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application_form.html
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application_form.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<title>Kisumu Jacaranda Academy | Home Page</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="author" content="LakeHub Kisumu">
<!-- styles -->
<link href="assets/css/bootstrap.min.css" rel="stylesheet">
<link href="assets/css/gallery.css" rel="stylesheet">
<link href="assets/css/custom.css" rel="stylesheet">
<link href="assets/css/lightbox.css" rel="stylesheet">
<!-- shims -->
<!-- HTML5 shim, for IE6-8 support of HTML5 elements -->
<!--[if lt IE 9]>
<script src="../assets/js/html5shiv.js"></script>
<![endif]-->
<!-- Fav and touch icons -->
</head>
<body>
<nav class="navbar navbar-default navbar-jacaranda" role="navigation">
<div class="container">
<div class="navbar-header">
<button type="button" class="navbar-toggle" data-toggle="collapse" data-target="#collapse">
<span class="sr-only">Toggle Navigation</span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
</div>
<div class="collapse navbar-collapse" id="collapse">
<!-- <a class="brand" href="index.html">Kisumu Jacaranda Academy</a> -->
<ul class="nav navbar-nav pull-right">
<li><a href="index.html">Home</a></li>
<li><a href="Gallery.html">Gallery</a></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Enrollment <b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a href="application_form.html">Apply Now!</a></li>
<li class="divider"></li>
<li><a href="#">Fees structures</a></li>
</ul>
</li>
<li><a href="results.html">Top Students</a></li>
<li><a href="about_us.html">Contact Us</a></li>
</ul>
</div>
</div>
</nav>
<div class="container">
<form>
<div>
<div class="row">
<h3>Student Details:</h3><br />
<div class="row">
<div class="form-group col-md-4">
<label for="studentFName">First Name</label>
<input type="text" class="form-control" placeholder="First Name">
</div>
<div class="form-group col-md-4">
<label for="studentMName">Middle Name</label>
<input type="text" class="form-control" placeholder="Middle Name">
</div>
<div class="form-group col-md-4">
<label for="studentLName">Last Name</label>
<input type="text" class="form-control" placeholder="Last Name">
</div>
</div>
<div class="row">
<div class="form-group col-md-4">
<label for="studentDOB">Date of Birth</label>
<input type="date" class="form-control" placeholder="Last Name">
</div>
<div class="form-group col-md-4">
<label for="studentGender">Gender <br />
<input type="radio" class="radio-inline" name="gender"> Male
<input type="radio" class="radio-inline" name="gender"> Female
</label>
</div>
<div class="form-group col-md-4">
<label for="studentCounty">Current residence county</label>
<input type="text" class="form-control" placeholder="Residence County">
</div>
</div>
</div>
<div class="row">
<div class="col-md-2">
<h3>Enducational backgraound:</h3> <br>
</div>
<div class="col-md-2">
former institution:<br />
class to join:<br />
</div>
<div class="col-md-8">
<input type="text" placeholder="kisumu primary"> <br />
<input type="number" min="1" max="8" placeholder="scrol to the right class"><br />
</div>
</div>
<div class="row">
<div class="col-md-2">
<h3>Parents details:</h3><br />
</div>
<div class="col-md-2">
name<br>
mobile number:<br />
email<br>
county<br />
</div>
<div class="col-md-8">
<input type="text" name="first name" placeholder="sir name">
<input type="text" name="second name" placeholder="other names"><br />
<input type="date" name="bday"><br />
<input type="email" name="email" placeholder"jacaranda@gmail.com"><br>
<input type="text" name="county"><br />
</div>
</div>
<p>results from former school<br />
<input type="file" name="attachedfiles" maxlength=50 allow="text/*" >
</p>
</form>
</div> <!--container-->
<hr class="featurette-divider">
<!--start of the Page footer -->
<footer>
<div class="container">
<div class="row">
<div class="col-md-4 "> <strong>We are registered with: </strong>
<br> The ministry of Education
<br> Kenya National Examination council (KNEC)
</div>
<div class="col-md-4 ">
<address>
<strong>Kisumu Jacaranda Academy.</strong>
<br> P. O. Box 744 – 40100
<br> Kisumu
<br> Email: kisumujacaranda@yahoo.com
<br>
<abbr title="Phone">Director’s No</abbr> +254727201032
<br>
<abbr title="Phone">Head Teacher’s No</abbr> +254701539285
<br>
</address>
</div>
<p>© 2015 Kisumu Jacaranda Academy. · <a href="#">Privacy</a> · <a href="#">Terms</a></p>
<!--2nd column of the Page footer -->
<!--3rd column of the Page footer -->
</div>
</div>
</footer>
</div>
<!-- /.container -->
</div>
</div>
</div>
<!-- /container -->
<!-- Le javascript
================================================== -->
<!-- Placed at the end of the document so the pages load faster -->
<script src="assets/js/jquery.js"></script>
<script src="assets/js/bootstrap.min.js"></script>
<script src="assets/js/bootstrap.dropdown.js"></script>
<script src="http://ajax.googleapis.com/ajax/libs/jquery/1.10.2/jquery.min.js"></script>
<script src="assets/js/lightbox.min.js"></script>
</body>
</html>