
<?php
session_start();
require_once("public/connection.php");
require_once("public/functions.php");

if ($_SERVER['REQUEST_METHOD'] === 'POST') {
    // Upload passport
    $passport = "";
    if (isset($_FILES['passport']) && $_FILES['passport']['error'] == 0) {
        $targetDir = "uploads/admissions";
        $passport = $targetDir . basename($_FILES['passport']['name']);
        if (!move_uploaded_file($_FILES['passport']['tmp_name'], $passport)) {
            die("Error uploading passport.");
        }
    }

    // Collect form data
	$status = 'PENDING';
    $fname = $_POST['fname'];
    $mname = $_POST['mname'];
    $oname = $_POST['oname'];
    $dob = $_POST['dob'];
    $gender = $_POST['gender'];
    $nationality = $_POST['nationality'];
    $state = $_POST['state'];
    $lga = $_POST['lga'];
    $lschool = $_POST['lschool'];
    $lclass = $_POST['lclass'];
    $class = $_POST['class'];
    $ftitle = $_POST['ftitle'];
    $fsname = $_POST['fsname'];
    $foname = $_POST['foname'];
    $faddress = $_POST['faddress'];
    $foccupation = $_POST['foccupation'];
    $femail = $_POST['femail'];
    $fpnumber = $_POST['fpnumber'];
    $fapnumber = $_POST['fapnumber'];
    $mtitle = $_POST['mtitle'];
    $msname = $_POST['msname'];
    $moname = $_POST['moname'];
    $maddress = $_POST['maddress'];
    $moccupation = $_POST['moccupation'];
    $memail = $_POST['memail'];
    $mpnumber = $_POST['mpnumber'];
    $mapnumber = $_POST['mapnumber'];
    $language = $_POST['language'];
    $challenge = $_POST['challenge'];
    $hear = $_POST['hear'];

    // Generate a unique application number
    $application_number = strtoupper(uniqid('APPL-'));

    // Construct SQL query (without prepared statements)
    $sql = "INSERT INTO applications (
        application_number, status, passport, fname, mname, oname, dob, gender, nationality, state, lga,
        lschool, lclass, class, ftitle, fsname, foname, faddress, foccupation, 
        femail, fpnumber, fapnumber, mtitle, msname, moname, maddress, 
        moccupation, memail, mpnumber, mapnumber, language, challenge, hear
    ) VALUES (
        '$application_number', '$status', '$passport', '$fname', '$mname', '$oname', '$dob', '$gender', '$nationality', '$state', '$lga',
        '$lschool', '$lclass', '$class', '$ftitle', '$fsname', '$foname', '$faddress', '$foccupation',
        '$femail', '$fpnumber', '$fapnumber', '$mtitle', '$msname', '$moname', '$maddress',
        '$moccupation', '$memail', '$mpnumber', '$mapnumber', '$language', '$challenge', '$hear'
    )";

    // Execute the query
    $run_query = mysqli_query($connection, $sql);

if ($run_query) {
    $_SESSION['login_msg'] = "Application submitted successfully. Your Application Number is: <strong>$application_number</strong>";
    $_SESSION['alert_type'] = "success";
    header("Location: application_summary.php?app_number=$application_number");
    exit();
} else {
    $_SESSION['login_msg'] = "Error: " . mysqli_error($connection);
    $_SESSION['alert_type'] = "error";
    header("Location: applicationform.php");
    exit();
}

}
?>



<head>
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  <title>Online Admission-Syntax Digital School | Quality Education in Abuja, FCT</title>

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  <meta name="description" content="Syntax Digital School is a reputable private school located opposite De Premix Hotel and Resorts, Tombia-Amassoma Road, Okutukutu, Abuja, FCT. We provide quality nursery, primary and secondary education focused on academic excellence and character development.">

  <meta name="keywords" content="Syntax Digital School, Schools in Abuja, Private Schools in FCT, Nursery School Abuja, Primary School Abuja, Secondary School Abuja, Best Schools in FCT, Education in Nigeria, syntaxdigitaltech.com.ng
">

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">
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 for quality education.">
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">
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">
</head>






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  <!-- Fonts -->
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<style type="text/css">
  .mylabel{color:red; font-style: italic; font-size: 16px}
</style>










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<script>
function digi() {
  const now = new Date();

  // --- Time ---
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// Start clock on load
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</script>


<script>
function populateclass(s1,s2){
var s1 = document.getElementById(s1);
var s2 = document.getElementById(s2);
s2.innerHTML = "";

if(s1.value == "Nursery Section"){var optionArray = ["-Select-|-Select Class-",

"nur1a|Pre-School","nur1b|Pre-Nursery","nur2a|Nursery","nur2b|Reception","|-Select Class-"];

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else if(s1.value == "Primary Section"){var optionArray = ["-Select-|-Select Class-",

"class1a|Basic 1","class2a|Basic 2","class3a|Basic 3","class4a|Basic 4","class5a|Basic 5","|-Select Class-"];

}

else if(s1.value == "Junior Secondary Section"){var optionArray = ["-Select-|-Select Class-",

"jss1a|JSS 1A","jss1b|JSS 1B","jss2a|JSS 2A","jss2b|JSS 2B","jss3a|JSS 3A","jss3b|JSS 3B","|-Select Class-"];

}
else if(s1.value == "Senior Secondary Section"){var optionArray = ["-Select-|-Select Class-",

"ss1a|SS 1A","ss2a|SS 2A","ss3a|SS 3A","ss1b|SS 1B","ss2b|SS 2B","ss3b|SS 3B","|-Select Class-"];
}



for(var option in optionArray){var pair = optionArray[option].split("|");
var newOption = document.createElement("option");
newOption.value = pair[0];
newOption.innerHTML = pair[1];
s2.options.add(newOption);
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}

function populatesubject(s1,s2){
var s1 = document.getElementById(s1);
var s2 = document.getElementById(s2);
s2.innerHTML = "";

if(s1.value == "Nursery Section"){ var optionArray = ["-Select-|-Select Subject-",

"c1|LITERACY","c2|PHONICS","c3|NUMERACY","c4|EXPRESSIVE ART","c5|KNOWLEDGE OF THE WORLD","c6|PRACTICAL LIFE EXPERIENCE (PLE)","c7|PERSONAL SOCIAL & EMOTIONAL DEVELOPMENT (PSED)","c8|CURRENT AFFAIRS","c9|SENSORIAL EDUCATION","c10|HEALTH HABIT","c11|RHYMES","c12|ELOCUTION","c13|HAND WRITING","c14|SOCIAL STUDIES","c15|COMPUTER STUDIES","c16|GRAMMER","c17|CREATIVE ART",
"Rating|Rating",
"Class Teachers Comment|Class Teachers Comment",
"Attendance|Attendance"

];} 



else if(s1.value == "Primary Section"){var optionArray = ["-Select-|-Select Subject-",

"c1|BST - COMPUTER ST.","c2|BST - BASIC TECH.","c3|BST - PHE","c4|BST - BASIC SC.","c5|NVE - CIVIC EDU.","c6|NVE - SOCIAL ST.","c7|NVE - SECURITY ST.","c8|RELIGIOUS ST","c9|MATHEMATICS ","c10|ENGLISH ","c11|VERBAL REASONING","c12|QUAN. REASONING","c13|PSV - HOME ECONS & AGRIC SCI","c14|GHY-GEOGRAPHY","c15|CCA","c16|HISTORY","c17|FRENCH","c18|HAUSA","c19|ELOCUTION","c20|HAND WRITING","c21|MUSIC",

"Rating|Rating",
"Class Teachers Comment|Class Teachers Comment",
"Attendance|Attendance"

];}


else if(s1.value == "Junior Secondary Section"){var optionArray = ["-Select-|-Select Subject-",

