[ Mini Kiebo ]

Server: Windows NT DESKTOP-5B8S0D4 6.2 build 9200 (Windows 8 Professional Edition) i586 Path: D:/Backup/05122024/htdocs/pmb2/application/views/daftar/ [ Home ]
File: bg_daftar.php


<script type="text/javascript">

  function step1(){
    $("#step1").show();
    $("#step2").hide();

    $(".next1").show();
    $(".next2").hide();
    $(".submit").hide();
  }

  function step2(){

    var program_studi_1 = $('.program_studi_pmdk_1').val();
    var program_studi_2 = $('.program_studi_pmdk_2').val();
    var program_studi_3 = $('.program_studi_pmdk_3').val();

    var program_studi_4 = $('.program_studi_pmdk_4').val();
    var program_studi_5 = $('.program_studi_pmdk_5').val();

    var perguruan_tinggi = $('input[name=perguruan_tinggi]').val();

    if (perguruan_tinggi == 'POLTEKPOS'){

      if (program_studi_1 == ""){
        alert("Program Studi 1 harus dipilih")
        return false;
      }
      if (program_studi_2 == ""){
        alert("Program Studi 2 harus dipilih")
        return false;
      }
      if (program_studi_3 == ""){
        alert("Program Studi 3 harus dipilih")
        return false;
      }

      if (program_studi_1 == program_studi_2){
        alert("Pilihan Program Studi 1 tidak boleh sama dengan Pilihan Program Studi 2")
        return false;
      }
      if (program_studi_1 == program_studi_3){
        alert("Pilihan Program Studi 1 tidak boleh sama dengan Pilihan Program Studi 3")
        return false;
      }
      if (program_studi_2 == program_studi_3){
        alert("Pilihan Program Studi 2 tidak boleh sama dengan Pilihan Program Studi 3")
        return false;
      }
    }

    if (perguruan_tinggi == "STIMLOG"){
      if (program_studi_4 == ""){
        alert("Program Studi 1 harus dipilih")
        return false;
      }
      if (program_studi_5 == ""){
        alert("Program Studi 2 harus dipilih")
        return false;
      }
      if (program_studi_4 == program_studi_5){
        alert("Pilihan Program Studi 1 tidak boleh sama dengan Pilihan Program Studi 2")
        return false;
      }
    }

    $("#step2").show();
    $("#step1").hide();

    $(".next1").hide();
    $(".next2").show();
    $(".submit").show();
  }

  
</script>
            <div id="form_reguler" class="box box-warning" style="display: none;">
  <div class="box-header with-border">
    <h3 class="box-title">Registrasi Mahasiswa Baru (Jalur REGULER)</h3>
  </div>

  <div class="box-body">

    <form action="http://form.poltekpos.ac.id/index.php/mahasiswa/register_reguler" class=" form-horizontal" enctype="multipart/form-data" method="post" accept-charset="utf-8">

      <div class="hidden">
        <input type="text" class="form-control" name="perguruan_tinggi" value="">
        <input type="text" class="form-control" name="jalur" value="reguler">
      </div>

      

      <div id="step1_reguler">

        <h3 class="dtitle">Data Calon Mahasiswa</h3>

        
<div class="program_poltekpos">

  <div class="form-group">
    <label for="program_studi_1" class="col-sm-3 control-label">Pilihan Program Studi 1 <span class="text-danger">*</span></label>
    <div class="col-sm-4">
      
      <select name="program_studi_1" id="program_studi_1" class="program_studi_reguler_1 form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="01">Logistik Bisnis D-III</option>
<option value="02">Manajemen Bisnis D-III</option>
<option value="03">Manajemen Informatika D-III</option>
<option value="04">Teknik Informatika D-III</option>
<option value="05">Akuntansi D-III</option>
<option value="11">Logistik Bisnis D-IV</option>
<option value="12">Manajemen Bisnis D-IV</option>
<option value="13">Teknik Informatika D-IV</option>
<option value="14">Akuntansi Keuangan D-IV</option>
</select>

    </div>
  </div>

  <div class="form-group">
    <label for="program_studi_2" class="col-sm-3 control-label">Pilihan Program Studi 2 <span class="text-danger">*</span></label>
    <div class="col-sm-4">
      
