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<!DOCTYPE html>
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<title>Para Medical Council | New Study Centre</title>
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  <meta name="viewport" content="width=device-width, initial-scale=1">
 
  
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<link rel="stylesheet" href="assets/css/style.css">
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</head>

<body id="top-header">
<?php include"includes/header.php" ; ?>
<section class="page-header">
  <div class="container">
    <div class="row justify-content-center">
      <div class="col-lg-8">
          <div class="page-header-content">
            <h1>New Study Centre</h1>
            <ul class="list-inline mb-0">
              <li class="list-inline-item">
                <a href="index.html">Home</a>
              </li>
              <li class="list-inline-item">/</li>
              <li class="list-inline-item">
              New Study Centre
              </li>
            </ul>
          </div>
      </div>
    </div>
  </div>
</section>

<section class="contact-info section-padding">
    <div class="container">
        <div class="row align-items-center justify-content-center">
            <div class="col-lg-6">
                <div class="section-heading center-heading">
                    <span class="subheading">Para Medical Council</span>
                    <h3>New Study Centre
</h3>
                   
                </div>
            </div>
        </div>
       
        <div class="row justify-content-center p-3">

<div class="col-lg-12 form3">
			<form id="myForm" class="form-transparent" enctype="multipart/form-data">
              <div class="row">
                <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="name" class="form-control" placeholder="Name of  Centre*">
                           </div>
                       </div>
					  
					   <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="postaladdress" class="form-control" placeholder="Postal Address*">
                           </div>
                       </div>
					    <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="nameofngo" class="form-control" placeholder="Name of NGO*">
                           </div>
                       </div>
					   <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="pannumber" class="form-control" placeholder="Pan Number*">
                           </div>
                       </div>
					    <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="phone" class="form-control" placeholder="Contact Number*">
                           </div>
                       </div>
					    <div class="col-lg-6">
                           <div class="form-group">
                               <select name="course_applied" class="form-control p-3" style="height:50px;">
                                    <option value="">Select Course</option>
                                    <?php
                                        include 'includes/db.php';
                                        $sql = "select * from coursename";
                                        $query = mysqli_query($connection,$sql);
                                        while($row=mysqli_fetch_array($query)){?>
                                        <option value="<?php echo $row['name_id'];?>" ><?php echo $row['coursename']?> </option>
                                    <?php } ?>
                                </select>
                           </div>
                       </div>
					    <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="mobilenumber" class="form-control" placeholder="Mobile Number*">
                           </div>
                       </div>
					    <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="email" class="form-control" placeholder="Mail ID*">
                           </div>
                       </div>
					    <div class="col-lg-12">
                           <div class="form-group">
                              <p><strong>Current infrastructure that is available with you for educational purpose</strong></p>
                           </div>
                       </div>
					   <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="areaofcenter" class="form-control" placeholder="Total Area of the center*">
                           </div>
                       </div>
					    <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="totalcoveredcenter" class="form-control" placeholder="Total Covered center*">
                           </div>
                       </div>
					      <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="roomsavailable" class="form-control" placeholder="Number of Rooms Available*">
                           </div>
                       </div>
					      <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="facilityavailable" class="form-control" placeholder="Internet Facility Available ( YES/NO )?*">
                           </div>
                       </div>
					      <div class="col-lg-6">
                           <div class="form-group">
                               <input type="text" name="totalfaculties" class="form-control" placeholder="Total Facalties*">
                           </div>
                       </div>
					   
					   <div class="col-lg-6">
                           <div class="form-group">
                              
                           </div>
                       </div>
					   
					   
					   <div class="col-lg-12 pt-3">
                           <div class="form-group">
						   <p><strong>Attach one set of</strong></p>
						   <ul>
<li>1. Visiting card</li>
<li>2. Letter head</li>
<li>3. Profile of your center </li>
<li>4. Construction of the Organisation</li>
<li>5. List of the office bearers </li>
<li>6. Copy of the registration certificate</li>
<li>7. Details of actvities infrastructure facilities </li>
<li>8. Rs. 10000/- against inspection charges etc. are attached for affiliation process.</li>
<li>9. Per course reg. fee 2000/-</li>
</ul>
<p><strong>Upload Docs: </strong></p>
<p> Any other required information & necessary affiliation fee will 
be made available on demand. Therefore it is requested you to kindly complete 
the process of affiliation.</p>
<p>I hereby confirm that my training centre, processes and other requirements as mentioned in 
this application form are true to the best of my knowledge and information.  I further assure
 that we will provide the documents as and when required by the Para Medical Council.
I further assure you to provide all the details as required. We further acknowledge and 
understand that if any information provided by us in the application form or its enclosures is 
found to be wrong or misleading, Para Medical Council has all the rights to cancel our application 
and take such penal action as deemed proper.</p>
<p><strong>NOTE :</strong> Para- Medical Council  can modify or amend these Terms & Conditions and 
Charges from time to time as per need without any prior notice</p>
<p>
(NGO Registration Certificate,   
Photo, 
Aadhar card, 
Domicile certificate, 
Pan card,) in one PDF</p>

</div>
						   
                       </div>
					   
					   <div class="col-lg-6">
                           <div class="form-group">
						   <p><strong>Upload PDF file:</strong></p>
                              <input id="form_attachment" name="filename" class="file" value="" type="file">
                           </div>
						   
                       </div>
					     
					   
					    
              </div>
			  
            <div class="col-lg-12">
                       <div class="mt-4 text-left">
                           <button class="btn btn-main" type="submit" name="submit">Submit <i class="fa fa-angle-right ml-2"></i></button>
                       </div>
                   </div>
				   
				   
            </form>
			
               
            </div>
        </div>
    </div>
</section>

<br><br>
<?php include"includes/footer.php" ; ?>
  </body>
<script>
$(document).ready(function() {
    $('#myForm').on('submit', function(event) {
        event.preventDefault(); // Prevent the default form submission

var formData = new FormData(this); // Create a FormData object from the form

$.ajax({
            url: 'ajax/new-study-centre.php', // The URL to which the request is sent
            type: 'POST', // The type of request
            data: formData, // The data to send
            contentType: false, // Prevent jQuery from overriding the Content-Type
            processData: false, // Prevent jQuery from processing the data
            success: function(response) {
                // Handle the response from the server
                // Replace <br> with newline characters
                var formattedResponse = response.replace(/<br\s*\/?>/gi, '\n');

// Display the response in a more user-friendly way
                // For example, using an alert or a dedicated div
                alert(formattedResponse); // You can replace this with a more user-friendly message
                // Optionally, you can reset the form after successful submission
                $('#myForm')[0].reset();
            },
            error: function(jqXHR, textStatus, errorThrown) {
                // Handle errors
                alert('Error: ' + textStatus + ' - ' + errorThrown);
            }
        });
    });
});
</script>

</html>