bnmbertsurhetertertertertertertertpdf'tdfg

hjkhghopjkertteerterterterertertrtoirh bnmbertsurhetertertertertertertertpdf'tdfg

<?php include "includes/db.php"; ?>
<!DOCTYPE html>
<html dir="ltr" lang="en">

<head>

<meta name="viewport" content="width=device-width,initial-scale=1.0"/>
<meta http-equiv="content-type" content="text/html; charset=UTF-8"/>
<meta name="description" content="#" />
<meta name="author" content="Paramedical"/>

<title>Admission</title>

<link href="images/favicon.png" rel="shortcut icon" type="image/png">
<link href="images/apple-touch-icon.png" rel="apple-touch-icon">
<link href="images/apple-touch-icon-72x72.png" rel="apple-touch-icon" sizes="72x72">
<link href="images/apple-touch-icon-114x114.png" rel="apple-touch-icon" sizes="114x114">
<link href="images/apple-touch-icon-144x144.png" rel="apple-touch-icon" sizes="144x144">

<link href="css/bootstrap.min.css" rel="stylesheet" type="text/css">
<link href="css/jquery-ui.min.css" rel="stylesheet" type="text/css">
<link href="css/animate.css" rel="stylesheet" type="text/css">
<link href="css/css-plugin-collections.css" rel="stylesheet"/>

<link id="menuzord-menu-skins" href="css/menuzord-skins/menuzord-boxed.css" rel="stylesheet"/>

<link href="css/style-main.css" rel="stylesheet" type="text/css">

<link href="css/preloader.css" rel="stylesheet" type="text/css">

<link href="css/custom-bootstrap-margin-padding.css" rel="stylesheet" type="text/css">

<link href="css/responsive.css" rel="stylesheet" type="text/css">

<link  href="js/revolution-slider/css/settings.css" rel="stylesheet" type="text/css"/>
<link  href="js/revolution-slider/css/layers.css" rel="stylesheet" type="text/css"/>
<link  href="js/revolution-slider/css/navigation.css" rel="stylesheet" type="text/css"/>

<link href="css/colors/theme-skin-orange.css" rel="stylesheet" type="text/css">

<script src="js/jquery-2.2.0.min.js"></script>
<script src="js/jquery-ui.min.js"></script>
<script src="js/bootstrap.min.js"></script>

<script src="js/jquery-plugin-collection.js"></script>

<script src="js/revolution-slider/js/jquery.themepunch.tools.min.js"></script>
<script src="js/revolution-slider/js/jquery.themepunch.revolution.min.js"></script>

<script async src="https://www.googletagmanager.com/gtag/js?id=UA-147079398-1"></script>
<script>
  window.dataLayer = window.dataLayer || [];
  function gtag(){dataLayer.push(arguments);}
  gtag('js', new Date());

gtag('config', 'UA-147079398-1');
</script>
</head>
<body class="has-side-panel side-panel-right fullwidth-page side-push-panel">
<div class="body-overlay"></div>
<div id="wrapper" class="clearfix">

<?php include "includes/header.php"; ?>
  
  
   
  <div class="main-content">
    
    <section class="inner-header divider layer-overlay overlay-deep" data-bg-img="images/bg/bg5.jpg">
      <div class="container pt-90 pb-50">
        
        <div class="section-content">
          <div class="row"> 
            <div class="col-md-12 xs-text-center">
              <h3 class="font-28">Admission</h3>
            </div>
          </div>
        </div>
      </div>
    </section>

<section>
      <div class="container">
        <div class="row">	
	<div class="col-sm-12">
            <div class="sidebar sidebar-right mt-sm-30 mb-sm-30">
			    <div class="sidebar-widget p-15 pt-10">
                    <div class="border-2px border-theme-colored p-15">
                  <h4 class="m-0 mb-30"> <i class="fa fa-envelope text-theme-colored"></i> Admission Form ( All the fields are mandatory. ) </h4>
				
                  
				          <form id="appointment_form_at_home" name="appointment_form_at_home" enctype="multipart/form-data" method="post" action="admissionform.php">
                        <div class="row">
						      <div class="col-sm-12">
                             <div class="form-group">
                             <label for="form_name">Course Applied for <small>*</small></label>
                             <input id="form_name" name="courseapplied" class="form-control" type="text"  placeholder="Enter course name..." aria-required="true" required="">
                             </div>
                           </div>

<div class="col-sm-12">
							   <h5> Select Course </h5>
                            <div class="form-group mb-10">
                              <input type="radio" name="selectcourse" value="regular" checked> Regular
							      <input type="radio" name="selectcourse" value="executive" checked> Executive
								  <input type="radio" name="selectcourse" value="part_time" checked> Part Time
                            </div>
                         </div>
						 
						    
						  
						     <div class="col-sm-12">
                             <div class="form-group">
                             <label for="form_name">Name of Candidate <small>*</small></label>
                             <input id="form_name" name="name" class="form-control" type="text"  placeholder="Enter your name..." aria-required="true" required="">
                             </div>
                           </div>
                          
						     <div class="col-sm-12">
                             <div class="form-group">
                             <label for="form_name">Name of Father <small>*</small></label>
                             <input id="form_name" name="fathername" class="form-control" type="text"  placeholder="Enter your father name..." aria-required="true" required="">
                             </div>
                           </div>
						  
