-
Notifications
You must be signed in to change notification settings - Fork 0
/
visa_form.html
263 lines (239 loc) · 8.25 KB
/
visa_form.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
<!-- Passsport Form -->
<!DOCTYPE html>
<html lang="en">
<head>
<title>Visa Form</title>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8"/>
<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1.0, user-scalable=no"/>
<!-- CSS -->
<link href="https://fonts.googleapis.com/icon?family=Material+Icons" rel="stylesheet">
<link href="css/materialize.css" type="text/css" rel="stylesheet" media="screen,projection"/>
<link href="css/style.css" type="text/css" rel="stylesheet" media="screen,projection"/>
<style>
/* Class for placement of error messages for jQuery Validate */
.errorMessage {
font-size: 18px;
}
.errorMessage i,
.errorMessage [class^="mdi-"], .breadcrumb [class*="mdi-"],
.errorMessage i.material-icons {
display: inline-block;
float: left;
font-size: 24px;
}
.errorMessage:before {
color: rgba(255, 255, 255, 0.7);
vertical-align: top;
display: inline-block;
font-family: 'Material Icons';
font-weight: normal;
font-style: normal;
font-size: 25px;
margin: 0 10px 0 8px;
-webkit-font-smoothing: antialiased;
}
.errorMessage:first-child:before {
display: none;
}
.invalid {
color: red;
font-size: 1em;
}
</style>
</head>
<body>
<div class="grey lighten-3 visa_image1">
<div class="row">
<div class="col s12 m12 l12">
<div class="header">
<h1 class="center">Visa Application</h1>
</div>
<div class="row">
<form class="col s12" id="VisaForm" action="Visa_validate.asp" method="POST">
<div class="row">
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">account_circle</i>
<input id="fname" type="text" class="validate" name="fname2">
<label for="fname">First Name</label>
</div>
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">account_circle</i>
<input id="lname" type="text" class="validate" name="lname2">
<label for="lname">Last Name</label>
</div>
</div>
</div>
<div class="row">
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">phone</i>
<input id="mobile" type="text" name="mobile2" class="validate">
<label for="mobile">Mobile No </label>
</div>
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">email</i>
<input id="em1" type="text" class="validate" name="em2">
<label for="em1">Email </label> <!-- If Above 18 ,Validate !-->
</div>
</div>
<div class="row">
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">reorder</i>
<textarea id="textarea1" class="materialize-textarea validate" name="address2"></textarea>
<label for="textarea1">Address</label>
</div>
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">perm_identity</i>
<label for="gender">Gender</label>
<br>
<input name="grp1" type="radio" id="r1">
<label for="r1">Male</label>
<input name="grp1" type="radio" id="r2">
<label for="r2">Female</label>
</div>
</div>
<div class="row">
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">perm_identity</i>
<input id="dob" type="date" class="datepicker validate" name="dob2">
<label for="dob">Date Of Birth </label>
</div>
<div class="input-field col s12 m8 l6">
<select>
<option value="Passport" class="selected" name="vtype2">Select</option>
<option value="1">Business Visa</option>
<option value="2">Tourist Visa</option>
</select>
<label>Visa Type</label>
</div>
</div>
<div class="row">
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">comment</i>
<select name="country2">
<option value="Visa" selected>Select</option>
<option value="1">United Kingdom</option>
<option value="2">France</option>
<option value="3">New Zealand</option>
<option value="4">United States of America</option>
<option value="5">Germany</option>
<option value="6">Canada</option>
<option value="7">United Arab Emirates</option>
</select>
<label>Country</label>
</div>
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">comment</i>
<input id="em1" type="text" class="validate" name="city2">
<label for="city">City</label>
</div>
</div>
<div class="row">
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">comment</i>
<input id="em1" type="text" class="validate" name="acn2">
<label for="em1">Aadhar Card No </label>
</div>
<div class="input-field col s12 m8 l6">
<i class="material-icons prefix">offline_pin</i>
<input id="pancard" type="text" class="validate" name="pcn2">
<label for="pancard" class="iconstyle">Pan Card No </label>
</div>
</div>
<div class="row center-align" style="padding-left:150>
<div class="col s12 m8 l6">
<h5><button type="submit" class="waves-effect waves-light btn">Submit</a></h5>
</div>
</div>
<div class="row">
<div class="col s12 m6 l12">
<h5><a href="index.html" class="waves-effect waves-light btn"> Back To HomePage</h5></a>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
<!-- Scripts-->
<script src="js/jquery-3.1.0.min.js"></script>
<script src="js/materialize.js"></script>
<script src="js/jquery.validate.min.js"></script>
<script src="js/additional-methods.min.js"></script>
<script src="js/init.js"></script>
<script>
//JQuery Select Option
$(document).ready(function() {
$('select').material_select();
});
//jQuery Validate defaults
jQuery.validator.setDefaults({
errorClass: 'errorMessage invalid',
validClass: "valid",
errorElement : 'div',
errorPlacement: function(error, element) {
var placement = $(element).data('error');
if (placement) {
$(placement).append(error)
} else {
error.insertAfter(element);
}
}
});
//Text Fields
$(document).ready(function() {
Materialize.updateTextFields();
});
//Date Picker
$(document).ready(function() {
$('.datepicker').pickadate({
selectMonths: true, // Creates a dropdown to control month
selectYears: 100 // Creates a dropdown of 15 years to control year
});
$("#VisaForm").validate({
rules: {
fname2: {
required: true,
pattern: /^[a-zA-Z ]+$/,
maxlength: 16
},
lname2: {
required: true,
pattern: /^[a-zA-Z ]+$/,
maxlength: 16
},
mobile2: {
required: true,
digits: true,
minlength: 10,
maxlength: 10
},
em2: {
required: true,
email: true,
pattern: /^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+\.[a-zA-Z0-9-.]+$/,
maxlength: 64
},
address2: {
required: true,
maxlength: 56
},
dob2: {
required: true
},
acn2: {
required: true,
digits:true,
maxlength: 64
},
pcn2: {
required: true,
email: true,
pattern: /^[a-zA-Z0-9]+$/,
maxlength: 64
}
}
});
});
</script>
</body>
</html>