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form.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=device-width, initial-scale=1.0" />
<title>Sample Form</title>
<link rel="stylesheet" href="./form.css" />
<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/2.1.3/jquery.min.js"></script>
</head>
<body>
<h1><span>Course Enrollment Form</span></h1>
<div class="container">
<form>
<div class="row">
<h4>Student Details</h4>
<div class="input-group input-group-icon">
<input type="text" placeholder="Full Name" />
<div class="input-icon"><i class="fa fa-user"></i></div>
</div>
<div class="input-group input-group-icon">
<input type="email" placeholder="Email Adress" />
<div class="input-icon"><i class="fa fa-envelope"></i></div>
</div>
<div class="input-group input-group-icon">
<input type="text" placeholder="Permanent address" />
<div class="input-icon"><i class="fa fa-home"></i></div>
</div>
</div>
<div class="row">
<div class="col-half">
<h4>Date of Birth</h4>
<div class="input-group">
<div class="col-third">
<input type="text" placeholder="DD" />
</div>
<div class="col-third">
<input type="text" placeholder="MM" />
</div>
<div class="col-third">
<input type="text" placeholder="YYYY" />
</div>
</div>
</div>
<div class="col-half">
<h4>Gender</h4>
<div class="input-group">
<input id="gender-male" type="radio" name="gender" value="male" />
<label for="gender-male">Male</label>
<input
id="gender-female"
type="radio"
name="gender"
value="female"
/>
<label for="gender-female">Female</label>
</div>
</div>
</div>
<div class="row">
<h4>Course Enrollment</h4>
<div class="input-group">
<input id="course-btech" type="radio" name="course" value="btech" />
<label for="course-btech"
><span><i class="fa fa-book"></i>B.Tech</span></label
>
<input id="course-mtech" type="radio" name="course" value="mtech" />
<label for="course-mtech"
><span><i class="fa fa-desktop"></i>M.Tech</span></label
>
</div>
<div class="row">
<h4>Preferred Branch</h4>
<div class="input-group">
<input id="branch-cs" type="radio" name="branch" value="cs" />
<label for="branch-cs"
><span><i class="fa fa-desktop"></i>Computer</span></label
>
<input
id="branch-electrical"
type="radio"
name="branch"
value="electrical"
/>
<label for="branch-electrical"
><span><i class="fa fa-bolt"></i>Electrical</span></label
>
<input
id="branch-mechanical"
type="radio"
name="branch"
value="mechanical"
/>
<label for="branch-mechanical"
><span><i class="fa fa-wrench"></i>Mechanic</span></label
>
<input
id="branch-civil"
type="radio"
name="branch"
value="civil"
/>
<label for="branch-civil"
><span><i class="fa fa-building"></i>Civil</span></label
>
</div>
</div>
</div>
<div class="row">
<h4>Terms and Conditions</h4>
<div class="input-group">
<input id="terms" type="checkbox" />
<label for="terms"
>I hereby accept that all the above mentioned details are
correct.</label
>
</div>
</div>
<div class="sub">
<button type="submit" id="submit-btn">
<i class="fa fa-paper-plane"></i> Submit
</button>
</div>
</form>
</div>
</body>
</html>