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form.php
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form.php
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<!DOCTYPE html>
<html>
<head>
<title>Application Form</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" type="text/css" href="css/bootstrap.css">
<link rel="stylesheet" type="text/css" href="css/bootstrap-material-design.css">
<link rel="stylesheet" type="text/css" href="https://maxcdn.bootstrapcdn.com/font-awesome/4.7.0/css/font-awesome.min.css">
<link rel="stylesheet" type="text/css" href="css/jquery.dropdown.css">
<link rel="stylesheet" type="text/css" href="css/datepicker3.css">
<link rel="stylesheet" type="text/css" href="css/ripples.css">
<link rel="stylesheet" type="text/css" href="css/inputmask.css">
<!-- <link rel="stylesheet" type="text/css" href="https://cdnjs.cloudflare.com/ajax/libs/materialize/0.97.1/css/materialize.min.css"> -->
<script src="https://npmcdn.com/[email protected]/dist/js/tether.min.js"></script>
<style type="text/css">@import "compass/css3";
label {
color: #0C63E7 !important
}
p {
color: #999;
}
.msg-block {
margin-right: 145px;
}
form.ng-minlength {
background-color:red;
}
code {
color: blue;
}
/* The switch - the box around the slider */
.switch {
position: relative;
display: inline-block;
width: 40px;
height: 25px;
}
/* Hide default HTML checkbox */
.switch input {display:none;}
/* The slider */
.slider {
position: absolute;
cursor: pointer;
top: 0;
left: 0;
right: 0;
bottom: 0;
background-color: #ccc;
-webkit-transition: .4s;
transition: .4s;
}
.slider:before {
position: absolute;
content: "";
height: 19px;
width: 19px;
left: 3px;
bottom: 3px;
background-color: white;
-webkit-transition: .4s;
transition: .4s;
}
input:checked + .slider {
background-color: #2196F3;
}
input:focus + .slider {
box-shadow: 0 0 1px #2196F3;
}
input:checked + .slider:before {
-webkit-transform: translateX(16px);
-ms-transform: translateX(16px);
transform: translateX(16px);
}
input:text {
color: black;
}
img{
position: absolute;
left: 0px;
right: 0px;
z-index: 0;
background-position: center;
}
/* Rounded sliders */
.slider.round {
border-radius: 34px;
}
.slider.round:before {
border-radius: 50%;
}
</style>
</head>
<body>
<hr style="padding-bottom: 1%;">
<div class="row">
<div class="col-md-1"></div>
<div class="col-md-10">
<form action="serverside.php" name="myForm" novalidate id="myForm" ng-app="" method="post" enctype="multipart/form-data">
<div class="card container" id="container1">
<img src="ag.png" >
<legend style="margin-top: 20px; text-align: center"><i class="fa fa-wpforms"></i> APPLICATION FORM</legend>
<br>
<div class="row col-md-12">
<div class="col-md-6">
<div class="form-group">
<label for="position">Position applying for:</label>
<select id="position" name="position_name" class="select form-control" required="true">
<?php
include('connect.php');
$sql = "SELECT * FROM tbl_position WHERE status = 1 ORDER BY position_name ASC";
$result = $conn->query($sql);
while($row = $result->fetch_assoc()){
echo "<option value='".$row['position_desc']."'>".$row['position_name']."</option>";
}
?>
</select>
</div>
<div class="form-group">
<label>Are You amenable to shifting schedule?</label>
<div class="radio radio-primary">
<label>
<input type="radio" name="sched" id="sched2" value="YES">
YES
</label>
<label>
<input type="radio" name="sched" id="sched2" value="NO" checked>
NO
</label>
</div>
</div>
<div class="form-group">
<label>Are You willing to work on weekends/holidays?</label>
<div class="radio radio-primary">
<label>
<input type="radio" name="holidays" id="holidays2" value="YES">
YES
</label>
<label>
<input type="radio" name="holidays" id="holidays2" value="NO" checked>
NO
</label>
</div>
</div>
</div>
<div class="col-md-6 sample">
<div class="form-group">
<div class="form-group input-group "><!-- EMPLOYMENT DATE -->
<label>Available date for employment</label>
<input data-provide="datepicker" class="form-control" ng-model="empdate" name="empdate" data-date-start-date="today" data-date-format="MM dd, yyyy" required>
<span class="input-group-addon">
<span><i class="fa fa-calendar" style="margin-top: 35px"></i></span>
<span ng-show="!myForm.empdate.$pristine && myForm.empdate.$error.required" style="color:red;">This is required. </span>
</span>
</div>
</div>
<div class="form-group"><!-- SALARY -->
<label for="salary">Expected Salary</label>
<select id="salary" class="select form-control" name="salary" required>