"c1|ENGLISH STUDIES","c2|MATHEMATICS ","c3|BUSINESS STUDIES","c4|FRENCH","c5|RELIGIOUS STUDIES","c6|HISTORY","c7|NVE- CIVIC EDU.","c8|NVE- SOCIAL ST.","c9|NVE- SECURITY ED.","c10|BST- PHE","c11|BST- COMPUTER","c12|BST- BASIC TECH","c13|BST- BASIC SC.","c14|GHY-GEOGRAPHY","c15|PVS- HOME-ECONS & AGRIC SCI","c16|CCA","c17|ELOCUTION","c18|HAUSA","c19|LIT. IN ENGLISH","c20|MUSIC",

"Rating|Rating",
"Class Teachers Comment|Class Teachers Comment",
"Attendance|Attendance"

];}

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"c1|English Language","c2|Mathematics","c3|Physics","c4|Chemistry","c5|Biology","c6|Computer Studies","c7|History","c8|Civic Education","c9|Islamic Religious Knowledge","c10|Geography","c11|Literature in English","c12|Government","c13|Economics","c14|Quran","c15|Agricultural Science ",
"Rating|Rating",
"Class Teachers Comment|Class Teachers Comment",
"Attendance|Attendance"

];}




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newOption.value = pair[0];
newOption.innerHTML = pair[1];
s2.options.add(newOption);
}
}
</script>
<script type="text/jscript">

function populateclass(s1,s2){
var s1 = document.getElementById(s1);
var s2 = document.getElementById(s2);
s2.innerHTML = "";

if(s1.value == "Abia State"){ var optionArray = ["|-Select LGA-",
"Aba North|Aba North",
"Aba South|Aba South",
"Arochukwu|Arochukwu",
"Bende|Bende",
"Isiala Ngwa South|Isiala Ngwa South",
"Ikwuano|Ikwuano",
"Isiala|Isiala",
"Ngwa North|Ngwa North",
"Isukwuato|Isukwuato",
"Ukwa West|Ukwa West",
"Ukwa East|Ukwa East",
"Umuahia|Umuahia",
"Umuahia South|Umuahia South"
];}

if(s1.value == "Adamawa State"){ var optionArray = ["|-Select LGA-",
"Demsa|Demsa",
"Fufore|Fufore",
"Ganye|Ganye",
"Girei|Girei",
"Gombi|Gombi",
"Jada|Jada",
"Yola North|Yola North",
"Lamurde|Lamurde",
"Madagali|Madagali",
"Maiha|Maiha",
"Mayo-Belwa|Mayo-Belwa",
"Michika|Michika",
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"Numna|Numna",
"Shelleng|Shelleng",
"Song|Song",
"Toungo|Toungo",
"Jimeta|Jimeta",
"Yola South|Yola South",
"Hung|Hung"
];}

if(s1.value == "Anambra State"){ var optionArray = ["|-Select LGA-",
"Aguata|Aguata",
"Anambra|Anambra",
"Anambra West|Anambra West",
"Anaocha|Anaocha",
"Awka South|Awka South",
"Awka North|Awka North",
"Ogbaru|Ogbaru",
"Onitsha South|Onitsha South",
"Onitsha North|Onitsha North",
"Orumba North|Orumba North",
"Orumba South|Orumba South",
"Oyi|Oyi"
];}


if(s1.value == "Akwa Ibom State"){ var optionArray = ["|-Select LGA-",
"Abak|Abak",
"Eastern Obolo|Eastern Obolo",
"Eket|Eket",
"Essien Udim|Essien Udim",
"Etimekpo|Etimekpo",
"Etinan|Etinan",
"Ibeno|Ibeno",
"Ibesikpo Asutan|Ibesikpo Asutan",
"Ibiono Ibom|Ibiono Ibom",
"Ika|Ika",
"Ikono|Ikono",
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"Itu|Itu",
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"Oruko Ete|Oruko Ete",
"Uyo|Uyo"
];}

if(s1.value == "Bauchi State"){ var optionArray = ["|-Select LGA-",
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"Bauchi|Bauchi",
"Bogoro|Bogoro",
"Darazo|Darazo",
"Dass|Dass",
"Gamawa|Gamawa",
"Ganjuwa|Ganjuwa",
"Giade|Giade",
"Jamaare|Jamaare",
"Katagum|Katagum",
"Kirfi|Kirfi",
"Misau|Misau",
"Ningi|Ningi",
"Hira|Hira",
"Tafawa Balewa|Tafawa Balewa",
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"Toro|Toro",
"Warji|Warji",
"Zaki|Zaki",
"Dambam|Dambam"
];}

if(s1.value == "FCT"){ var optionArray = ["|-Select LGA-",
"Brass|Brass",
"Ekeremor|Ekeremor",
"Kolok/Opokuma|Kolok/Opokuma",
"Nembe|Nembe",
"Ogbia|Ogbia",
"Sagbama|Sagbama",
"Southern Ijaw|Southern Ijaw",
"Abuja|Abuja",
"Membe|Membe"
];}

if(s1.value == "Benue State"){ var optionArray = ["|-Select LGA-",
"Ador|Ador",
"Agatu|Agatu",
"Apa|Apa",
"Buruku|Buruku",
"Gboko|Gboko",
"Guma|Guma",
"Gwer East|Gwer East",
"Gwer West|Gwer West",
"Kastina-ala|Kastina-ala",
"Konshisha|Konshisha",
"Kwande|Kwande",
"Logo|Logo",
"Makurdi|Makurdi",
"Obi|Obi",
"Ogbadibo|Ogbadibo",
"Ohimini|Ohimini",
"Oju|Oju",
"Okpokwu|Okpokwu",
"Oturkpo|Oturkpo",
"Tarka|Tarka",
"Ukum|Ukum",
"Vandekya|Vandekya"
];}

if(s1.value == "Borno State"){ var optionArray = ["|-Select LGA-",
"Abadan|Abadan",
"Askira/Uba|Askira/Uba",
"Bama|Bama",
"Bayo|Bayo",
"Biu|Biu",
"Chibok|Chibok",
"Damboa|Damboa",
"Dikwa|Dikwa",
"Gubio|Gubio",
"Guzamala|Guzamala",
"Gwoza|Gwoza",
"Hawul|Hawul",
"Jere|Jere",
"Kaga|Kaga",
"Kalka/Balge|Kalka/Balge",
"Konduga|Konduga",
"Kukawa|Kukawa",
"Kwaya-kusar|Kwaya-kusar",
"Mafa|Mafa",
"Magumeri|Magumeri",
"Maiduguri|Maiduguri",
"Marte|Marte",
"Mobbar|Mobbar",
"Monguno|Monguno",
"Ngala|Ngala",
"Nganzai|Nganzai",
"Shani|Shani"
];}

if(s1.value == "Cross River State"){ var optionArray = ["|-Select LGA-",
"Abia|Abia",
"Akampa|Akampa",
"Akpabuyo|Akpabuyo",
"Bakassi|Bakassi",
"Bekwara|Bekwara",
"Biase|Biase",
"Boki|Boki",
"Calabar South|Calabar South",
"Etung|Etung",
"Ikom|Ikom",
"Obanliku|Obanliku",
"Obubra|Obubra",
"Obudu|Obudu",
"Odukpani|Odukpani",
"Ogoja|Ogoja",
"Ugep North|Ugep North",
"Yala|Yala",
"Yarkur|Yarkur"
];}

if(s1.value == "Delta State"){ var optionArray = ["|-Select LGA-",
"Aniocha South|Aniocha South",
"Anioha|Anioha",
"Bomadi|Bomadi",
"Burutu|Burutu",
"Ethiope west|Ethiope west",
"Ethiope east|Ethiope east",
"Ika south|Ika south",
"Ika north east|Ika north east",
"Isoko south|Isoko south",
"Isoko north|Isoko north",
"Ndokwa east|Ndokwa east",
"Ndokwa west|Ndokwa west",
"Okpe|Okpe",
"Oshimili north|Oshimili north",
"Oshimili south|Oshimili south",
"Patani|Patani",
"Sapele|Sapele",
"Udu|Udu",
"Ughelli south|Ughelli south",
"Ughelli north|Ughelli north",
"Ukwuani|Ukwuani",
"Uviwie|Uviwie",
"Warri central|Warri central",
"Warri north|Warri north",
"Warri south|Warri south",
];}

