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signup.html
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<!DOCTYPE html>
<html lang='en'>
<head>
<title>Sign Up</title>
<link href='css/bootstrap.css' rel='stylesheet'>
<link href='css/hackathon.css' rel='stylesheet'>
</head>
<body><nav class="navbar navbar-inverse" role="navigation">
<!-- Brand and toggle get grouped for better mobile display -->
<div class="navbar-header">
<button type="button" class="navbar-toggle" data-toggle="collapse" data-target="#navbar-collapse-1">
<span class="sr-only">Toggle navigation</span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
</div>
<a class="navbar-brand" href="#">United Us, Multiplied Development</a>
<!-- Collect the nav links, forms, and other content for toggling -->
<div class="collapse navbar-collapse" id="navbar-collapse-1">
<ul class="nav navbar-nav navbar-left">
<li><a href="#">What We Do</a></li>
<li><a href="#">Contact Us</a></li>
</ul>
<ul class="nav navbar-nav navbar-right">
<li><a href="#">Discussions</a></li>
<li><a href="#">Locations</a></li>
<li><a href="#"></a></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">More<b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a href="#">FAQs</a></li>
<li><a href="#">Reviews</a></li>
<li class="divider"></li>
<li><a href="#">Scope for Improvement</a></li>
</ul>
</li>
</ul>
</div><!-- /.navbar-collapse -->
</nav>
<!-- /.nav-->
<!-- signup-->
<div class='row well col-sm-6 col-sm-offset-3 col-sm-offset-3'>
<div class="SIGNUP">
<div class="container">
<div class="row">
<!--Login1-->
<div class="col-md-4 col-md-offset-1">
<form class="form-horizontal">
<fieldset>
<!-- Form Name -->
<legend>Sign Up First!</legend>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Name">Name</label>
<div class="controls">
<input id="Name" name="Name" type="text" placeholder="Name" class="input-xlarge">
</div>
</div>
<div><!--enclosing div-->
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Country">Country</label>
<div class="controls">
<select id="country" name="country" class="countries" id="countryId">
<option value="">Select Country</option>
</select>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="State">State</label>
<div class="controls">
<select id="state" name="state" class="states" id="stateId">
<option value="">Select State</option>
</select>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="City">City</label>
<div class="controls">
<select id="city" name="city" class="cities" id="cityId">
<option value="">Select City</option>
</select>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/1.11.1/jquery.min.js"></script>
<script src="http://iamrohit.in/lab/js/location.js"></script>
</div>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Society">Society/Colony</label>
<div class="controls">
<input id="Society" name="Society" type="text" placeholder="Society/Colony" class="input-xlarge">
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Name">House No</label>
<div class="controls">
<input id="Houseno" name="Houseno" type="text" placeholder="Houseno" class="input-xlarge">
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Zip_Code">Zip Code</label>
<div class="controls">
<input id="Zip_Code" name="Zip_Code" type="text" placeholder="Zip Code" class="input-xlarge">
</div>
</div>
<!--Date of Birth-->
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="date_of_birth">Date of Birth</label>
<div class="controls">
<select name="date_of_birth" class="input-xlarge">
<option> - Month - </option>
<option value="January">January</option>
<option value="Febuary">Febuary</option>
<option value="March">March</option>
<option value="April">April</option>
<option value="May">May</option>
<option value="June">June</option>
<option value="July">July</option>
<option value="August">August</option>
<option value="September">September</option>
<option value="October">October</option>
<option value="November">November</option>
<option value="December">December</option>
</select>
<select id="date_of_birth" name="DOBDay" class="input-xlarge">
<option> - Day - </option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select id="date_of_birth" name="DOBYear" class="input-xlarge">
<option> - Year - </option>
<option value="1993">2006</option>
<option value="1993">2005</option>
<option value="1993">2004</option>
<option value="1993">2003</option>
<option value="1993">2002</option>
<option value="1993">2001</option>
<option value="1992">2000</option>
<option value="1991">1999</option>
<option value="1990">1998</option>
<option value="1989">1997</option>
<option value="1988">1996</option>
<option value="1987">1995</option>
<option value="1986">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1957">1946</option>
<option value="1956">1945</option>
<option value="1955">1944</option>
<option value="1954">1943</option>
<option value="1953">1942</option>
<option value="1952">1941</option>
<option value="1951">1940</option>
<option value="1950">1939</option>
<option value="1949">1938</option>
<option value="1948">1937</option>
<option value="1947">1936</option>
</select>
</div>
</div>
<!--date of birth-->
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Contact Number">Contact Number</label>
<div class="controls">
<input id="Contact Number" name="Home_Number" type="text" placeholder="Home" class="input-xlarge">
<input id="Contact Number" name="Cell_Number" type="text" placeholder="Mobile" class="input-xlarge">
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Email_Address">Email Address</label>
<div class="controls">
<input id="Email_Address" name="Email_Address" type="text" placeholder="Email Address" class="input-xlarge">
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Name">Username</label>
<div class="controls">
<input id="Username" name="Username" type="text" placeholder="Username" class="input-xlarge">
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="Name">Password</label>
<div class="controls">
<input id="Password" name="Password" type="text" placeholder="********" class="input-xlarge">
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="sign_in_as">Sign in as</label>
<div class="controls">
<select id="sign_in_as" name="sign_in_as" class="input-xlarge">
<option>Designation</option>
<option value="Resident">Resident</option>
<option value="RWA Associate">RWA Associate</option>
</select>
<!--upload aadhar card-->
<div class="control-group">
<label class="control-label" for="upload_aadhar_card">Upload scanned copy of your Aadhar Card</label>
<div class="controls">
<form action="upload.php" method="post" enctype="multipart/form-data">
<input type="file" name="fileToUpload" id="fileToUpload">
</br>
<input type="submit" value="Upload Image" name="submit">
</form>
</div>
</div>
<!--/.upload aadhar card-->
</fieldset>
</form>
</div>
</div>
</div>
</div>
</div>
<script src='https://ajax.googleapis.com/ajax/libs/jquery/1.11.1/jquery.min.js'></script>
<script src='js/bootstrap.js'></script>
<script src='js/hackathon.js'></script>
</body>
</html>