<option value="10,000.00 - 15,000.00">₱10,000.00 - ₱15,000.00</option>
<option value="16,000.00 - 20,000.00">₱16,000.00 - ₱20,000.00</option>
<option value="21,000.00 - 25,000.00">₱21,000.00 - ₱25,000.00</option>
<option value="26,000.00 - 30,000.00">₱26,000.00 - ₱30,000.00</option>
<option value="31,000.00 - 35,000.00">₱31,000.00 - ₱35,000.00</option>
<option value="36,000.00 - 40,000.00">₱36,000.00 - ₱40,000.00</option>
<option value="41,000.00 - 50,000.00">₱41,000.00 - ₱50,000.00</option>
<option value="51,000.00 - 55,000.00">₱51,000.00 - ₱55,000.00</option>
</select>
</div>
</div>
</div>
<!-- personal information -->
<div class="row col-md-12">
<h6 style="margin-top: 2%"><i class="fa fa-user-o"></i><b> PERSONAL INFORMATION</b></h6>
<hr style="padding-bottom: 10px;">
<div class="col-md-6">
<div class="form-group label-floating" >
<label for="lname" class="control-label">Last Name</label>
<input class="form-control" type="text" ng-minlength="2" name="lname" ng-model="lname" required>
<span class="help-block" ng-show="!myForm.lname.$untouched && myForm.lname.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.lname.$dirty && myForm.lname.$error.minlength" style="color:red;">This is too short </span>
</div>
<div class="form-group label-floating">
<label for="fname" class="control-label">First Name</label>
<input name="fname" id="fname" class="form-control" ng-model="fname" ng-minlength="2" required capitalized-fisrt >
<span class="help-block" ng-show="!myForm.fname.$pristine && myForm.fname.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.fname.$dirty && myForm.fname.$error.minlength" style="color:red;">This is too short </span>
</div>
<div class="form-group label-floating">
<label for="mname" class="control-label">Middle Name</label>
<input type="text" name="mname" ng-model="mname" id="mname" class="form-control">
</div>
<div class="form-group label-floating">
<label for="ename" class="control-label">Name Extension</label>
<input type="text" name="ename" id="ename" class="form-control">
</div>
<div class="form-group">
<label>Sex</label>
<div class="radio radio-primary">
<label>
<input type="radio" name="sex123" id="s1" value="Male" checked="true">
MALE
</label>
<label>
<input type="radio" name="sex123" id="s1" value="Female" >
FEMALE
</label>
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group label-floating">
<label for="nickname" class="control-label">Nick Name</label>
<input type="text" name="nickname123" id="nickname" class="form-control">
</div>
<div class="form-group label-floating input-group">
<label for="date-ofbirth" class="control-label">Date of Birth</label>
<input data-provide="datepicker" name="bday123" id="date-ofbirth" ng-model="bday123" class="form-control" data-date-end-date="-17y" data-date-format="MM dd, yyyy" required>
<span class="input-group-addon">
<span><i class="fa fa-calendar" ></i></span>
<span ng-show="myForm.bday123.$touched && myForm.bday123.$error.required" style="color:red;">This is required. </span>
</span>
</div>
<div class="form-group label-floating">
<label for="place-of-birth" class="control-label">Place of Birth</label>
<input type="text" name="bplace" id="place-of-birth" class="form-control" ng-model="placeOfBirth" ng-minlength="2" required>
<span class="help-block" ng-show="!myForm.bplace.$pristine && myForm.bplace.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.bplace.$dirty && myForm.bplace.$error.minlength" style="color:red;">This is too short </span>
</div>
<div class="form-group label-floating">
<label for="citizen" class="control-label" >Citizenship</label>
<input type="text" id="citizen" name="citizen" class="form-control" ng-model="citizen" ng-minlength="2" required>
<span class="help-block" ng-show="!myForm.citizen.$pristine && myForm.citizen.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.citizen.$dirty && myForm.citizen.$error.minlength" style="color:red;">This is too short </span>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group label-static">
<label for="cstatus" class="control-label">Civil Status</label>
<select id="cstatus" class="select form-control" name="cstatus" onchange="showspec(this)" required>
<option value="Single">Single</option>
<option value="Married">Married</option>
<option value="Annuled">Annuled</option>
<option value="Widowed">Widowed</option>
<option value="Separated">Separated</option>
<option value="Others">Others</option>
</select>
</div>
</div>
<!-- <div class="switch form-group" >