if(s1.value == "Ebonyi State"){ var optionArray = ["|-Select LGA-",
"Abakaliki|Abakaliki",
"Afikpo south|Afikpo south",
"Afikpo north|Afikpo north",
"Ebonyi|Ebonyi",
"Ezza|Ezza",
"Ezza south|Ezza south",
"Ikwo|Ikwo",
"Ishielu|Ishielu",
"Ivo|Ivo",
"Ohaozara|Ohaozara",
"Ohaukwu|Ohaukwu",
"Onicha|Onicha",
"Izzi|Izzi"
];}

if(s1.value == "Edo State"){ var optionArray = ["|-Select LGA-",
"Akoko-Edo|Akoko-Edo",
"Egor|Egor",
"Essann east|Essann east",
"Esan south east|Esan south east",
"Esan central|Esan central",
"Esan west|Esan west",
"Etsako central|Etsako central",
"Etsako east|Etsako east",
"Etsako|Etsako",
"Orhionwon|Orhionwon",
"Ivia north|Ivia north",
"Ovia south west|Ovia south west",
"Owan west|Owan west",
"Owan south|Owan south",
"Uhunwonde|Uhunwonde"
];}

if(s1.value == "Ekiti State"){ var optionArray = ["|-Select LGA-",
"Ado Ekiti|Ado Ekiti",
"Effon Alaiye|Effon Alaiye",
"Ekiti south west|Ekiti south west",
"Ekiti west|Ekiti west",
"Ekiti east|Ekiti east",
"Emure/ise|Emure/ise",
"Orun|Orun",
"Ido|Ido",
"Osi|Osi",
"Ijero|Ijero",
"Ikere|Ikere",
"Ikole|Ikole",
"Ilejemeje|Ilejemeje",
"Irepodun|Irepodun",
"Ise/Orun|Ise/Orun",
"Moba|Moba",
"Oye|Oye",
"Aiyekire|Aiyekire",
];}

if(s1.value == "Enugu State"){ var optionArray = ["|-Select LGA-",
"Awgu|Awgu",
"Aninri|Aninri",
"Enugu east|Enugu east",
"Enugu south|Enugu south",
"Enugu north|Enugu north",
"Ezeagu|Ezeagu",
"Igbo Eze north|Igbo Eze north",
"Igbi etiti|Igbi etiti",
"Nsukka|Nsukka",
"Oji river|Oji river",
"Undenu|Undenu",
"Uzo Uwani|Uzo Uwani",
"Udi|Udi"
];}

if(s1.value == "FCT (Abuja)"){ var optionArray = ["|-Select LGA-",
"Abaji|Abaji",
"Abuja Municipal|Abuja Municipal",
"Bwari|Bwari",
"Gwagwalada|Gwagwalada",
"Kuje|Kuje",
"Kwali|Kwali",
];}

if(s1.value == "Gombe State"){ var optionArray = ["|-Select LGA-",
"Akko|Akko",
"Balanga|Balanga",
"Billiri|Billiri",
"Dukku|Dukku",
"Funakaye|Funakaye",
"Gombe|Gombe",
"Kaltungo|Kaltungo",
"Kwami|Kwami",
"Nafada/Bajoga|Nafada/Bajoga",
"Shomgom|Shomgom",
"Yamaltu/Deba|Yamaltu/Deba"
];}

if(s1.value == "Imo State"){ var optionArray = ["|-Select LGA-",
"Aboh-mbaise|Aboh-mbaise",
"Ahiazu-Mbaise|Ahiazu-Mbaise",
"Ehime-Mbaino|Ehime-Mbaino",
"Ezinhite Mbaise|Ezinhite Mbaise",
"Ideato North|Ideato North",
"Ideato south|Ideato south",
"Ihitte/Uboma|Ihitte/Uboma",
"Ikeduru|Ikeduru",
"Isiala|Isiala",
"Isu|Isu",
"Mbaitoli|Mbaitoli",
"Ngor Okpala|Ngor Okpala",
"Njaba|Njaba",
"Nwangele|Nwangele",
"Nkwere|Nkwere",
"Obowo|Obowo",
"Aguta|Aguta",
"Ohaji Egbema|Ohaji Egbema",
"Okigwe|Okigwe",
"Onuimo|Onuimo",
"Orlu|Orlu",
"Orsu|Orsu",
"Oru west|Oru west",
"Oru|Oru",
"Owerri|Owerri",
"Owerri North|Owerri North",
"Owerri south|Owerri south"
];}

if(s1.value == "Jigawa State"){ var optionArray = ["|-Select LGA-",
"Auyo|Auyo",
"Babura|Babura",
"Birnin- Kudu|Birnin- Kudu",
"Birniwa|Birniwa",
"Buji|Buji",
"Dutse|Dutse",
"Garki|Garki",
"Gagarawa|Gagarawa",
"Gumel|Gumel",
"Guri|Guri",
"Gwaram|Gwaram",
"Gwiwa|Gwiwa",
"Hadejia|Hadejia",
"Jahun|Jahun",
"Kafin-Hausa|Kafin-Hausa",
"kaugama|kaugama",
"Kazaure|Kazaure",
"Kirikisamma|Kirikisamma",
"Birnin-magaji|Birnin-magaji",
"Maigatari|Maigatari",
"Malamaduri|Malamaduri",
"Miga|Miga",
"Ringim|Ringim",
"Roni|Roni",
"Sule Tankarkar|Sule Tankarkar",
"Taura|Taura",
"Yankwasi|Yankwasi"
];}

if(s1.value == "Kaduna State"){ var optionArray = ["|-Select LGA-",
"Brnin Gwari|Brnin Gwari",
"Chukun|Chukun",
"Giwa|Giwa",
"Kajuru|Kajuru",
"Igabi|Igabi",
"Ikara|Ikara",

"Jaba|Jaba",
"Kachia|Kachia",
"Kaduna North|Kaduna North",
"Kaduna south|Kaduna south",
"Kagaroko|Kagaroko",
"Kajuru|Kajuru",
"Kabau|Kabau",
"Kudan|Kudan",
"Lere|Lere",
"Makarfi|Makarfi",
"Sabongari|Sabongari",
"Sanga|Sanga",
"Soba|Soba",
"Zangon-Kataf|Zangon-Kataf",
"Zaria|Zaria"
];}

if(s1.value == "Kano State"){ var optionArray = ["|-Select LGA-",
"Ajigi|Ajigi",
"Albasu|Albasu",
"Bagwai|Bagwai",
"Bebeji|Bebeji",
"Bichi|Bichi",
"Bunkure|Bunkure",
"Dala|Dala",
"Dambatta|Dambatta",
"Dawakin kudu|Dawakin kudu",
"Dawakin tofa|Dawakin tofa",
"Doguwa|Doguwa",
"Fagge|Fagge",
"Gabasawa|Gabasawa",
"Garko|Garko",
"Garun mallam|Garun mallam",
"Gaya|Gaya",
"Gezawa|Gezawa",
"Gwale|Gwale",
"Gwarzo|Gwarzo",
"Kano|Kano",
"Karaye|Karaye",
"Kibiya|Kibiya",
"Kiru|Kiru",
"Kumbtso|Kumbtso",
"Kunch|Kunch",
"Kura|Kura",
"Maidobi|Maidobi",
"Makoda|Makoda",
"Minjibir |Minjibir ",
"Nassarawa|Nassarawa",
"Rano|Rano",
"Rimin gado|Rimin gado",
"Rogo|Rogo",
"Shanono|Shanono",
"Sumaila|Sumaila",
"Takai|Takai",
"Tarauni|Tarauni",
"Tofa|Tofa",
"Tsanyawa|Tsanyawa",
"Tudunwada|Tudunwada",
"Ungogo|Ungogo",
"Warawa|Warawa",
"Wudil|Wudil"
];}

