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applicationug.php
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<?php
include("connection.php");
?>
<!DOCTYPE html>
<HTML>
<Head>
<title>BGC Application Form for UG</title>
<link rel="stylesheet" type="text/css"href="style.css">
</Head>
<body>
<div class="row1">
<div class="coln">
<img src= 'images/Icon.jpg' height="100"/>
</div>
<div class="col1">
<h1>BERHAMPORE GIRLS' COLLEGE</h1>
<p5 style="padding-left:70px;"><b>ONLINE APPLICATION FORM FOR BGCEE 2021-2022</b></p5>
</div>
</div>
<div class="applicationform">
<form id="applicationform" method="post" action="ug_next.php" enctype="multipart/form-data">
<label for="course"><b>Course :</b></label>
<select name="course" id="course" >
<option>Choose course</option>
<optgroup label="BA">
<option>BA English hons</option>
<option>BA Bengali hons</option>
<option>BA Sanskrit hons</option>
<option>BA history hons</option>
<option>BA Philosophy hons</option>
<option>BA Political Science hons</option>
<option>BA Sociology hons</option>
<option>BA Geography hons</option>
<option>BA Economics hons</option>
<option>BA Physical Education hons</option>
</optgroup>
<optgroup label="B.Sc">
<option>B.Sc Mathematics hons</option>
<option>B.Sc Physics hons</option>
<option>B.Sc Chemistry hons</option>
<option>B.Sc Computer Science hons</option>
<option>B.Sc Botany hons</option>
<option>B.Sc Zoology hons</option>
<option>B.Sc physiology hons</option>
<option>B.Sc Geography hons</option>
<option>B.Sc Economics hons</option>
<option>B.Sc Environmental Science hons</option>
</optgroup>
</select><br><br>
<center> <h8 style="font-size:25px;">Personal details-<br></h8> </center><br>
<div class="name">
<label><b> Name : </b> </label>
<input type="text" name="fname" id="name" placeholder="First name">
<input type="text" name="mname" id="name" placeholder="Middle name">
<input type="text" name="lname" id="name" placeholder="Last name"><br><br>
</div>
<label for="dob"><b>Date of birth :</b></label>
<input type="date" name="dob" class="name" placeholder="Date of birth">
<label for="bloodgroup"><b>Blood Group :</b></label>
<select name="bloodgroup" class="blood">
<option>Choose Blood Group</option>
<option>A+</option>
<option>O+</option>
<option>B+</option>
<option>AB+</option>
<option>A-</option>
<option>O-</option>
<option>B-</option>
<option>AB-</option>
</select><br><br>
<label for="address"><b>Address :</b></label>
<input type="address" name="address1" id="address" placeholder="Address">
<label for="pincode"><b>Pincode :</b></label>
<input type="num" name="pincode" id="number" placeholder="Pincode" maxlength="6">
<label for="stat"><b>State :</b></label>
<select name="stat" id="blood">
<option>Choose State</option>
<option>Andhra Pradesh</option>
<option>Arunachal Pradesh</option>
<option>Assam</option>
<option>Bihar</option>
<option>Chhattishgarh</option>
<option>Goa</option>
<option>Gujrat</option>
<option>Haryana</option>
<option>Himachal Pradesh</option>
<option>Jammu And Kashmir</option>
<option>Jharkhand</option>
<option>Karnataka</option>
<option>Kerala</option>
<option>Madhya Pradesh</option>
<option>Maharashtra</option>
<option>Manipur</option>
<option>Meghalaya</option>
<option>Mizoram</option>
<option>Nagaland</option>
<option>Odisha</option>
<option>Punjab</option>
<option>Rajasthan</option>
<option>Sikkim</option>
<option>Tamil Nadu</option>
<option>Telengana</option>
<option>Tripura</option>
<option>Uttar Pradesh</option>
<option>Uttrakhand</option>
<option>West Bengal</option>
</select><br><br>
<label for="email"><b>Email :</b></label>
<input type="email"name="email" id="name"placeholder="Email">
<label for="number"><b>Mobile Number :</b></label>
<select id="num">
<option>+91</option>
</select>
<input type="string" name="number1" id="name"placeholder=" Mobile number" maxlength="10"><br><br>
<label for="religion"><b>Religion :</b></label>
<input type="radio"name="religion"value="Hindu">
<label for="Hindu">Hindu</label>
<input type="radio"name="religion"value="Muslim">
<label for="Muslim">Muslim</label>
<input type="radio"name="religion"value="Others">
<label for="Others">Others</label>
<label for="Caste"><b> Caste :</b></label>