<label><input onchange="checkspec(this)" type="checkbox" name="child2" id="child2" value="1"> Do You Have Child/Children</label> -->
<div class="col-md-6">
<div id="other_div" class="form-group label-floating">
<label class="control-label" for="wewe">Civil Status</label>
<input type="text" name="cstatusspec" class="form-control" id="wewe" >
</div>
</div>
</div>
</div>
</div>
<button type="button" style="margin-bottom: 2%" class="btn btn-raised btn-primary pull-right" onclick="document.getElementById('container1').style.display='none'; document.getElementById('container2').style.display='block';" ng-disabled="myForm.citizen.$invalid || myForm.bplace.$invalid || myForm.bday.$invalid || myForm.fname.$invalid || myForm.lname.$invalid || myForm.empdate.$invalid ">NEXT</button><!-- -->
</div> <!-- End of container 1 -->
<div class="card container" id="container2">
<h6 style="padding-top: 2%;"><i class="fa fa-user-o"></i> <b>PERSONAL INFORMATION</b></h6>
<hr style="padding-bottom: 10px;">
<div class="row col-md-12">
<div class="col-md-6">
<label>Height</label>
<div class="row">
<div class="col-md-6">
<div class="form-group label-floating">
<label for="feet" class="control-label">Feet (ft.)</label>
<input type="number" name="feet" class="form-control" id="feet">
</div>
</div>
<div class="col-md-6">
<div class="form-group label-floating">
<label for="inches" class="control-label">Inches (in.)</label>
<input type="number" name="inch" class="form-control" id="inches">
</div>
</div>
</div>
<div class="form-group label-floating">
<label for="bloodtype" class="control-label">Blood type</label>
<select class="select form-control" id="bloodtype" name="btype">
<option value="O+">O+</option><option value="B+A">B+–</option>
<option value="O–">O–</option><option value="B–">B–</option>
<option value="A+">A+</option><option value="AB+">AB+</option>
<option value="A–">A–</option><option value="AB–"> AB–</option>
</select>
</div>
<div class="form-group label-floating">
<label class="control-label" for="currendaddress">Current Address (Number, Street, Subdivision)</label>
<textarea class="form-control" id="currendaddress" ng-minlenght="2" ng-model="curadd" rows="3" name="curadd" required></textarea>
<span class="help-block" ng-show="!myForm.curadd.$pristine && myForm.curadd.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.curadd.$dirty && myForm.curadd.$error.minlength" style="color:red;">This is too short </span>
</div>
<div class="form-group label-floating">
<label class="control-label" for="provincialaddress">Provincial Address (Number, Street, Subdivision)</label>
<textarea class="form-control" id="provincialaddress" rows="3" name="provadd"></textarea>
</div>
</div>
<div class="col-md-6">
<label>Weight</label>
<div class="form-group label-floating">
<label for="pounds" class="control-label">Pounds (lbs:)</label>
<input type="number" name="weight" class="form-control" id="pounds">
</div>
<div class="form-group label-floating">
<label for="religion" class="control-label">Religion</label>
<input type="text" name="religion123" class="form-control" id="religion">
</div>
<div class="row">
<div class="col-md-5">
<div class="form-group label-floating">
<label class="control-label" for="disctrict1">City/Municipality</label>
<input class="form-control" id="disctrict1" type="text" name="curdis" ng-minlength="2" ng-model="curdis" required></input>
<span class="help-block" ng-show="!myForm.curdis.$pristine && myForm.curdis.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.curdis.$dirty && myForm.curdis.$error.minlength" style="color:red;">This is too short </span>
</div>
</div>
<div class="col-md-5">
<div class="form-group label-floating">
<label class="control-label" for="municipality">Province</label>
<input class="form-control" id="municipality" type="text" name="curmuni" ng-model="curmuni" ng-minlength="2"></input>
<span class="help-block" ng-show="!myForm.curmuni.$pristine && myForm.curmuni.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.curmuni.$dirty && myForm.curmuni.$error.minlength" style="color:red;">This is too short </span>
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="zipcode1">Zip Code</label>
<input class="form-control" id="zipcode1" type="number" name="curzip" ng-minlength="2" ng-model="curzip" required></input>
<span class="help-block" ng-show="!myForm.curzip.$pristine && myForm.curzip.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.curzip.$dirty && myForm.curzip.$error.minlength" style="color:red;">This is too short </span>