if(s1.value == "Katsina State"){ var optionArray = ["|-Select LGA-",

"Bakori|Bakori",
"Batagarawa|Batagarawa",
"Batsari|Batsari",
"Baure|Baure",
"Bindawa|Bindawa",
"Charanchi|Charanchi",
"DanMusa|DanMusa",
"Dandume|Dandume",
"Danja|Danja",
"Daura|Daura",
"Dutsi|Dutsi",
"Dutsinma|Dutsinma",
"Faskar|Faskar",
"Funtua|Funtua",
"Ingawa|Ingawa",
"Jibiya|Jibiya",
"Kafur|Kafur",
"Kaita|Kaita",
"Kankara|Kankara",
"Kankiya|Kankiya",
"Katsina|Katsina",
"Furfi|Furfi",
"Kusada|Kusada",
"Mai aduwa|Mai aduwa",
"Malumfashi|Malumfashi",
"Mani|Mani",
"Mash|Mash",
"Matazu|Matazu",
"Musawa|Musawa",
"Rimi|Rimi",
"Sabuwa|Sabuwa",
"Safana|Safana",
"Sandamu|Sandamu",
"Zango|Zango"

];}

if(s1.value == "Kebbi State"){ var optionArray = ["|-Select LGA-",

"Aliero|Aliero",
"Arewa Dandi|Arewa Dandi",
"Argungu|Argungu",
"Augie|Augie",
"Bagudo|Bagudo",
"Birnin Kebbi|Birnin Kebbi",
"Bunza|Bunza",
"Dandi|Dandi",
"Danko|Danko",
"Fakai|Fakai",
"Gwandu|Gwandu",
"Jeda|Jeda",
"Kalgo|Kalgo",
"Koko-besse|Koko-besse",
"Maiyaama|Maiyaama",
"Ngaski|Ngaski",
"Sakaba|Sakaba",
"Shanga|Shanga",
"Suru|Suru",
"Wasugu|Wasugu",
"Yauri|Yauri",
"Zuru|Zuru"
];}

if(s1.value == "Kogi State"){ var optionArray = ["|-Select LGA-",

"Adavi|Adavi",
"Ajaokuta|Ajaokuta",
"Ankpa|Ankpa",
"Bassa|Bassa",
"Dekina|Dekina",
"Ibaji|Ibaji",
"Idah|Idah",
"Igalamela|Igalamela",
"Ijumu|Ijumu",
"Kabba bunu|Kabba bunu",
"Kogi|Kogi",
"Mopa muro|Mopa muro",
"Ofu|Ofu",
"Ogori magongo|Ogori magongo",
"Okehi|Okehi",
"Okene|Okene",
"Olamaboro|Olamaboro",
"Omala|Omala",
"Yagba east|Yagba east",
"Yagba west|Yagba west"
];}

if(s1.value == "Kwara State"){ var optionArray = ["|-Select LGA-",

"Asa|Asa",
"Baruten|Baruten",
"Ede|Ede",
"Ekiti|Ekiti",
"Ifelodun|Ifelodun",
"Ilorin east|Ilorin east",
"Ilorin south|Ilorin south",
"Ilorin west|Ilorin west",
"Irepodun|Irepodun",
"Isin|Isin",
"Kaiama|Kaiama",
"Moro|Moro",
"Offa|Offa",
"Oke ero|Oke ero",
"Oyun|Oyun",
"Pategi|Pategi"
];}

if(s1.value == "Lagos State"){ var optionArray = ["|-Select LGA-",

"Agege|Agege",
"Alimosho Ifelodun|Alimosho Ifelodun",
"Alimosho|Alimosho",
"Amuwo-Odofin|Amuwo-Odofin",
"Apapa|Apapa",
"Badagry|Badagry",
"Epe|Epe",
"Eti-Osa|Eti-Osa",
"Ibeju- Lekki|Ibeju- Lekki",
"Ifako/Ijaye|Ifako/Ijaye",
"Ikeja|Ikeja",
"Ikorodu|Ikorodu",
"Kosofe|Kosofe",
"Lagos Island|Lagos Island",
"Lagos Mainland|Lagos Mainland",
"Mushin|Mushin",
"Ojo|Ojo",
"Oshodi-Isolo|Oshodi-Isolo",
"Shomolu|Shomolu",
"Surulere|Surulere"
];}

if(s1.value == "Nasarawa State"){ var optionArray = ["|-Select LGA-",

"Akwanga|Akwanga",
"Awe|Awe",
"Doma|Doma",
"Karu|Karu",
"Keana|Keana",
"Keffi|Keffi",
"Kokona|Kokona",
"Lafia|Lafia",
"Nassarawa|Nassarawa",
"Nassarawa/Eggon|Nassarawa/Eggon",
"Obi|Obi",
"Toto|Toto",
"Wamba|Wamba"
];}

if(s1.value == "Niger State"){ var optionArray = ["|-Select LGA-",

"Agaie|Agaie",
"Agwara|Agwara",
"Bida|Bida",
"Borgu|Borgu",
"Bosso|Bosso",
"Chanchanga|Chanchanga",
"Edati|Edati",
"Gbako|Gbako",
"Gurara|Gurara",
"Kitcha|Kitcha",
"Kontagora|Kontagora",
"Lapai|Lapai",
"Lavun|Lavun",
"Magama|Magama",
"Mariga|Mariga",
"Mokwa|Mokwa",
"Moshegu|Moshegu",
"Muya|Muya",
"Paiko|Paiko",
"Rafi|Rafi",
"Shiroro|Shiroro",
"Suleija|Suleija",
"Tawa|Tawa",
"Wushishi|Wushishi"
];}

if(s1.value == "Ogun State"){ var optionArray = ["|-Select LGA-",

"Abeokuta south|Abeokuta south",
"Abeokuta north|Abeokuta north",
"Ado-odo/otta|Ado-odo/otta",
"Agbado south|Agbado south",
"Agbado north|Agbado north",
"Ewekoro|Ewekoro",
"Idarapo|Idarapo",
"Ifo|Ifo",
"Ijebu east|Ijebu east",
"Ijebu north|Ijebu north",
"Ikenne|Ikenne",
"Ilugun Alaro|Ilugun Alaro",
"Imeko afon|Imeko afon",
"Ipokia|Ipokia",
"Obafemi/owode|Obafemi/owode",
"Odeda|Odeda",
"Odogbolu|Odogbolu",
"Ogun waterside|Ogun waterside",
"Sagamu|Sagamu"
];}

if(s1.value == "Ondo State"){ var optionArray = ["|-Select LGA-",

"Akoko north|Akoko north",
"Akoko north east|Akoko north east",
"Akoko south east|Akoko south east",
"Akoko south|Akoko south",
"Akure north|Akure north",
"Akure|Akure",
"Idanre|Idanre",
"Ifedore|Ifedore",
"Ese odo|Ese odo",
"Ilaje|Ilaje",
"Ilaje oke-igbo|Ilaje oke-igbo",
"Irele|Irele",
"Odigbo|Odigbo",
"Okitipupa|Okitipupa",
"Ondo|Ondo",
"Ondo east|Ondo east",
"Ose|Ose",
"Owo|Owo"
];}