<select name="caste" class="cast">
<option>Choose Caste</option>
<option>General</option>
<option>SC</option>
<option>ST</option>
<option>OBC</option>
</select>
<label for="nationality"><b> Nationality :</b></label>
<select name="nationality"class="cast">
<option>Indian</option>
</select><br><br>
<label for="fathername"><b>Father's Name :</b></label>
<input type="text"name="ffname"id="name"placeholder="First name">
<input type="text"name="fmname"id="name"placeholder="Middle name">
<input type="text"name="flname"id="name"placeholder="Last name"><br><br>
<label for="mfname"><b>Mother's Name :</b></label>
<input type="text"name="mfname"id="name"placeholder="First name">
<input type="text"name="mmname"id="name"placeholder="Middle name">
<input type="text"name="mlname"id="name"placeholder="Last name"><br><br>
<label for="gfname"><b>Guardian's Name :</b></label>
<input type="text"name="gfname"id="name"placeholder="First name">
<input type="text"name="gmname"id="name"placeholder="Middle name">
<input type="text"name="glname"id="name"placeholder="Last name"><br><br>
<label for="relation"><b>Guardian relation :</b></label>
<select name="relation"id="num">
<option>Choose relation</option>
<option>Father</option>
<option>Husband</option>
<option>Brother</option>
<option>Mother</option>
<option>Sister</option>
<option>Others</option>
</select><br><br>
<label for="occupation"><b>Guardian's Occupation :</b></label>
<input type="text"name="occupation"id="name"placeholder="Guardian's Occupation">
<label for="gnum"><b>Guardian's Contact Number :</b></label>
<select id="num">
<option>+91</option>
</select>
<input type="text" name="gnum" id="num" placeholder="Guardian's Contact Number" maxlength="10"><br><br>
<center> <h8>Academic details-<br></h8> </center>
<label for="classx"style="font-size:20px;"><b>Class X :-</b></label><BR><br>
<label for="board"><b>Board/Council :</b></label>
<input type="text" name="board" id="name"placeholder="Board">
<label for="Schoolx"><b>School Name :</b></label>
<input type="text"name="schoolx"id="name"placeholder="School name">
<label for="yearp"><b>Passing Year :</b></label>
<select name="yearp"id="num">
<option>Choose Year</option>
<option>2019</option>
<option>2018</option>
<option>2017</option>
<option>2016</option>
<option>2015</option>
</select><br><br>
<label for="marksobx"><b>Marks Obtained :</b></label>
<input type="num"name="marksobx"id="name"placeholder="Marks Obtained"maxlength="3">
<label for="marksfullx"><b> Marks :</b></label>
<input type="num"name="marksfullx"id="name"placeholder="Full Marks"maxlength="3">
<label for="marksavgx"><b>% Average :</b></label>
<input type="num"name="marksavgx"id="name"placeholder="%"maxlength="2"><br><br>
<label for="classxii"style="font-size:20px;"><b>Class XII :-</b></label><BR><br>
<label for="board1"><b>Board/Council :</b></label>
<input type="text" name="board1" id="name"placeholder="Board">
<label for="Schoolxii"><b>School Name :</b></label>
<input type="text"name="schoolxii"id="name"placeholder="School name">
<label for="yearpxii"><b>Passing Year :</b></label>
<select name="yearpxii"id="num">
<option>Choose year</option>
<option>2021</option>
<option>2020</option>
<option>2019</option>
<option>2018</option>
<option>2017</option>
</select><br><br>
<label for="marksobxii"><b>Marks Obtained :</b></label>
<input type="num"name="marksobxii"id="name"placeholder="Marks Obtained"maxlength="3">
<label for="marksfullxii"><b>Full Marks :</b></label>
<input type="num"name="marksfullxii"id="name"placeholder="Full Marks"maxlength="3">
<label for="marksavgxii"><b>% Average :</b></label>
<input type="num"name="marksavgxii"id="name"placeholder="%"maxlength="2"><br><br>
<label for="filep"><b>Upload your phpto :</b></label>
<input type="file"name="filep"placeholder="choose file">
<label for="files"><b>Upload your Signature :</b></label>
<input type="file"name="files"placeholder="choose file"><br><br>
<label for="covid"><b>Are you covid vaccinated?</b> </label>
<select name="covid"id="num">
<option>Choose</option>
<option>Yes</option>
<option>No</option>
</select><br><br>
<div class="submit">
<button type="submit" name="submit" >SUBMIT</button>
</div>
</form>
</div>
</body>
</html>