</div>
</div>
</div>
<div class="row">
<div class="col-md-5">
<div class="form-group label-floating">
<label class="control-label" for="disctrict2">City/Municipality</label>
<input class="form-control" id="disctrict2" type="text" name="provdis"></input>
</div>
</div>
<div class="col-md-5">
<div class="form-group label-floating">
<label class="control-label" for="municipality2">Province</label>
<input class="form-control" id="municipality2" type="text" name="provmuni"></input>
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="zipcode2">Zip Code</label>
<input class="form-control" id="zipcode2" type="number" name="provzip"></input>
</div>
</div>
</div>
</div>
</div>
<!-- contact -->
<div class="row col-md-12">
<h6 style="padding-top:5%"><i class="fa fa-phone"></i><b> CONTACT INFORMATION</b></h6>
<hr style="padding-bottom: 10px;">
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="email">E-Mail Address</label>
<input type="email" name="email" ng-model="mail" class="form-control" id="email" required>
<p ng-show="!myForm.email.$valid " class="help-block">E-mail Address is required</p>
</div>
<div class="row">
<div class="col-md-6" ng-app="">
<div class="form-group label-floating">
<label style="font-size: 11px;" class="control-label text-sm" for="contactperson">Contact Person in case of emergency</label>
<input class="form-control" type="text" name="contact_name" id="contactperson" ng-minlength="2" ng-model="contact_name" required>
<span class="help-block" ng-show="!myForm.contact_name.$pristine && myForm.contact_name.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.contact_name.$dirty && myForm.contact_name.$error.minlength" style="color:red;">This is too short </span>
</div>
</div>
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="contactpersonno">{{contact_name}}'s Contact Details</label>
<input class="form-control" type="number" name="contact_details" id="contactpersonno" ng-model="contact_details" ng-minlength="2" required>
<span class="help-block" ng-show="!myForm.contact_details.$pristine && myForm.contact_details.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.contact_details.$dirty && myForm.contact_details.$error.minlength" style="color:red;">This is too short </span>
</div>
</div>
</div>
</div>
<!-- -->
<div class="row col-md-6">
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="celno">Mobile No.</label>
<input data-inputmask="'mask': '9999-999-9999'" type="text" name="mobile_num" class="form-control" id="celno" ng-model="mobile_num" ng-minlength="2" required>
<span class="help-block" ng-show="!myForm.mobile_num.$pristine && myForm.mobile_num.$error.required" style="color:red;">This is required. </span>
<span class="help-block" ng-show="myForm.mobile_num.$dirty && myForm.mobile_num.$error.minlength" style="color:red;">This is too short </span>
</div>
</div>
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="telno">Home Tel No.</label>
<input data-inputmask="'mask': '(999)-9999'" type="text" name="home_telnum" class="form-control" id="telno" ng-minlength="2" ng-model="home_telnum">
</div>
</div>
<div class="col-md-12">
<div class="form-group label-floating">
<label class="control-label" for="skype">Skype User Id</label>
<input type="text" name="skype_userid" class="form-control" id="skype">
</div>
</div>
</div>
</div>
<!-- buttons -->
<button type="button" href="#container1" class="btn btn-raised btn-primary pull-left" onclick="document.getElementById('container1').style.display='block';document.getElementById('container2').style.display='none';">PREVIOUS</button>
<button type="button" style="margin-bottom: 1%" class="btn btn-raised btn-primary pull-right" onclick="document.getElementById('container2').style.display='none'; document.getElementById('container3').style.display='block';" ng-disabled="myForm.home_telnum.$invalid || myForm.mobile_num.$invalid || myForm.contact_details.$invalid || myForm.contact_name.$invalid || myForm.email.$invalid || myForm.curmuni.$invalid || myForm.curdis.$invalid || myForm.curzip.$invalid">NEXT</button>
</div> <!-- End of container 2 -->
<!-- <input type="submit" name="" class="btn btn-primary btn-raised" ng-disabled="myForm.$invalid"> -->
<div class="card container" id = "container3">
<h6 style="padding-top: 30px"><i class="fa fa-group"> </i><b> FAMILY BACKGROUND</b></h6>
<hr style="padding-bottom: 10px;">
<!-- for married ones -->
<div id="married_div" class="row col-md-12">
<h2 style="padding-top: 2%;" align="center"> Spouse </h2>