if(s1.value == "Osun State"){ var optionArray = ["|-Select LGA-",

"Atakumosa west|Atakumosa west",
"Atakumosa east|Atakumosa east",
"Ayeda-ade|Ayeda-ade",
"Ayedire|Ayedire",
"Bolawaduro|Bolawaduro",
"Boripe|Boripe",
"Ede|Ede",
"Ede north|Ede north",
"Egbedore|Egbedore",
"Ejigbo|Ejigbo",
"Ife north|Ife north",
"Ife central|Ife central",
"Ife south|Ife south",
"Ife east|Ife east",
"Ifedayo|Ifedayo",
"Ifelodun|Ifelodun",
"Ilesha west|Ilesha west",
"Ila-orangun|Ila-orangun",
"Ilesah east|Ilesah east",
"Irepodun|Irepodun",
"Irewole|Irewole",
"Isokan|Isokan",
"Iwo|Iwo",
"Obokun|Obokun",
"Odo-otin|Odo-otin",
"Ola oluwa|Ola oluwa",
"Olorunda|Olorunda",
"Oriade|Oriade",
"Orolu|Orolu",
"Osogbo|Osogbo"
];}

if(s1.value == "Oyo State"){ var optionArray = ["|-Select LGA-",

"Afijio|Afijio",
"Akinyele|Akinyele",
"Attba|Attba",
"Atigbo|Atigbo",
"Egbeda|Egbeda",
"Ibadan|Ibadan",
"Ibadan north east|Ibadan north east",
"Ibadan central|Ibadan central",
"Ibadan south east|Ibadan south east",
"Ibadan west south|Ibadan west south",
"Ibarapa east|Ibarapa east",
"Ibarapa north|Ibarapa north",
"Ido|Ido",
"Ifedapo|Ifedapo",
"Ifeloju|Ifeloju",
"Irepo|Irepo",
"Iseyin|Iseyin",
"Itesiwaju|Itesiwaju",
"Iwajowa|Iwajowa",
"Iwajowa olorunshogo|Iwajowa olorunshogo",
"Kajola|Kajola",
"Lagelu|Lagelu",
"Ogbomosho north|Ogbomosho north",
"Ogbomosho south|Ogbomosho south",
"Ogo oluwa|Ogo oluwa",
"Oluyole|Oluyole",
"Ona ara|Ona ara",
"Ore lope|Ore lope",
"Orire|Orire",
"Oyo east|Oyo east",
"Oyo west|Oyo west",
"Saki east|Saki east",
"Saki west|Saki west",
"Surulere|Surulere"
];}

if(s1.value == "Plateau State"){ var optionArray = ["|-Select LGA-",

"Barkin/ladi|Barkin/ladi",
"Bassa|Bassa",
"Bokkos|Bokkos",
"Jos north|Jos north",
"Jos east|Jos east",
"Jos south|Jos south",
"Kanam|Kanam",
"Kiyom|Kiyom",
"Langtang north|Langtang north",
"Langtang south|Langtang south",
"Mangu|Mangu",
"Mikang|Mikang",
"Pankshin|Pankshin",
"Quaan pan|Quaan pan",
"Shendam|Shendam",
"Wase|Wase"
];}

if(s1.value == "Rivers State"){ var optionArray = ["|-Select LGA-",

"Abua/Odial|Abua/Odial",
"Ahoada west|Ahoada west",
"Akuku toru|Akuku toru",
"Andoni|Andoni",
"Asari toru|Asari toru",
"Bonny|Bonny",
"Degema|Degema",
"Eleme|Eleme",
"Emohua|Emohua",
"Etche|Etche",
"Gokana|Gokana",
"Ikwerre|Ikwerre",
"Oyigbo|Oyigbo",
"Khana|Khana",
"Obio/Akpor|Obio/Akpor",
"Ogba east|Ogba east",
"Edoni|Edoni",
"Ogu/bolo|Ogu/bolo",
"Okrika|Okrika",
"Omumma|Omumma",
"Opobo/Nkoro|Opobo/Nkoro",
"Portharcourt|Portharcourt",
"Tai|Tai"
];}

if(s1.value == "Sokoto State"){ var optionArray = ["|-Select LGA-",

"Binji|Binji",
"Bodinga|Bodinga",
"Dange/shuni|Dange/shuni",
"Gada|Gada",
"Goronyo|Goronyo",
"Gudu|Gudu",
"Gwadabawa|Gwadabawa",
"Illela|Illela",
"Kebbe|Kebbe",
"Kware|Kware",
"Rabah|Rabah",
"Sabon-Birni|Sabon-Birni",
"Shagari|Shagari",
"Silame|Silame",
"Sokoto south|Sokoto south",
"Sokoto north|Sokoto north",
"Tambuwal|Tambuwal",
"Tangaza|Tangaza",
"Tureta|Tureta",
"Wamakko|Wamakko",
"Wurno|Wurno",
"Yabo|Yabo"
];}

if(s1.value == "Taraba State"){ var optionArray = ["|-Select LGA-",

"Akdo-kola|Akdo-kola",
"Bali|Bali",
"Donga|Donga",
"Gashaka|Gashaka",
"Gassol|Gassol",
"Ibi|Ibi",
"Jalingo|Jalingo",
"K/Lamido|K/Lamido",
"Kurmi|Kurmi",
"law|law",
"Sardauna|Sardauna",
"Tarum|Tarum",
"Ussa|Ussa",
"Wukari|Wukari",
"Yorro|Yorro",
"Zing|Zing"
];}

if(s1.value == "Yobe State"){ var optionArray = ["|-Select LGA-",

"Borsari|Borsari",
"Damaturu|Damaturu",
"Fika|Fika",
"Fune|Fune",
"Geidam|Geidam",
"Gogaram|Gogaram",
"Gujba|Gujba",
"Gulani|Gulani",
"Jakusko|Jakusko",
"Karasuwa|Karasuwa",
"Machina|Machina",
"Nagere|Nagere",
"Nguru|Nguru",
"Potiskum|Potiskum",
"Tarmua|Tarmua",
"Yunusari|Yunusari",
"Yusufari|Yusufari",
"Gashua|Gashua"
];}

if(s1.value == "Zamfara State"){ var optionArray = ["|-Select LGA-",

"Anka|Anka",
"Bukkuyum|Bukkuyum",
"Dungudu|Dungudu",
"Chafe|Chafe",
"Gummi|Gummi",
"Gusau|Gusau",
"Isa|Isa",
"Kaura Namoda|Kaura Namoda",
"Maradun|Maradun",
"Maru|Maru",
"Shinkafi|Shinkafi",
"Talata Mafara|Talata Mafara",
"Zumi|Zumi"
];}















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                    <div class="col-12">
                        <button type="submit" name="loginasstudent" class="btn p-2 pull-right text-white" style="background-color: #0093DD"><i class='fa fa-sign-in'></i>&nbsp; Login</button>
                        <a class="btn p-2 btn-transparent pull-left" href="index-2.html"><i class='fa fa-times'></i>&nbsp; Cancel</a> 
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>




<!-- Login as Staff 
 <div class="modal fade" id="StaffLoginModal" tabindex="-1" role="dialog" aria-hidden="true">
    <div class="modal-dialog modal-md" role="document">
        <div class="modal-content rounded-0 border-0 p-4">
            <div class="modal-header border-0">
                <h3>Login as Staff</h3>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form method="post" class="row">
                    <div class="col-12">
                        <input type="text" class="form-control mb-3 rounded" id="pnumber" name="pnumber" placeholder="Phone Number">
                    </div>
                    <div class="col-12">
                        <input type="password" class="form-control mb-3 rounded" id="password" name="password" placeholder="Password">
                    </div>
                    <div class="col-12">
                        <button type="submit" name="loginasstaff" class="btn p-2 pull-right text-white" style="background-color: #0093DD"><i class='fa fa-sign-in'></i>&nbsp; Login</button>
                        <a class="btn p-2 btn-transparent pull-left" href="index-"><i class='fa fa-times'></i>&nbsp; Cancel</a> 
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>-->




