Preview: apply_now.php
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/home/urbanman/hindustansecurity.in/apply_now.php
<?php
error_reporting(0);
include("admin/common/app_function.php");
include("admin/config.php");
include("header.php");
//index_header($title);
?>
<br/>
<div class="container-fluid py-5">
<div class="row justify-content-center">
<div class="col-lg-10 col-md-12">
<div class="card shadow-sm border-0">
<div class="card-header bg-primary text-white">
<h4 class="mb-0 text-center">Application Form</h4>
</div>
<div class="card-body p-4">
<form class="container" autocomplete="off" action="submit_form.php" method="post" enctype="multipart/form-data">
<p class="text-primary fw-bold">APPLICATION DETAILS</p>
<!-- Notification -->
<?php if ($_GET['flag'] == "send") { ?>
<div class="alert alert-success" role="alert">
Your Enquiry Successfully Sent!
</div>
<?php } ?>
<!-- Job Application Details -->
<div class="row mb-3">
<div class="col-md-8">
<label class="form-label" style="color:#8a7c7c;">For Which Job Application</label>
<input type="text" class="form-control" name="postname" value="Urgent Need <?php echo $_GET['job_name']; ?>" readonly>
</div>
<div class="col-md-4">
<label class="form-label" style="color:#8a7c7c;">Appointed</label>
<br>
<input type="radio" id="appointmentYes" name="appointed" value="Yes" onclick="toggleDateInput()"> Yes
<input type="radio" id="appointmentNo" name="appointed" value="No" checked onclick="toggleDateInput()"> No
</div>
</div>
<!-- Appointment Date -->
<div class="row mb-3" id="dateInputRow" style="display: none;">
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Appointment Date/Time</label>
<input type="date" name="appointment_date" style="border:1px solid #ddd;">
<input type="time" name="appointment_time" style="border:1px solid #ddd;">
</div>
</div>
<!-- Applicant Details -->
<div class="row mb-3">
<div class="col-md-12">
<label class="form-label" style="color:#8a7c7c;">Applicant Full Name <font color="red">*</font></label>
<input type="text" class="form-control" name="applicant_name" placeholder="Enter Full Name" maxlength="50" required>
</div>
</div>
<!-- Applicant Address -->
<div class="row mb-3">
<div class="col-md-12">
<label class="form-label" style="color:#8a7c7c;">Permanent Address <font color="red">*</font></label>
<textarea class="form-control" name="address_permanant" rows="2" placeholder="Enter Address" maxlength="100" required></textarea>
</div>
</div>
<div class="row mb-3">
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Town <font color="red">*</font></label>
<input type="text" class="form-control" name="town" placeholder="Enter Town" required>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Taluka <font color="red">*</font></label>
<input type="text" class="form-control" name="taluka" placeholder="Enter Taluka" required>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">District <font color="red">*</font></label>
<input type="text" class="form-control" name="district" placeholder="Enter District" required>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">State <font color="red">*</font></label>
<input type="text" class="form-control" name="state" placeholder="Enter State" required>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Pincode </label>
<input type="text" class="form-control" name="pincode" maxlength="6" placeholder="Enter Pincode" >
</div>
</div>
<div class="row mb-3">
<div class="col-md-12">
<input type="checkbox" id="sameAddressCheckbox" onclick="copyAddress()"> Permanent Address is same as Local Address.
</div>
</div>
<div class="row mb-3">
<div class="col-md-12">
<label class="form-label" style="color:#8a7c7c;">Local Address <font color="red">*</font></label>
<textarea class="form-control" name="local_address" rows="2" placeholder="Enter Local Address" maxlength="100" required></textarea>
</div>
</div>
<div class="row mb-3">
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Town <font color="red">*</font></label>
<input type="text" class="form-control" name="town_local" placeholder="Enter Town" required>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Taluka <font color="red">*</font></label>
<input type="text" class="form-control" name="taluka_local" placeholder="Enter Taluka" required>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">District <font color="red">*</font></label>
<input type="text" class="form-control" name="district_local" placeholder="Enter District" required>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">State <font color="red">*</font></label>
<input type="text" class="form-control" name="state_local" placeholder="Enter State" required>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Pincode </label>
<input type="text" class="form-control" name="pincode_local" maxlength="6" placeholder="Enter Pincode" >
</div>
</div>
<hr><p class="text-primary fw-bold">PERSONAL DETAILS</p>
<!-- Additional Details -->
<div class="row mb-3">
<div class="col-md-4">
<label class="form-label" style="color:#8a7c7c;">Reference By</label>
<input type="text" class="form-control" name="reference_by" placeholder="Enter Reference">
</div>
<div class="col-md-4">
<label class="form-label" style="color:#8a7c7c;">Gender </label>
<select name="gender" class="form-control" >
<option value="">Select</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