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="slname">Spouse's Last Name</label>
<input id="slname" type="text" name="spouse_lname" class="form-control" ng-minlength="2" ng-model="spouse_lname" required>
<span ng-show="!myForm.spouse_lname.$pristine && myForm.spouse_lname.$error.required" style="color:red;">This is required. </span>
<span ng-show="myForm.spouse_lname.$dirty && myForm.spouse_lname.$error.minlength" style="color:red;">This is too short </span>
</div>
<div class="form-group label-floating">
<label class="control-label" for="sfname">Spouse's First Name</label>
<input id="sfname" type="text" name="spouse_fname" class="form-control" >
</div>
<div class="form-group label-floating">
<label class="control-label" for="smname">Spouse's Middle Name</label>
<input id="smname" type="text" name="spouse_midname" class="form-control" >
</div>
</div>
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="occupation">Spouse's Occupation</label>
<input type="text" name="spouse_occ" id="occupation" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="employer-name">Company Name</label>
<input type="text" name="spouse_empname" id="employer-name" class="form-control">
</div>
</div>
</div> <!-- end for married ones -->
<!-- for widowed ones -->
<div id="widowed_div" class="row col-md-12">
<h2 style="padding-top: 2%;" align="center"> Spouse </h2>
<div class="col-md-6">
<div class="form-group label-floating">
<label class="control-label" for="slname">Spouse's Last Name</label>
<input id="slname" type="text" name="spouse_lname" class="form-control" >
</div>
<div class="form-group label-floating">
<label class="control-label" for="sfname">Spouse's First Name</label>
<input id="sfname" type="text" name="spouse_fname" class="form-control" >
</div>
<div class="form-group label-floating">
<label class="control-label" for="smname">Spouse's Middle Name</label>
<input id="smname" type="text" name="spouse_midname" class="form-control" >
</div>
</div>
<div class="col-md-6">
</div>
</div> <!-- end for widowed ones -->
<div class="row col-md-12">
<div class="col-md-6">
<h3 style="padding-top: 3%;" align="center">Father's Information</h3>
<div class="form-group label-floating">
<label class="control-label" for="flname">Father's Last name</label>
<input type="text" name="flname" id="flname" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="ffname">Father's First Name</label>
<input type="text" name="ffname" id="ffname" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="fmname">Father's Middle Name</label>
<input type="text" name="fmname" id="fmname" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="fplace-birth">Place of Birth</label>
<input type="text" name="father_placebirth" id="fplace-birth" class="form-control">
</div>
<label class="switch col-md-4">
<input id="positive" type="checkbox">
<div class="slider round"></div>
</label>
<h5 class="col-md-5"> Do you have Child/Children?</h5>
</div>
<div class="col-md-6">
<h3 style="padding-top: 3%;" align="center">Mother's Information</h3>
<div class="form-group label-floating">
<label class="control-label" for="mlname">Mother's Maiden name</label>
<input type="text" name="mother_lname" id="mlname" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="mfname">Mother's First Name</label>
<input type="text" name="mother_fname" id="mfname" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="mmname">Mother's Middle Name</label>
<input type="text" name="mother_midname" id="mmname" class="form-control">
</div>
<div class="form-group label-floating">
<label class="control-label" for="mplace-birth">Place of Birth</label>
<input type="text" name="mother_placebirth" id="mplace-birth" class="form-control">
</div>
</div>
</div>
<div class="waw btn-group-sm" id="siblings">
<button type="button" class="btn btn-raised btn-info add_field_button_sibling">Add Sibling</button>
<div class="input_fields_wrap_sibling">
<div class="row col-md-12">
<div class="col-md-6">
<div class="col-md-8">
<div class="form-group label-floating">
<label class="control-label" for="sibling" >Enter sibling name</label>
<input type="text" name="siblings" id="sibling" class="form-control">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="sage">Age</label>
<input id="sage" class="form-control" type="number" name="sibling_age"/>
</div>
</div>
</div>
</div> <!-- second sibling -->
<div class="row col-md-12">
<div class="col-md-6">
<div class="col-md-8">
<div class="form-group label-floating">