 <!-- Application Login for Students -->
 <div class="modal fade" id="ApplyModal" tabindex="-1" role="dialog" aria-hidden="true">
    <div class="modal-dialog modal-md" role="document">
        <div class="modal-content rounded-0 border-0 p-4">
            <div class="modal-header border-0">
                <h3>Apply for Admission</h3>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form method="post" class="row">
                    <div class="col-12">
                        <input type="text" class="form-control mb-3 rounded" id="pin" name="pin" placeholder="PIN Code">
                    </div>
                    <div class="col-12">
                        <input type="number" class="form-control mb-3 rounded" id="serialno" name="serialno" placeholder="Serial Number">
                    </div>
                    <div class="col-12">
                        <button type="submit" name="submitapply" class="btn p-2 pull-right text-white" style="background-color: #0093DD"><i class='fa fa-send'></i>&nbsp;Apply</button>
						<a class="btn p-2 btn-transparent pull-left" href="index-2.html"><i class='fa fa-times'></i>&nbsp;Cancel</a> 
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>





<!-- View Admission List -->
 <div class="modal fade" id="AdmissionListModal" tabindex="-1" role="dialog" aria-hidden="true">
    <div class="modal-dialog modal-md" role="document">
        <div class="modal-content rounded-0 border-0 p-4">
            <div class="modal-header border-0">
                <h3>View Admission List</h3>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form method="post" class="row">
                   <div class="col-12">
                   <select name='section' class='form-control mb-3 rounded rounded w-100' required required/>
         <option value=''>-Select Section-</option>
         <option>Nursery Section</option>
         <option>Primary Section</option>
         <option>Junior Secondary Section</option>
         <option>Senior Secondary Section</option>
         </select>                   </div>
                   <div class="col-12">
                   
       <select name='session' class='form-control mb-3 rounded rounded w-100' required required>
              <option value=''>-Select Session-</option>



              <option>2023/2024</option>
              <option>2024/2025</option>
              <option>2025/2026</option>
              <option>2026/2027</option>
              <option>2027/2028</option>
              <option>2028/2029</option>
              <option>2029/2030</option>
              <option>2030/2031</option>
              <option>2031/2032</option>
              <option>2032/2033</option>
              <option>2033/2034</option>
              <option>2034/2035</option>
      </select>
                     </div>

                    <div class="col-12">
                        <button type="submit" name="view" class="btn p-2 pull-right text-white" style="background-color: #0093DD"><i class='fa fa-eye'></i>&nbsp; View List</button> &nbsp;&nbsp;
                        <a class="btn p-2 btn-transparent pull-left" href="index-2.html"><i class='fa fa-times'></i>&nbsp; Cancel</a> 
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>





<!-- Reprint Slip modal -->
 <div class="modal fade" id="ReprintSlipModal" tabindex="-1" role="dialog" aria-hidden="true">
    <div class="modal-dialog modal-md" role="document">
        <div class="modal-content rounded-0 border-0 p-4">
            <div class="modal-header border-0">
                <h3>Re-print Application Slip</h3>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form method="post" class="row">
                    <div class="col-12">
                        <input type="text" class="form-control mb-3" id="appnumber" name="appnumber" placeholder="Application Number">
                    </div>
                    <div class="col-12">
                        <button type="submit" name="printslip1" class="btn text-white pull-right p-2" style="background-color: #0093DD"><i class='fa fa-print'></i>&nbsp; Re-Print</button>
                       <br><br>
                       <hr>
                        <span class="display-4">OR</span>
                     </div>

                    <div class="col-12">
                        <input type="text" class="form-control mb-3" id="surname" name="surname" placeholder="Surname">
                    </div>
                    <div class="col-12">
                        Date of Birth:
                        <input type="date" class="form-control mb-3" id="dob" name="dob" placeholder="Password">
                    </div>

                    <div class="col-12">
                        <button type="submit" name="printslip2" class="btn pull-right text-white p-2" style="background-color: #0093DD"><i class='fa fa-print'></i>&nbsp; Re-Print</button>
                        <a class="btn btn-transparent pull-left p-2" href="index-2.html"><i class='fa fa-times'></i>&nbsp; Cancel</a> 
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>






<!-- Reprint Slip modal -->
 <div class="modal fade" id="CheckAdmissionModal" tabindex="-1" role="dialog" aria-hidden="true">
    <div class="modal-dialog modal-md" role="document">
        <div class="modal-content rounded-0 border-0 p-4">
            <div class="modal-header border-0">
                <h3>Check Admission Status</h3>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form method="post" class="row">
                    <div class="col-12">
                        <input type="text" class="form-control mb-3" id="appnumber" name="appnumber" placeholder="Application Number">
                    </div>
                    <div class="col-12">
                        <button type="submit" name="checkstatus" class="btn text-white pull-right p-2" style="background-color: #0093DD"><i class='fa fa-search'></i>&nbsp; Check Admission Status</button>
                       <br><br>
                      
                     </div>

                   

                   
                </form>
            </div>
        </div>
    </div>
</div>      <!-- End of Header -->
<br>















<!-- page title -->
<!--================================
=            Page Title            =
=================================-->
<section class="page-title mt-0 p-2 shadow">
  <div class="row">
    <div class="col-sm-8">
      <font style="font-family: 'Nova Mono', monospace; font-size: 20px; color: #fff;" align="right">
        Home/Admission Form
      </font> &nbsp;&nbsp;&nbsp;&nbsp;
      <a href="#" class="btn p-2 btn-secondary p-2">
        <i class='fa fa-angle-double-left'></i> Back
      </a>
    </div>

    <div class="col-sm-4">
      <!-- Auto date -->
      <font style="font-family: 'Nova Mono', monospace; font-size: 20px; color: #fff;" id="dd" align="right"></font>&nbsp;&nbsp;&nbsp;&nbsp;

      <!-- Auto time -->
      <font style="font-family: 'Nova Mono', monospace; font-size: 20px; color: #fff;" id="tt" align="right"></font>
    </div>
  </div>
</section>




<form method="post" enctype="multipart/form-data">
<section class="area mt-4">
  <div class="container shadow p-4">

<div class="row">
  <div class="col-lg-12">
    <center>
<img src="upload/pic.png" name="image" id="image" style="border-radius: 100px; border: 7px solid #ccc; width: 150px; height: 150px"/>
</center>
  </div>


   <div class="col-md-12 form-group">
   <center>             
      <div class="upload-btn-wrapper">
        <button class="btn  text-white rounded shadow p-2 m-2" style="background-color: #0093DD">Upload a Passport</button>
      <input type="file" name="passport" accept="video/*;capture=camcorder" id="file-input" onChange="onFileSelected(event)" required> 
      </div>           
  </center>
  </div>
</div>




       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="fname">First Name:</label> 
                  <input type="text" id="fname" name="fname" class="form-control rounded mb-2" placeholder="First Name" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="mname">Last Name:</label> 
                  <input type="text" id="mname" name="mname" class="form-control rounded mb-2" placeholder="Last Name" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="oname">Other Name (If any):</label> 
                  <input type="text" id="oname" name="oname" class="form-control rounded mb-2" placeholder="Other Name">
                </div>
       </div>


             <div class="row">

                <div class="col-md-6 col-lg-6 col-sm-12">
                  <label class="mylabel" for="dob">Date of Birth:</label> 
                  <input type="date" id="dob" name="dob" class="form-control rounded mb-2" placeholder="Date of Birth" required>
                </div>

                <div class="col-md-6 col-lg-6 col-sm-12">
                  <label class="mylabel" for="gender">Gender:</label> 
                  <select name='gender' class="form-control rounded mb-2" required>
                    <option value="">-Select Gender-</option>
                    <option value="Male">Male</option>
                    <option value="Female">Female</option>
                  </select>
                </div>
          
             </div>



             <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="gender">Nationality:</label> 
                 <select name="nationality" required class="form-control rounded mb-2">
                   <option value="">-Select Country-</option>
                   
