GOOGLE
<!DOCTYPE html>
<html lang="en">
<!-- Mirrored from sdmca.edu.in/ by HTTrack Website Copier/3.x [XR&CO'2014], Thu, 27 Sep 2018 18:21:24 GMT -->
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="author" content="">
<title>Agnihotri School of Technology (Polytechnic) Wardha</title>
<!-- core CSS -->
<link href="css/bootstrap.min.css" rel="stylesheet">
<link href="css/font-awesome.min.css" rel="stylesheet">
<link href="css/animate.min.css" rel="stylesheet">
<link href="css/prettyPhoto.css" rel="stylesheet">
<link href="css/main.css" rel="stylesheet">
<link href="css/responsive.css" rel="stylesheet">
<link rel="shortcut icon" href="">
<script >
$(document).ready(function () {
$("#background-image").fullscreenBackground();
});
</script>
<!-- banner code end-->
<script src="js/slider.js"></script>
<script src="includePage.js"></script>
<!-- Global site tag (gtag.js) - Google Analytics -->
</head><!--/head-->
<body class="homepage">
<?php include("header.php"); ?>
<section id="middle">
<div class="container container_bg">
<div class="row">
<div class="col-sm-3 col-md-3 wow fadeInDown">
<script >
ajaxinclude("left_Site.html");
</script>
</div><!--/.col-sm-6-->
<h1 style="color: red;">Online Admission Form</h1>
<hr/>
<div class="col-sm-8 col-md-9 wow fadeInDown">
<section id="middle">
<div class="container container_bg">
<div class="row">
<style type="text/css">
#deceased{
background-color:#FFF3F5;
padding-top:10px;
margin-bottom:10px;
}
.remove_field{
float:right;
cursor:pointer;
position : absolute;
}
.remove_field:hover{
text-decoration:none;
}
</style>
<div class="panel panel-primary" style="margin:20px;">
<div class="panel-heading">
<h3 class="panel-title">Registration Form</h3>
</div>
<div class="panel-body">
<form>
<div class="col-md-12 col-sm-12">
<div class="form-group col-md-6 col-sm-6">
<label for="name">Name* </label>
<input type="text" class="form-control input-sm" id="name" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="email">Email*</label>
<input type="email" class="form-control input-sm" id="email" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="mobile">Mobile*</label>
<input type="text" class="form-control input-sm" id="mobile" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="address">Address*</label>
<textarea class="form-control input-sm" id="address" rows="3"></textarea>
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="city">City*</label>
<input type="text" class="form-control input-sm" id="city" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="state">State*</label>
<input type="text" class="form-control input-sm" id="state" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="country">Country*</label>
<input type="text" class="form-control input-sm" id="country" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="pincode">Pincode</label>
<input type="text" class="form-control input-sm" id="pincode" placeholder="">
</div>
</div>
<div class="col-md-12 col-sm-12">
<div class="form-group col-md-3 col-sm-3 pull-right" >
<input type="submit" class="btn btn-primary" value="Submit"/>
</div>
</div>
</form>
</div>
<!--/#accordion1-->
</div>
</div><!--/.row-->
</div><!--/.container-->
</section>
</div>
</div> <br>
</div>
</div><!--/.row-->
</div><!--/.container-->
</section><!--/#middle-->
<!--/#content-->
<!--/#partner-->
<!--/#conatcat-info-->
<!--/#bottom-->
<script >
ajaxinclude("footer.html");
</script>
<!--/#footer-->
<script src="js/jquery.js"></script>
<script src="js/bootstrap.min.js"></script>
<script src="js/jquery.prettyPhoto.js"></script>
<script src="js/jquery.isotope.min.js"></script>
<script src="js/main.js"></script>
<script src="js/wow.min.js"></script>
</body>
<!-- Mirrored from sdmca.edu.in/ by HTTrack Website Copier/3.x [XR&CO'2014], Thu, 27 Sep 2018 18:25:12 GMT -->
</html>
Copyright © 1945 -