						      <div class="col-sm-12">
                             <div class="form-group">
                             <label for="form_name">Name of Mother <small>*</small></label>
                             <input id="form_name" name="mothername" class="form-control" type="text"  placeholder="Enter your mother name..." aria-required="true" required="">
                             </div>
                           </div>

<div class="col-sm-12">
					   <div class="form-group mb-10">
                      <label for="form_message">Address for Correspondence <small>*</small></label>
                      <textarea id="form_message" name="addresscorrespondence" class="form-control required"  placeholder="Enter correspondence address..." rows="5" aria-required="true" required=""></textarea>
                    </div>
					 </div>
					   
					  
					  <div class="col-sm-12">
					   <div class="form-group mb-10">
                      <label for="form_message">Permanent Address <small>*</small></label>
                      <textarea id="form_message" name="permanentaddress" class="form-control required"  placeholder="Enter permanent address..." rows="5" aria-required="true" required=""></textarea>
                    </div>
					 </div>
					   
					     <div class="col-sm-12">
                  <div class="form-group mb-10">
                     <label for="form_phone">Mobile Number <small>*</small></label>
                    <input id="form_phone" name="mobile" class="form-control" type="text"  placeholder="Enter your 10 digit phone number..." aria-required="true" required="">
                  </div>
                </div>

<div class="col-sm-12">
                  <div class="form-group mb-10">
                     <label for="form_phone">Contact Number <small>*</small></label>
                    <input id="form_phone" name="contact" class="form-control" type="text"  placeholder="Enter your 10 contact number..." aria-required="true" required="">
                  </div>
                </div>
					  
						  	  
					<div class="col-sm-12">
                    <div class="form-group mb-10">
                      <label for="form_email">Email ID <small>*</small></label>
                      <input id="form_email" name="email" class="form-control required email" type="email"  placeholder="Enter email id..." aria-required="true" required="">
                    </div>
                  </div>
						    
							
				    <div class="col-sm-12">
                    <div class="form-group mb-10">
                      <label for="dob">Date of Birth: <small>*</small></label>
                      <input id="form_name" name="dateofbirth" class="form-control" type="date"  placeholder="" aria-required="true" required="">
                    </div>
                  </div>
						 
						 
						  <div class="col-sm-12">
                            <div class="form-group mb-10">
							   <label for="form_post">Nationality <small>*</small></label>
                            <select id="form_post" name="formpost" class="form-control required">
                              <option value="Select Nationality"> Select Nationality</option>
							           <option value="Indian">Indian</option>
									    <option value="Other">Other </option>
                              </select>
                           </div>
                         </div>
						 
						 
						  <div class="col-sm-12">
							   <h5> Gender </h5>
                            <div class="form-group mb-10">
                              <input type="radio" name="gender" value="male" checked> Male
							      <input type="radio" name="gender" value="female" checked> Female
                            </div>
                         </div>
						 
						 
						 <div class="col-sm-12">
							   <h5> Martial Status</h5>
                            <div class="form-group mb-10">
                              <input type="radio" name="martialstatus" value="single" checked> Single
							      <input type="radio" name="martialstatus" value="married" checked> Married
                            </div>
                         </div>
						  
						<div class="col-sm-12">
					   <div class="form-group mb-10">
                        <label for="form_attachment">Education Qualification (Attach photocopy) </label>
                        <input id="form_attachment" name="filename" class="file" value="" type="file" >
						
						   <small class="font-13">NOTE: Whether belongs to SC/ST/OBC etc.(if so attach certificate).................. I solemnly declare that the above facts are correct to the best my Knowledge</small>

</div>
                      </div>
					  
					  <div class="col-sm-12">
                    <div class="form-group mb-0 mt-10">
                      <input id="form_botcheck" name="form_botcheck" class="form-control" type="hidden" value="">
                      <button type="submit" name="cvubmit" class="btn btn-dark btn-theme-colored" data-loading-text="Please wait...">Submit</button>
                    </div>
					   </div>
					   </div>
                  </form>
    
                  
               
                </div>
                </div>
	  </div>
      </div>
	  </div>
	  
	         <div class="row">
          <div class="col-md-7 ml-15">
            <h4 class="mt-0 text-theme-colored">Hello Applicant,</h4>
            <p><strong class="text-black">Note:</strong> Read out all information carefully given below.</p>
			
			 <p class="text-uppercase">PARAMEDICAL COUNCIL RULES & REGULATION</p>
			 
			 <p class="text-black"><strong>1. Fees once paid is not refundable.</strong><br>
			 <strong>2. Any change in address should be communicated to the Academy office without delay.</strong><br>
			 <strong>3. Student joining the Academy shall have to abide by the rules and regulation from time to time and maintain decorum. In case of dispute. The decision of the Academy will be final</strong><br>
			 <strong>4. In case of legal dispute. The jurisdiction will be at Baghpat courts only.</strong><br>
			 <strong>5. Any harsh or abusive language used in the office or written in the letter may effect the admission of the candidate.</strong></p>
			 </div>
			 </div>
			 
			 
			 <div class="row">
             <div class="col-md-2 ml-15">
				 <a href="images/paramedical/pdf-file/admission-form.pdf" target="_blank"><img alt="" src="images/paramedical/pdf.png"></a>
             </div>
          </div>
			 
			 <h3 class="ml-15 text-theme-colored">All the best for Future Shaping with in advance.</h3>
          
        
	  </div>
    </section>

</div>

<?php include "includes/footer.php"; ?>