<section id="scholership">
<div
class="container">
<form
action="https://creativeitinstitute.com/admission"
method="post" enctype="multipart/form-data">
<input type="hidden" name="_token" value="eykf8eNg5yFvWHaZnZKB4xvkeGK25Rm4AJGb6hOJ"> <div
class="row">
<div class="col-lg-12">
<div class="row form">
<div class="col-lg-12 form-head">
<h3>PERSONAL &
CONTACT INFORMATION</h3>
</div>
<div class="col-lg-12 col-sm-12">
<input
type="text" name="student_name" value=""
placeholder="Student Name*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="father_name" value=""
placeholder="Father’s Name*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="mother_name" value=""
placeholder="Mother’s Name*" class="form-control ">
</div>
<div
class="col-lg-12 col-sm-12">
<input
type="text" name="present_address" value=""
placeholder="Present Address*" class="form-control ">
</div>
<div
class="col-lg-12">
<input
type="text" name="permanent_address" value=""
placeholder="Permanent Address*" class="form-control ">
</div>
<div class="col-lg-6">
<input
type="text" name="office_address" value=""
placeholder="Office Address (If Applicable)" class="form-control
">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="nid" value=""
placeholder="National ID*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="occupation" value=""
placeholder="Occupation*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="date" name="dob" value=""
placeholder="Date of Birth*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<select
class="form-control " name="country">
<option
value="">Nationality*</option>
<option
value="1">Bangladeshi</option>
<option
value="2">Other Country</option>
</select>
</div>
<div class="col-lg-6">
<div
class="row">
<div
class="col-lg-5 col-sm-4">
<select class="form-control " name="blood_group">
<option value="">Blood Group*</option>
<option value="A+">A+</option>
<option value="A-">A-</option>
<option
value="B+">B+</option>
<option value="B-">B-</option>
<option value="AB+">AB+
<option value="AB- ">AB-
<option value="O+">O+</option>
<option value="O-">O-</option>
</select>
</div>
<div
class="col-lg-7 col-sm-8 ru-main text-right">
<span class="ru">Gender*</span>
<label class="customcheck">Male
<input
type="radio" name="gender" value="1">
<span class="checkmark"></span>
</label>
<label class="customcheck">Female
<input type="radio" name="gender"
value="2">
<span class="checkmark"></span>
</label>
</div>
</div>
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="phone" value=""
placeholder="Phone*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="email" value=""
placeholder="Email*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="guardian_number" value=""
placeholder="Guardian’s Phone*" class="form-control ">
</div>
<div class="col-lg-6
col-sm-6">
<input
type="text" name="relationship" value=""
placeholder="Relationship with the Guardian*"
class="form-control ">
</div>
</div>
</div>
<div class="col-lg-12" id="getintouch-part">
<div class="form-head">
<h3>Educational Background</h3>
</div>
<table width="100%"
height="50" class="text-center tbl1">
<tbody><tr>
<th>Degree</th>
<th>School /College/ University
<th>Board</th>
<th>Year
of Passing</th>
<th>Division / GPA</th>
</tr>
</tbody></table>
<table width="100%" class="text-center tbl2">
<tbody><tr>
<td>S.S.C
/ O Level</td>
<td><input type="text"
name="s_university"></td>
<td><input type="text" name="s_board"></td>
<td><input type="text"
name="s_year"></td>
<td><input type="text"
name="s_gpa"></td>
</tr>
</tbody></table>
<table width="100%"
class="text-center tbl2">
<tbody><tr>
<td>H.S.C
/ Diploma</td>
<td><input type="text"
name="h_university"></td>
<td><input type="text"
name="h_board"></td>
<td><input type="text"
name="h_year"></td>
<td><input type="text"
name="h_gpa"></td>
</tr>
</tbody></table>
<table width="100%" class="text-center tbl2">
<tbody><tr>
<td>Graduation</td>
<td><input type="text"
name="g_university"></td>
<td><input type="text"
name="g_board"></td>
<td><input type="text"
name="g_year"></td>
<td><input type="text"
name="g_gpa"></td>
</tr>
</tbody></table>
<table width="100%" class="text-center tbl2">
<tbody><tr>
<td>Post
Graduation</td>
<td><input type="text"
name="pg_university"></td>
<td><input type="text"
name="pg_board"></td>
<td><input type="text"
name="pg_year"></td>
<td><input type="text" name="pg_gpa"></td>
</tr>
</tbody></table>
</div>
<div class="col-lg-12">
<div class="row form">
<div class="col-lg-12 form-head">
<h3>Reference Details</h3>
</div>
<div class="col-lg-12 col-sm-12">
<input
type="text" name="name" value=""
placeholder="Name*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="phone_no" value=""
placeholder="Mobile Number*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="batch_name" value=""
placeholder="Batch*" class="form-control ">
</div>
<div class="col-lg-6
col-sm-6">
<input
type="text" name="batch_id" value=""
placeholder="ID*" class="form-control ">
</div>
<div class="col-lg-6 col-sm-6">
<input
type="text" name="relation" value=""
placeholder="Relation with Student" class="form-control
">
</div>
</div>
</div>
<div class="col-lg-12 text-center">
<div class="submit">
<button type="submit"
class="btn">Submit</button>
</div>
</div>
</div>
</form>
</div>
</section>
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