<label class="control-label" for="sibling" >Enter sibling name</label>
<input type="text" name="sibling2" id="sibling" class="form-control">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="sage">Age</label>
<input id="sage" class="form-control" type="number" name="sibling_age2"/>
</div>
</div>
<button type=button style="margin-top: 5%" class="btn btn-raised btn-sm btn-danger pull-right remove_field" >Remove</button>
</div>
</div><!-- third sibling -->
<div class="row col-md-12" >
<div class="col-md-6">
<div class="col-md-8">
<div class="form-group label-floating">
<label class="control-label" for="sibling" >Enter sibling name</label>
<input type="text" name="sibling3" id="sibling" class="form-control">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="sage">Age</label>
<input id="sage" class="form-control" type="number" name="sibling_age3"/>
</div>
</div>
<button type=button style="margin-top: 5%" class="btn btn-raised btn-danger btn-sm pull-right remove_field">Remove</button>
</div>
</div>
</div>
</div>
<div class="waw btn-group-sm" id="children" style="display: none;">
<div class="input_fields_wrap">
<div class="row col-md-12">
<div class="col-md-6">
<!-- fillings -->
</div>
<div class="col-md-6">
<button type="button" class="btn btn-raised btn-sm btn-info add_field_button">Add Child</button>
</div>
<div class="col-md-6">
<!-- fillings -->
</div>
</div>
<div class="row col-md-12" id="1chi">
<div class="col-md-6">
<!-- fillings -->
</div>
<div class="col-md-6">
<div class="col-md-8">
<div class="form-group label-floating">
<label class="control-label" for="child" >Enter child name</label>
<input type="text" name="child_name" id="child" class="form-control">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="age">Age</label>
<input id="age" class="form-control" type="number" name="child_age"/>
</div>
</div>
</div>
</div>
<div class="row col-md-12" id="2chi">
<div class="col-md-6">
<!-- fillings -->
</div>
<div class="col-md-6">
<div class="col-md-8">
<div class="form-group label-floating">
<label class="control-label" for="child" >Enter child name</label>
<input type="text" name="child_name2" id="child" class="form-control">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="age">Age</label>
<input id="age" class="form-control" type="number" name="child_age2"/>
</div>
</div>
<button type=button style="margin-top: 5%" class="btn btn-raised btn-sm btn-danger pull-right remove_field">Remove</button>
</div>
</div>
<div class="row col-md-12" id="3chi">
<div class="col-md-6">
<!-- fillings -->
</div>
<div class="col-md-6">
<div class="col-md-8">
<div class="form-group label-floating">
<label class="control-label" for="child" >Enter child name</label>
<input type="text" name="child_name3" id="child" class="form-control">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="age">Age</label>
<input id="age" class="form-control" type="number" name="child_age3"/>
</div>
</div>
<button type=button style="margin-top: 5%" class="btn btn-raised btn-danger btn-sm pull-right remove_field">Remove</button>
</div>
</div>
</div>
</div>
<!-- buttons -->
<button type="button" class="btn btn-raised btn-primary pull-left" onclick="document.getElementById('container2').style.display='block';document.getElementById('container3').style.display='none';">PREVIOUS</button>
<button type="button" style="margin-bottom: 1%" class="btn btn-raised btn-primary pull-right" onclick="document.getElementById('container3').style.display='none'; document.getElementById('container4').style.display='block';">NEXT</button>
</div> <!-- end of container 3 -->
<div class="card container" id = "container4">
<h6 style="padding-top: 30px"><i class="fa fa-briefcase"> </i><b> WORK EXPERIENCE <small>(Most recent on top)</small></b></h6>
<hr>
<button type="button" class="btn btn-raised btn-sm btn-info add_field_button_work">Add Work Experience</button>
<div class="input_fields_wrap_work">
<div class="row col-md-12">
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="from">From:</label>
<input class="form-control" data-provide="datepicker" name="datefrom" id="from" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="to">To:</label>
<input class="form-control" data-provide="datepicker" name="dateto" id="to" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="employers_name">Company Name</label>
<input class="form-control" type="text" name="company_name" id="employers_name">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="employers_contact_number">Contact number</label>