<option>Andorra</option>
<option>United Arab Emirates</option>
<option>Afghanistan</option>
<option>Antigua and Barbuda</option>
<option>Anguilla</option>
<option>Albania</option>
<option>Armenia</option>
<option>Netherlands Antilles</option>
<option>Angola</option>
<option>Antarctica</option>
<option>Argentina</option>
<option>American Samoa</option>
<option>Austria</option>
<option>Australia</option>
<option>Aruba</option>
<option>Azerbaijan</option>
<option>Bosnia and Herzegovina</option>
<option>Barbados</option>
<option>Bangladesh</option>
<option>Belgium</option>
<option>Burkina Faso</option>
<option>Bulgaria</option>
<option>Bahrain</option>
<option>Burundi</option>
<option>Benin</option>
<option>Bermuda</option>
<option>Brunei</option>
<option>Bolivia</option>
<option>Brazil</option>
<option>Bahamas</option>
<option>Bhutan</option>
<option>Bouvet Island</option>
<option>Botswana</option>
<option>Belarus</option>
<option>Belize</option>
<option>Canada</option>
<option>Cocos [Keeling] Islands</option>
<option>Congo [DRC]</option>
<option>Central African Republic</option>
<option>Congo [Republic]</option>
<option>Switzerland</option>
<option>Côte d'Ivoire</option>
<option>Cook Islands</option>
<option>Chile</option>
<option>Cameroon</option>
<option>China</option>
<option>Colombia</option>
<option>Costa Rica</option>
<option>Cuba</option>
<option>Cape Verde</option>
<option>Christmas Island</option>
<option>Cyprus</option>
<option>Czech Republic</option>
<option>Germany</option>
<option>Djibouti</option>
<option>Denmark</option>
<option>Dominica</option>
<option>Dominican Republic</option>
<option>Algeria</option>
<option>Ecuador</option>
<option>Estonia</option>
<option>Egypt</option>
<option>Western Sahara</option>
<option>Eritrea</option>
<option>Spain</option>
<option>Ethiopia</option>
<option>Finland</option>
<option>Fiji</option>
<option>Falkland Islands [Islas Malvinas]</option>
<option>Micronesia</option>
<option>Faroe Islands</option>
<option>France</option>
<option>Gabon</option>
<option>United Kingdom</option>
<option>Grenada</option>
<option>Georgia</option>
<option>French Guiana</option>
<option>Guernsey</option>
<option>Ghana</option>
<option>Gibraltar</option>
<option>Greenland</option>
<option>Gambia</option>
<option>Guinea</option>
<option>Guadeloupe</option>
<option>Equatorial Guinea</option>
<option>Greece</option>
<option>South Georgia and the South Sandwich Islands</option>
<option>Guatemala</option>
<option>Guam</option>
<option>Guinea-Bissau</option>
<option>Guyana</option>
<option>Gaza Strip</option>
<option>Hong Kong</option>
<option>Heard Island and McDonald Islands</option>
<option>Honduras</option>
<option>Croatia</option>
<option>Haiti</option>
<option>Hungary</option>
<option>Indonesia</option>
<option>Ireland</option>
<option>Israel</option>
<option>Isle of Man</option>
<option>India</option>
<option>British Indian Ocean Territory</option>
<option>Iraq</option>
<option>Iran</option>
<option>Iceland</option>
<option>Italy</option>
<option>Jersey</option>
<option>Jamaica</option>
<option>Jordan</option>
<option>Japan</option>
<option>Kenya</option>
<option>Kyrgyzstan</option>
<option>Cambodia</option>
<option>Kiribati</option>
<option>Comoros</option>
<option>Saint Kitts and Nevis</option>
<option>North Korea</option>
<option>South Korea</option>
<option>Kuwait</option>
<option>Cayman Islands</option>
<option>Kazakhstan</option>
<option>Laos</option>
<option>Lebanon</option>
<option>Saint Lucia</option>
<option>Liechtenstein</option>
<option>Sri Lanka</option>
<option>Liberia</option>
<option>Lesotho</option>
<option>Lithuania</option>
<option>Luxembourg</option>
<option>Latvia</option>
<option>Libya</option>
<option>Morocco</option>
<option>Monaco</option>
<option>Moldova</option>
<option>Montenegro</option>
<option>Madagascar</option>
<option>Marshall Islands</option>
<option>Macedonia [FYROM]</option>
<option>Mali</option>
<option>Myanmar [Burma]</option>
<option>Mongolia</option>
<option>Macau</option>
<option>Northern Mariana Islands</option>
<option>Martinique</option>
<option>Mauritania</option>
<option>Montserrat</option>
<option>Malta</option>
<option>Mauritius</option>
<option>Maldives</option>
<option>Malawi</option>
<option>Mexico</option>
<option>Malaysia</option>
<option>Mozambique</option>
<option>Namibia</option>
<option>New Caledonia</option>
<option>Niger</option>
<option>Norfolk Island</option>
<option>Nigeria</option>
<option>Nicaragua</option>
<option>Netherlands</option>
<option>Norway</option>
<option>Nepal</option>
<option>Nauru</option>
<option>Niue</option>
<option>New Zealand</option>
<option>Oman</option>
<option>Panama</option>
<option>Peru</option>
<option>French Polynesia</option>
<option>Papua New Guinea</option>
<option>Philippines</option>
<option>Pakistan</option>
<option>Poland</option>
<option>Saint Pierre and Miquelon</option>
<option>Pitcairn Islands</option>
<option>Puerto Rico</option>
<option>Palestinian Territories</option>
<option>Portugal</option>
<option>Palau</option>
<option>Paraguay</option>
<option>Qatar</option>
<option>Réunion</option>
<option>Romania</option>
<option>Serbia</option>
<option>Russia</option>
<option>Rwanda</option>
<option>Saudi Arabia</option>
<option>Solomon Islands</option>
<option>Seychelles</option>
<option>Sudan</option>
<option>Sweden</option>
<option>Singapore</option>
<option>Saint Helena</option>
<option>Slovenia</option>
<option>Svalbard and Jan Mayen</option>
<option>Slovakia</option>
<option>Sierra Leone</option>
<option>San Marino</option>
<option>Senegal</option>
<option>Somalia</option>
<option>Suriname</option>
<option>São Tomé and Príncipe</option>
<option>El Salvador</option>
<option>Syria</option>
<option>Swaziland</option>
<option>Turks and Caicos Islands</option>
<option>Chad</option>
<option>French Southern Territories</option>
<option>Togo</option>
<option>Thailand</option>
<option>Tajikistan</option>
<option>Tokelau</option>
<option>Timor-Leste</option>
<option>Turkmenistan</option>
<option>Tunisia</option>
<option>Tonga</option>
<option>Turkey</option>
<option>Trinidad and Tobago</option>
<option>Tuvalu</option>
<option>Taiwan</option>
<option>Tanzania</option>
<option>Ukraine</option>
<option>Uganda</option>
<option>U.S. Minor Outlying Islands</option>
<option>United States</option>
<option>Uruguay</option>
<option>Uzbekistan</option>
<option>Vatican City</option>
<option>Saint Vincent and the Grenadines</option>
<option>Venezuela</option>
<option>British Virgin Islands</option>
<option>U.S. Virgin Islands</option>
<option>Vietnam</option>
<option>Vanuatu</option>
<option>Wallis and Futuna</option>
<option>Samoa</option>
<option>Kosovo</option>
<option>Yemen</option>
<option>Mayotte</option>
<option>South Africa</option>
<option>Zambia</option>
<option>Zimbabwe</option>
<option>Others</option>

                         </select>
               </div>
          
                 <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="gender">State of Origin:</label> 
                 <select id='state' name='state' onchange="populateclass(this.id,'lga')"  required class="form-control rounded mb-2">
                   <option value=''>-Select State of Origin-</option>
                   