</select>
</div>
<div class="col-md-4">
<label class="form-label" style="color:#8a7c7c;">Marital Status </label>
<select name="mstatus" class="form-control" >
<option value="">Select</option>
<option value="Married">Married</option>
<option value="Unmarried">Unmarried</option>
<option value="Widowed">Widowed</option>
<option value="Divorced">Divorced</option>
</select>
</div>
</div>
<!-- Date of Birth -->
<div class="row mb-3">
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Birth Day <font color="red">*</font></label>
<select id="birthDay" name="birth_day" class="form-control" required onchange="calculateAge()">
<option value="">Select</option>
<!-- Generate options dynamically -->
<script>
for (let i = 1; i <= 31; i++) {
document.write(`<option value="${i}">${i}</option>`);
}
</script>
</select>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Birth Month <font color="red">*</font></label>
<select id="birthMonth" name="birth_month" class="form-control" required onchange="calculateAge()">
<option value="">Select</option>
<!-- Generate options dynamically -->
<script>
const months = [
"January", "February", "March", "April", "May", "June",
"July", "August", "September", "October", "November", "December"
];
months.forEach((month, index) => {
document.write(`<option value="${index + 1}">${month}</option>`);
});
</script>
</select>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Birth Year <font color="red">*</font></label>
<select id="birthYear" name="birth_year" class="form-control" required onchange="calculateAge()">
<option value="">Select</option>
<!-- Generate options dynamically -->
<script>
const currentYear = new Date().getFullYear();
for (let year = currentYear; year >= 1900; year--) {
document.write(`<option value="${year}">${year}</option>`);
}
</script>
</select>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Age</label>
<input type="text" id="age" name="age" class="form-control" readonly>
</div>
</div>
<hr><p class="text-primary fw-bold">EXPERIENCE DETAILS</p>
<div class="row mb-3">
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Education <font color="red">*</font></label>
<select name="education" class="form-control" required>
<option value="">Select</option>
<option value="4th">4th</option>
<option value="5th">5th</option>
<option value="6th">6th</option>
<option value="7th">7th</option>
<option value="8th">8th</option>
<option value="9th">9th</option>
<option value="10th">10th</option>
<option value="12th">12th</option>
<option value="B.A. Apear">B.A. Apear</option>
<option value="B.A.">B.A.</option>
<option value="B.A. I">B.A. I</option>
<option value="B.A. II">B.A. II</option>
<option value="B.A. II">B.A. III Apeared</option>
<option value="BBA">BBA</option>
<option value="M.Sc"> M.Sc</option>
<option value="B.tech"> B.tech</option>
<option value="D.Pharm"> D.Pharm</option>
<option value="FYBA"> FYBA</option>
<option value="A.M."> A.M.</option>
<option value="B.Com"> B.Com</option>
<option value="M.A"> M.A</option>
<option value="B.Com III"> B.Com III</option>
<option value="B.Sc"> B.Sc</option>
<option value="B.Sc. (C.S)"> B.Sc. (C.S)</option>
<option value="B.Sc. (C.S)"> B. Sc. II</option>
<option value="D.Ed"> D.Ed</option>
<option value="BPEI"> BPEI</option>
. <option value="Graduation"> Graduation</option>
</select>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Height <font color="red">*</font></label>
<select name="height" class="form-control" required>
<option value="">Select</option>
<!-- Generate options dynamically -->
<script>
for (let feet = 4; feet <= 7; feet++) { // Loop for feet (4' to 7')
for (let inches = 0; inches < 12; inches++) { // Loop for inches (0" to 11")
const height = `${feet}'${inches}"`;
const value = feet + inches / 12; // Convert to decimal (e.g., 5'6" => 5.5)
document.write(`<option value="${value.toFixed(2)}">${height}</option>`);
}
}
</script>
</select>
</div>
<div class="col-md-2">
<label class="form-label" style="color:#8a7c7c;">Pre. Experience <font color="red">*</font></label>
<select name="prevexp" class="form-control" required>
<option value="">Select</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Type of Experience</label>
<input type="text" class="form-control" name="typ_exp" placeholder="Enter">
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Experience Where</label>
<input type="text" class="form-control" name="exp_where" placeholder="Enter">
</div>
</div>
<hr><p class="text-primary fw-bold">OTHER ABILITY DETAILS</p>
<div class="row mb-3">
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Other Ability if Any </label>
<select name="orther_ability" class="form-control" >
<option value="">Select</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Four Wheeler driving License</label>
<select name="driving_lic" class="form-control" >
<option value="">Select</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;">Gun License </label>
<select name="gun_lic" class="form-control" >
<option value="">Select</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Own Gun/Revalvar </label>
<select name="own_gun" class="form-control" >
<option value="">Select</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
</div>
<div class="row mb-3">
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Shift Preference </label>
