91 lines
5.4 KiB
PHP
91 lines
5.4 KiB
PHP
<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta http-equiv="X-UA-Compatible" content="IE=edge">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>Aspire Canada</title>
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<link rel="stylesheet" href="{{ asset('assets/rosetta_canada/css/style.css') }}">
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<link rel="stylesheet" href="{{ asset('assets/rosetta_canada/css/bootstrap.min.css') }}">
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<link href="{{ asset('assets/rosetta_canada/css/select2.min.css') }}" rel="stylesheet" />
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</head>
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<body>
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<div class="container p-2">
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<div class="row d-flex align-items-center justify-content-start">
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<div class="col-md-5 pt-5 ">
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<div class="row">
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<div class="col-lg-12">
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<img src="{{ asset('assets/rosetta_canada/img/1.png') }}" class="img-fluid">
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</div>
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<div class="col-lg-12 mt-4">
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<!-- Form Section -->
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<div class="mt-10 p-2">
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<form class="form row g-3 form-group p-3 border border-2 rounded" action="#">
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<div class="text-center form3-head d-flex justify-content-center align-content-center">
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<label for="">
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<h3 class="text-uppercase">Register now</h3>
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</label>
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</div>
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<div class="col-md-12">
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<input required="required" type="text" class="form-control" id="full-name" placeholder="Enter Your Full Name" name="name">
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</div>
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<div class="col-md-6">
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<input required="required" placeholder="Enter Email Address" id="email" class="form-control" name="email" type="email">
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</div>
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<div class="col-md-6">
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<input required="required" placeholder="Enter Phone" id="phone" class="form-control" name="phone" type="number">
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</div>
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<div class="col-md-6">
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<select name="highest_qualification" class="form-select">
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<option value="" disabled="" selected="">Select Qualification</option>
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<option value="NEB +2 / A - Levels">NEB +2 / A - Levels</option>
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<option value="Bachelors">Bachelors</option>
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<option value="Master">Master</option>
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</select>
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</div>
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<div class="col-md-6">
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<input placeholder="Grade" class="form-control" name="highest_grade" type="text">
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</div>
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<div class="col-md-4">
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<input placeholder="University/Board" class="form-control" name="highest_stream" type="text">
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</div>
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<div class="col-md-4">
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<select name="test_name" class="form-select">
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<option value="" disabled="" selected="">Select Test Preparation</option>
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<option value="TOEFL">TOEFL</option>
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<option value="IELTS">IELTS</option>
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<option value="PTE">PTE</option>
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</select>
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</div>
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<div class="col-md-4">
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<input placeholder="Test Score " class="form-control" name="test_score" type="text">
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</div>
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<div class="col-md-12">
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<select class="js-select2 form-control" name="interested_course[]" multiple="multiple" aria-placeholder="Enter Your Desired Field of Study" style="width: 100%">
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<option value="IT">IT</option>
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<option value="EN">Engineering</option>
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<option value="IT">IT</option>
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<option value="EN">Engineering</option>
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<option value="IT">IT</option>
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<option value="EN">Engineering</option>
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</select>
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</div>
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<div class="col-md-12 text-center">
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<input type="submit" class="btn btn-submit" value="Submit">
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<script src="https://ajax.googleapis.com/ajax/libs/jquery/2.1.1/jquery.min.js"></script><!-- jQuery base library needed -->
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<script src="{{ asset('assets/rosetta_canada/js/select2.min.js ') }}"></script>
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<script src="{{ asset('assets/rosetta_canada/js/custom.js ') }}"></script>
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<script src="{{ asset('assets/rosetta_canada/js/bootstrap.min.js') }}"></script>
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</body>
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</html> |