  <option>Abia State</option>
  <option>Adamawa State</option>
  <option>Anambra State</option>
  <option>Akwa Ibom State</option>
  <option>Bauchi State</option>
  <option>FCT</option>
  <option>Benue State</option>
  <option>Borno State</option>
  <option>Cross River State</option>
  <option>Delta State</option>
  <option>Ebonyi State</option>
  <option>Edo State</option>
  <option>Ekiti State</option>
  <option>Enugu State</option>
  <option>FCT (Abuja)</option>
  <option>Gombe State</option>
  <option>Imo State</option>
  <option>Jigawa State</option>
  <option>Kaduna State</option>
  <option>Kano State</option>
  <option>Katsina State</option>
  <option>Kebbi State</option>
  <option>Kogi State</option>
  <option>Kwara State</option>
  <option>Lagos State</option>
  <option>Nasarawa State</option>
  <option>Niger State</option>
  <option>Ogun State</option>
  <option>Ondo State</option>
  <option>Osun State</option>
  <option>Oyo State</option>
  <option>Plateau State</option>
  <option>Rivers State</option>
  <option>Sokoto State</option>
  <option>Taraba State</option>
  <option>Yobe State</option>
  <option>Zamfara State</option>
  <option>Others</option>
                     </select>
                 </div>

                 <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="gender">LGA:</label> 
                 <select id='lga' name='lga'   required class="form-control rounded mb-2"></select> 
                 </div> 

             </div>


       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="lschool">Last School Attended:</label> 
                  <input type="text" id="lschool" name="lschool" class="form-control rounded mb-2" placeholder="Last School Attended" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="lclass">Last Completed Class:</label> 
                  <input type="text" id="lclass" name="lclass" class="form-control rounded mb-2" placeholder="Last Completed Class" required>
                </div>
                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="class">Class Applied for:</label> 
                   <select name='class' class='form-control mb-3 rounded w-100' required required/> 
 <option value=''>-Select Class-</option> <option value='class1a'>Basic 1</option>  <option value='class2a'>Basic 2</option>  <option value='class3a'>Basic 3</option>  <option value='class4a'>Basic 4</option>  <option value='class5a'>Basic 5</option>  <option value='jss1a'>JSS 1A</option>  <option value='jss1b'>JSS 1B</option>  <option value='jss2a'>JSS 2A</option>  <option value='jss2b'>JSS 2B</option>  <option value='jss3a'>JSS 3A</option>  <option value='jss3b'>JSS 3B</option>  <option value='nur1a'>Pre-School</option>  <option value='nur1b'>Pre-Nursery</option>  <option value='nur2a'>Nursery</option>  <option value='nur2b'>Reception</option>  <option value='ss1a'>SS 1A</option>  <option value='ss2a'>SS 2A</option>  <option value='ss3a'>SS 3A</option>  <option value='ss1b'>SS 1B</option>  <option value='ss2b'>SS 2B</option>  <option value='ss3b'>SS 3B</option> </select>                </div>
       </div>


<div class="row">

                <div class="col-md-12 col-lg-12 col-sm-12"><hr>
                  <center><h2>Sponsor 1 Details (Father)</h2></center>
                </div>
</div>



       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="ftitle">Title:</label> 
                  <input type="text" id="ftitle" name="ftitle" class="form-control rounded mb-2" placeholder="Title" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="fsname">SurName:</label> 
                  <input type="text" id="fsname" name="fsname" class="form-control rounded mb-2" placeholder="Surname" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="foname">Other Name:</label> 
                  <input type="text" id="foname" name="foname" class="form-control rounded mb-2" placeholder="Other Name">
                </div>
       </div>


       <div class="row">

                <div class="col-md-6 col-lg-6 col-sm-12">
                  <label class="mylabel" for="faddress">Address:</label> 
                  <input type="text" id="faddress" name="faddress" class="form-control rounded mb-2" placeholder="Address" required>
                </div>

                <div class="col-md-6 col-lg-6 col-sm-12">
                  <label class="mylabel" for="foccupation">Occupation:</label> 
                  <input type="text" id="foccupation" name="foccupation" class="form-control rounded mb-2" placeholder="Occupation">
                </div>
       </div>



       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="femail">Email Address:</label> 
                  <input type="email" id="femail" name="femail" class="form-control rounded mb-2" placeholder="Email Address" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="fpnumber">Phone Number:</label> 
                  <input type="number" id="fpnumber" name="fpnumber" class="form-control rounded mb-2" placeholder="Phone Number" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="fapnumber">Alternative Phone Number:</label> 
                  <input type="number" id="fapnumber" name="fapnumber" class="form-control rounded mb-2" placeholder="Alternative Phone Number">
                </div>
       </div>










<div class="row">

                <div class="col-md-12 col-lg-12 col-sm-12"><hr>
                  <center><h2>Sponsor 2 Details (Mother)</h2></center>
                </div>
</div>



       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="mtitle">Title:</label> 
                  <input type="text" id="mtitle" name="mtitle" class="form-control rounded mb-2" placeholder="Title" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="msname">SurName:</label> 
                  <input type="text" id="msname" name="msname" class="form-control rounded mb-2" placeholder="Surname" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="moname">Other Name:</label> 
                  <input type="text" id="moname" name="moname" class="form-control rounded mb-2" placeholder="Other Name">
                </div>
       </div>


       <div class="row">

                <div class="col-md-6 col-lg-6 col-sm-12">
                  <label class="mylabel" for="maddress">Address:</label> 
                  <input type="text" id="maddress" name="maddress" class="form-control rounded mb-2" placeholder="Address" required>
                </div>

                <div class="col-md-6 col-lg-6 col-sm-12">
                  <label class="mylabel" for="moccupation">Occupation:</label> 
                  <input type="text" id="moccupation" name="moccupation" class="form-control rounded mb-2" placeholder="Occupation">
                </div>
       </div>



       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="memail">Email Address:</label> 
                  <input type="email" id="memail" name="memail" class="form-control rounded mb-2" placeholder="Email Address" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="mpnumber">Phone Number:</label> 
                  <input type="number" id="mpnumber" name="mpnumber" class="form-control rounded mb-2" placeholder="Phone Number" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="mapnumber">Alternative Phone Number:</label> 
                  <input type="number" id="mapnumber" name="mapnumber" class="form-control rounded mb-2" placeholder="Alternative Phone Number">
                </div>
       </div>




<div class="row">

                <div class="col-md-12 col-lg-12 col-sm-12"><hr>
                  <center><h2>Other Details</h2></center>
                </div>
</div>





       <div class="row">

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="language">Student Language Spoken:</label> 
                  <input type="text" id="language" name="language" class="form-control rounded mb-2" placeholder="Student Language Spoken" required>
                </div>

                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="challenge">Does the Student have any learning challenges?:</label> 
                  <input type="text" id="challenge" name="challenge" class="form-control rounded mb-2" placeholder="Does the Student have any learning challenges" required>
                </div>
                <div class="col-md-4 col-lg-4 col-sm-12">
                  <label class="mylabel" for="hear">How did you hear about Us?:</label> 
                  <select name='hear' class="form-control rounded mb-2" required>
                    <option value="">-Select-</option>
                    <option>Friends</option>
                    <option>Facebook</option>
                    <option>Others</option>
                  </select>
                </div>
       </div>



<div class="row mt-3">
<div class="col-lg-12">
<center>
<a href="index.php" class="btn btn-transparent mt-3 rounded shadow p-2" ><i class="fa fa-times"></i>&nbsp; Cancel</a> 
<input name='send' type='submit' class='btn p-2 mt-3 w-25 shadow text-white rounded shadow' style="background-color: #0093DD" id="update" value='Submit Application' />
</center>
</div>
</div>




 
  </div><!-- container Closed -->
</section>


 
</form>
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