<select name="shift_pre" class="form-control" >
<option value="">Select</option>
<option value="8H">8H</option>
<option value="12H">12H</option>
<option value="Night">Night</option>
<option value="Day">Day</option>
<option value="Any">Any</option>
</select>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Salary Expectation</label>
<input type="text" class="form-control" name="salary_expe" placeholder="Enter">
</div>
</div>
<hr><p class="text-primary fw-bold">CONTACT DETAILS</p>
<div class="row mb-3">
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Mobile No <font color="red">*</font></label>
<input type="text" class="form-control" name="mobile" placeholder="Enter" required>
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Alternate Mobile No</label>
<input type="text" class="form-control" name="alt_mobile" placeholder="Enter">
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Email Id</label>
<input type="text" class="form-control" name="email" placeholder="Enter" >
</div>
<div class="col-md-3">
<label class="form-label" style="color:#8a7c7c;"> Aadharcard No </label>
<input type="text" class="form-control" name="aadharcardno" placeholder="Enter" >
</div>
</div>
</div>
<!-- Resume Upload
<div class="row mb-3">
<div class="col-md-6">
<label class="form-label" style="color:#8a7c7c;">Upload Resume</label>
<input type="file" class="form-control" name="resume_path" accept=".pdf,.doc,.docx" required>
</div>
</div>-->
<!-- Submit Button -->
<div class="row">
<div class="col-md-12 text-center">
<input type="hidden" name="jobid" value="<?php echo $_GET['id']; ?>">
<button type="submit" class="btn btn-primary px-5">Submit Form</button>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
<BR/>
<script>
function copyAddress() {
let isChecked = document.getElementById("sameAddressCheckbox").checked;
document.getElementsByName("local_address")[0].value = isChecked ? document.getElementsByName("address_permanant")[0].value : "";
document.getElementsByName("town_local")[0].value = isChecked ? document.getElementsByName("town")[0].value : "";
document.getElementsByName("taluka_local")[0].value = isChecked ? document.getElementsByName("taluka")[0].value : "";
document.getElementsByName("district_local")[0].value = isChecked ? document.getElementsByName("district")[0].value : "";
document.getElementsByName("state_local")[0].value = isChecked ? document.getElementsByName("state")[0].value : "";
document.getElementsByName("pincode_local")[0].value = isChecked ? document.getElementsByName("pincode")[0].value : "";
// Disable local address fields when checkbox is checked
document.getElementsByName("local_address")[0].readOnly = isChecked;
document.getElementsByName("town_local")[0].readOnly = isChecked;
document.getElementsByName("taluka_local")[0].readOnly = isChecked;
document.getElementsByName("district_local")[0].readOnly = isChecked;
document.getElementsByName("state_local")[0].readOnly = isChecked;
document.getElementsByName("pincode_local")[0].readOnly = isChecked;
}
</script>
<script>
function calculateAge() {
const day = parseInt(document.getElementById("birthDay").value);
const month = parseInt(document.getElementById("birthMonth").value);
const year = parseInt(document.getElementById("birthYear").value);
if (!day || !month || !year) {
document.getElementById("age").value = ""; // Clear the age field if input is incomplete
return;
}
const today = new Date();
const birthDate = new Date(year, month - 1, day); // Month is 0-indexed
let age = today.getFullYear() - birthDate.getFullYear();
const monthDiff = today.getMonth() - birthDate.getMonth();
if (monthDiff < 0 || (monthDiff === 0 && today.getDate() < birthDate.getDate())) {
age--; // Adjust for cases where the birthday hasn't occurred yet this year
}
document.getElementById("age").value = age; // Display the calculated age
}
</script>
<script>
document.addEventListener("DOMContentLoaded", function () {
// Populate Days (1-31)
const daySelect = document.getElementById("birthDay");
for (let day = 1; day <= 31; day++) {
const option = document.createElement("option");
option.value = day;
option.textContent = day;
daySelect.appendChild(option);
}
// Populate Months (1-12)
const monthSelect = document.getElementById("birthMonth");
const months = [
"January", "February", "March", "April", "May", "June",
"July", "August", "September", "October", "November", "December"
];
months.forEach((month, index) => {
const option = document.createElement("option");
option.value = index + 1; // Month values are 1-12
option.textContent = month;
monthSelect.appendChild(option);
});
// Populate Years (1900 - Current Year)
const yearSelect = document.getElementById("birthYear");
const currentYear = new Date().getFullYear();
for (let year = currentYear; year >= 1980; year--) {
const option = document.createElement("option");
option.value = year;
option.textContent = year;
yearSelect.appendChild(option);
}
});
</script>
<script>
function toggleDateInput() {
const dateInputRow = document.getElementById("dateInputRow");
const isYesSelected = document.getElementById("appointmentYes").checked;
// Show the date input if "Yes" is selected, hide it otherwise
dateInputRow.style.display = isYesSelected ? "block" : "none";
}
</script>
<?php include("footer.php");?>
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