label for="chb" class="form-check-label"> I accept all terms and conditions.
</label>
</div> -->
<div class="col-sm-2 form-group">
<label for="date">Date</label>
<input type="datetime-local" class="form-control" name="date" id="date" required>
</div>
<!-- -------Captcha Starts Here--------
<br>
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName">
Captcha
</label>
<script type="text/javascript">
//Created / Generates the captcha function
function DrawCaptcha()
{
var a = Math.ceil(Math.random() * 10)+ '';
var b = Math.ceil(Math.random() * 10)+ '';
var c = Math.ceil(Math.random() * 10)+ '';
var d = Math.ceil(Math.random() * 10)+ '';
var e = Math.ceil(Math.random() * 10)+ '';
var f = Math.ceil(Math.random() * 10)+ '';
var g = Math.ceil(Math.random() * 10)+ '';
var code = a + ' ' + b + ' ' + ' ' + c + ' ' + d + ' ' + e + ' '+ f + ' ' + g;
document.getElementById("txtCaptcha").value = code
}
// Validate the Entered input aganist the generated security code function
function ValidCaptcha(){
var str1 = removeSpaces(document.getElementById('txtCaptcha').value);
var str2 = removeSpaces(document.getElementById('txtInput').value);
if (str1 == str2) {
document.getElementById("submit").disabled = false;
return true;
}
return false;
}
// Remove the spaces from the entered and generated code
function removeSpaces(string)
{
return string.split(' ').join('');
}
</script>
<body onload="DrawCaptcha();">
<table>
<tr>
<td>
<input type="text" id="txtCaptcha"
style="background-color:#e7d16c; text-align:center; border:none;
font-weight:bold; font-family:Verdana; font-size:14px; width:234px;" />
<input type="button" id="btnrefresh" value="Refresh" onclick="DrawCaptcha();" />
</td>
</tr>
<tr>
<td>
<input type="text" id="txtInput" placeholder="Please Type Captcha Here" style="width:234px;" required/>
</td>
</tr>
<tr>
<td>
<input id="Button1" type="button" value="Check" onclick="alert('Captcha Verification is : ' + ValidCaptcha());"/>
</td>
</tr>
</table> -->
<div class="col-sm-12 form-group mb-0">
<!-- <a href="form2.html"> <button class="btn btn-success" type="butt">Next</button> </a> -->
<button class="btn btn-success" type="reset">Reset </button>
<button class="btn btn-success" type="submit" >Next</button>
</div>
</div>
</form>
</div>
</body>
</html>