form.html

<form action="{path-manage_registration}" method="POST" class="regform" id="expa_reg_form" accept-charset="UTF-8">
<div class="sighnup-form-table">
	<div class="form-group name">
		<div class="input-name">Imię<span class="required">*</span></div>
		<div class="input-field">
      <input class="text required expa-input" id="first_name" name="first_name" type="text" maxlength="50"
			required
			oninvalid="this.setCustomValidity('Podaj swoje imię')" 
			oninput="setCustomValidity('')">
    </div>
	</div>
  <div class="form-group name">
    <div class="input-name">Nazwisko<span class="required">*</span></div>
    <div class="input-field">
      <input class="text required expa-input" id="last_name" name="last_name" type="text" maxlength="50"
      required
      oninvalid="this.setCustomValidity('Podaj swoje nazwisko')" 
      oninput="setCustomValidity('')">
    </div>
  </div>
	<div class="form-group email">
		<div class="input-name">Adres e-mail <span class="required">*</span></div>
		<div class="input-field"><input class="text required expa-input" id="email" name="email" type="text" maxlength="50"
			required
			oninvalid="this.setCustomValidity('Podaj prawidłowy adres e-mail')"
			oninput="setCustomValidity('')"
			pattern="^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,4})$">
		</div>
	</div>
  <div class="form-group phone">
    <div class="input-name">Numer telefonu dla szybszgo kontaktu</div>
    <div class="input-field"> <input class="text expa-input" id="phone_number" name="phone_number" type="text" maxlength="50">
    </div>
  </div>
  <div class="form-group password">
    <div class="input-name">Wybierz hasło <span class="required">*</span></div>
    <div class="input-field"> <input class="text required expa-input" id="password" name="password" type="password"
      required 
      oninvalid="this.setCustomValidity('Hasło musi mieć przynajmniej 8 znaków')" 
      oninput="setCustomValidity('')"
      pattern=".{8,}">
    </div>
  </div>
	<div class="form-group university">
    <div class="input-name">Uniwersytet <span class="required">*</span></div>
    <div class="input-field"> 
      <select id="university" name="university" title="Uniwersytet">
          {leads-option-list}

      </select>
    </div>
  </div>
  <div class="form-group localcommittee">
    <div class="input-name">Oddział Lokalny <span class="required">*</span></div>
    <div class="input-field"> 
      <input class="readonly" id="localcommittee" name="localcommittee" title="{lc}" type="text" readonly />
    </div>
  </div>
	
	<div class="web-url">
    <input type="hidden" name="utm_source" value="{utm_source}">
    <input type="hidden" name="utm_medium" value="{utm_medium}">
    <input type="hidden" name="utm_campaign" value="{utm_campaign}">
    <input type="hidden" name="program" value="{program}">
    <input type="hidden" name="uniqid" value="{uniqid}">
    <input type="hidden" name="bucket" value="{bucket}">
    <input type="hidden" name="lc" value="{lc}">
    <input type="hidden" name="website_url" value="{website_url}">
  </div>
	<div id="error" class="error"><p></p></div>
	<div id="submit">
		<input type="submit" id="submit_button" name="submit" clicked="false" class="send rotate" value="zarejestruj się">
	</div>
  <div id="loader">
    <div class="spinner">
      <div class="bounce1"></div>
      <div class="bounce2"></div>
      <div class="bounce3"></div>
    </div>
  </div>
  <p id="thank-you-message" class="form-message">Dziękujemy bardzo za rejestrację. Wkrótce dostaniesz maila z potwierdzeniem założenia konta. Powodzenia w Twojej podróży do kariery!</p>
<p id="error-message" class="form-message">Wystąpił błąd podczas rejestracji. Spróbuj później lub skontaktuj się z nami mailowo.</p>
</div>
</form>

<!--<script type='text/javascript' src='{path-gis_lcMapper}'></script>-->
<script type='text/javascript'>
//var $j = jQuery.noConflict();
jQuery(document).ready(function($){

    //performs request to manage registration script
    jQuery( '#expa_reg_form' ).on( 'submit', function(e) {
      e.preventDefault();
      var values = jQuery(this).serialize();
      jQuery.ajax({
            url: "{path-manage_registration}",
            data: values,
            async: true,
            type: "POST",
            success: function(){
                //alert("success");
                $('#thank-you-message').show();
                //$("#result").html('Submitted successfully');
            },
            error:function(e){
              var err = e['responseText'].replace('Array', '');
              err = err.replace(/\s\s+/g, ' ')
                //alert(err.);
                $('#error-message').prepend('<b>'+err+'.</b><br>').show();
                //$("#result").html('There is error while submit');
            },
            beforeSend: function() {
               $('#loader').show();
               $('.form-message').hide();
            },
            complete: function(){
               $('#loader').hide();
            }
      });
    });

    //saves cookie and sends API request to update DB
    jQuery.ajax({
            url: "{path-manage_leads}?utm_source={utm_source}&utm_medium={utm_medium}&utm_campaign={utm_campaign}&program={program}&bucket={bucket}&lc={lc}&uniqid={uniqid}",
            async: false,
            type: "GET"
    });

    //var myJsonString = getLeads('{path-leads-json}');
    //jQuery(".regform").validationEngine();
    jQuery('#university').change(function($) {
       // $('#localcommittee').val((mapLC($('#university').val())));
       jQuery('#localcommittee').val(jQuery(this).val());
       
    });
});
</script>