<input class="form-control" type="number" name="contactnum" id="employers_contact_number">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="employers_address">Company's address</label>
<input class="form-control" type="text" name="compadd" id="employers_address">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="position-title">Postion Title</label>
<input class="form-control" type="text" name="position" id="position-title">
</div>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="name-supervisor">Name of immediate supervisor</label>
<input class="form-control" type="text" name="supervisor" id="name-supervisor">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="monthly-salary">Monthly salary</label>
<input class="form-control" type="number" name="salary" id="monthly-salary">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="reason">Reason of leaving</label>
<input class="form-control" type="text" name="reason" id="reason">
</div>
</div>
<br><br><br><br><br><br><br><br><br>
</div>
</div>
<div class="row col-md-12">
<h6 style="padding-top: 30px pull-left"><i class="fa fa-graduation-cap"> </i><b> EDUCATIONAL BACKGROUND </b></h6>
<hr>
<div class="col-md-12">
<label><b>Primary:</b></label>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="school">Name of School</label>
<input type="text" name="elem_name" class="form-control" id="school">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="pfrom">From:</label>
<input data-provide="datepicker" name="elem_datefrom" id="pfrom" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="pto">To:</label>
<input data-provide="datepicker" name="elem_dateto" id="pto" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="scholarship">Scholarship/Honors</label>
<input type="text" class="form-control" id="scholarship" name="elem_scholarship">
</div>
</div>
<div class="col-md-12">
<label><b>Secondary:</b></label>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="school">Name of School</label>
<input type="" name="hs_name" class="form-control" id="school">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="sfrom">From:</label>
<input data-provide="datepicker" name="hs_datefrom" id="sfrom" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="sto">To:</label>
<input data-provide="datepicker" name="hs_dateto" id="sto" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="scholarship">Scholarship/Honors</label>
<input type="text" class="form-control" id="scholarship" name="hs_scholarship">
</div>
</div>
<div class="col-md-12">
<label><b>Tertiary:</b></label>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="school">Name of School</label>
<input type="" name="col_name" class="form-control" id="school">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="pfrom">From:</label>
<input data-provide="datepicker" name="col_datefrom" id="pfrom" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="pfrom">To:</label>
<input data-provide="datepicker" name="col_dateto" id="pto" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="degree">Degree Course /Vocational</label>
<input type="text" id="degree" class="form-control" name="col_degree">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="scholarship">Scholarship/Honors</label>
<input type="text" class="form-control" id="scholarship" name="col_scholarship">
</div>
</div>
<div class="col-md-12">
<label><b>Graduate Studies:</b></label>
</div>
<div class="col-md-4">
<div class="form-group label-floating">
<label class="control-label" for="school">Name of School</label>
<input type="" name="grad_name" class="form-control" id="school">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="pfrom">From:</label>
<input data-provide="datepicker" name="grad_datefrom" id="pfrom" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="pfrom">To:</label>
<input data-provide="datepicker" name="grad_dateto" id="pto" class="form-control" data-date-min-view-mode="1" data-date-format="MM yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="degree">Degree Course /Vocational</label>
<input type="text" id="degree" class="form-control" name="grad_degree">
</div>
</div>
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="scholarship">Scholarship/Honors</label>
<input type="text" class="form-control" id="scholarship" name="grad_scholarship">
</div>
</div>
</div>
<div class="col-md-12">
<h6 style="padding-top: 30px"><i class="fa fa-id-card"> </i><b> Professional Qualifications</b></small></h6>
<hr>
<button type="button" class="btn btn-raised btn-info btn-sm add_field_button_professional">Add Professional Qualification</button>
</div>
<div class="input_fields_wrap_professional">
<div class="row col-md-12">
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="license">License/Certification</label>
<input type="text" class="form-control" name="license" id="license">
</div>
</div>
<div class="col-md-1">
<div class="form-group label-floating">
<label class="control-label" for="rate">Rating</label>
<input type="text" id="rate" class="form-control" name="rating">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="dateg">Date Grandted</label>
<input data-provide="datepicker" id="dateg" class="form-control" name="dategranted" data-date-format="MM dd, yyyy" data-date-end-date="-1d">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="institution">Granting Institution</label>
<input type="text" class="form-control" id="institution" name="institution">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="license-number">License Number</label>
<input type="number" class="form-control" id="license-number" name="licensenum">
</div>
</div>
<div class="col-md-2">
<div class="form-group label-floating">
<label class="control-label" for="dater">Date Release</label>
<input data-provide="datepicker" class="form-control" id="dater" name="datereleased" data-date-format="MM dd, yyyy" data-date-end-date="-1d">
</div>
</div>
</div>
</div>
<!-- buttons -->
<button type="button" class="btn btn-raised btn-primary pull-left" onclick="document.getElementById('container3').style.display='block';document.getElementById('container4').style.display='none';">PREVIOUS</button>
<button type="button" style="margin-bottom: 1%" class="btn btn-raised btn-primary pull-right" onclick="document.getElementById('container4').style.display='none'; document.getElementById('container5').style.display='block';">NEXT</button>
</div> <!-- end of container 4 -->
<div class="card container" id="container5">
<h6 style="padding-top: 30px"><i class="fa fa-language"> </i><b> Language proficiency</b> </h6>
<hr>
<button type="button" class="btn btn-raised btn-info add_field_button_language" value="Add another text input" onClick="addInput('dynamicInput');">Add Language</button>
<div class="input_fields_wrap_language" >
<div class="row col-md-12" id="dynamicInput">
<div class="col-md-3">
<div class="form-group label-floating">
<label class="control-label" for="language">Language you know</label>
<input type="text" class="form-control" id="language" name=" language">
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
<input type="checkbox" name="speak" value="yes"> Speak
</label>
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
<input type="checkbox" name="write" value="yes"> Write
</label>
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
<input type="checkbox" name="read" value="yes"> Read
</label>
</div>
</div>
</div>
</div>
<h6 style="padding-top: 30px"><b> Other Information</b> </h6>
<hr>
<div class="row col-md-12">
<div class="row col-md-4">
<div class="input_fields_wrap_skill">
<button type="button" class="btn btn-raised btn-info add_field_button_skill">ADD</button>
<div class="form-group label-floating">
<label class="control-label" for="skill">Special Skill/Hobbies</label>
<input type="text" class="form-control" id="skill" name="skill">
</div>
</div>
</div>
<div class="col-md-4">
<div class="input_fields_wrap_nacad">
<button type="button" class="btn btn-raised btn-info add_field_button_nacad">ADD</button>
<div class="form-group label-floating">
<label class="control-label" for="nacad">Non-Academic Distinction / Recognition</label>
<input type="text" class="form-control" id="nacad" name="recognition">
</div>
</div>
</div>
<div class="col-md-4">
<div class="input_fields_wrap_org">
<button type="button" class="btn btn-raised btn-info add_field_button_org">ADD</button>
<div class="form-group label-floating">
<label class="control-label" for="org">Membership in Association / Organization</label>
<input type="text" class="form-control" id="org" name="org">
</div>
</div>
</div>
</div>
<div class="row col-md-12" style="margin-top: 10px">
<div class="col-md-5">
<div class="form-group">
<label style="font-size: 25px">Have you ever been formally charged?</label>
<div class="radio radio-primary">
<label>
<input type="radio" name="charge" value ="yes" onclick="document.getElementById('charged').style.display='block';" >YES