      <select name="program_studi_2" id="program_studi_2" class="program_studi_reguler_2 form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="01">Logistik Bisnis D-III</option>
<option value="02">Manajemen Bisnis D-III</option>
<option value="03">Manajemen Informatika D-III</option>
<option value="04">Teknik Informatika D-III</option>
<option value="05">Akuntansi D-III</option>
<option value="11">Logistik Bisnis D-IV</option>
<option value="12">Manajemen Bisnis D-IV</option>
<option value="13">Teknik Informatika D-IV</option>
<option value="14">Akuntansi Keuangan D-IV</option>
</select>

    </div>
  </div>

  <div class="form-group">
    <label for="program_studi_3" class="col-sm-3 control-label">Pilihan Program Studi 3 <span class="text-danger">*</span></label>
    <div class="col-sm-4">
      
      <select name="program_studi_3" id="program_studi_3" class="program_studi_reguler_3 form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="01">Logistik Bisnis D-III</option>
<option value="02">Manajemen Bisnis D-III</option>
<option value="03">Manajemen Informatika D-III</option>
<option value="04">Teknik Informatika D-III</option>
<option value="05">Akuntansi D-III</option>
<option value="11">Logistik Bisnis D-IV</option>
<option value="12">Manajemen Bisnis D-IV</option>
<option value="13">Teknik Informatika D-IV</option>
<option value="14">Akuntansi Keuangan D-IV</option>
</select>

    </div>
  </div>

</div>



<div class="program_stimlog">

  <div class="form-group">
    <label for="program_studi_1_stimlog" class="col-sm-3 control-label">Pilihan Program Studi 1 <span class="text-danger">*</span></label>
    <div class="col-sm-4">
            
      <select name="program_studi_1_stimlog" id="program_studi_1_stimlog" class="program_studi_reguler_4 form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="31">Manajemen Transportasi Logistik</option>
<option value="32">Manajemen Logistik</option>
</select>

    </div>
  </div>

  <div class="form-group">
    <label for="program_studi_2_stimlog" class="col-sm-3 control-label">Pilihan Program Studi 2 <span class="text-danger">*</span></label>
    <div class="col-sm-4">
            
      <select name="program_studi_2_stimlog" id="program_studi_2_stimlog" class="program_studi_reguler_5 form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="31">Manajemen Transportasi Logistik</option>
<option value="32">Manajemen Logistik</option>
</select>

    </div>
  </div>

</div>
        <div class="form-group">
          <label for="lokasi_usm" class="col-sm-3 control-label">Lokasi Ujian  <span class="text-danger">*</span></label>
          <div class="col-sm-5">
            
            
            <select name="lokasi_usm" id="lokasi_usm" class="form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="01">Kampus POLTEKPOS-STIMLOG</option>
<option value="02">Kantor POS Yogyakarta</option>
<option value="03">Kantor POS Surabaya</option>
<option value="04">Kantor POS Bandar Lampung</option>
<option value="05">Kantor POS Pangkal Pinang</option>
<option value="06">Kantor POS Medan</option>
<option value="07">Kantor POS Mataram</option>
<option value="08">Kantor POS Palangkaraya</option>
<option value="09">Kantor POS Padang</option>
<option value="10">Kantor POS Padang Sidempuan</option>
<option value="11">Kantor POS Pematangsiantar</option>
<option value="12">Kantor POS Pare-pare</option>
<option value="13">Kantor POS Denpasar</option>
<option value="14">Kantor POS Banjarmasin</option>
<option value="15">Kantor POS Palembang</option>
<option value="16">Kantor POS Semarag</option>
<option value="17">Kantor POS Pontianak</option>
<option value="18">Kantor POS Semarang</option>
<option value="19">Kantor POS Atambua</option>
<option value="20">Kantor POS Makasar</option>
</select>

          </div>
        </div>


        <div class="form-group">
          <label for="nama_lengkap" class="col-sm-3 control-label">Nama Lengkap  <span class="text-danger">*</span></label>
          <div class="col-sm-5">
                        <input type="text" class="form-control" id="nama" name="nama_lengkap" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="jenis_kelamin" class="col-sm-3 control-label">Jenis Kelamin  <span class="text-danger">*</span></label>
          <div class="col-sm-9">
            
            
            <div class="radio">
              <label class="left_0">
                <input type="radio" name="jenis_kelamin" value="Laki-laki" checked="">
                &nbsp;Laki-laki
              </label> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

              <label>
                <input type="radio" name="jenis_kelamin" value="Perempuan" >
                &nbsp;Perempuan
              </label> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;           
            </div>

          </div>
        </div>

        <div class="form-group">
          <label for="nisn" class="col-sm-3 control-label">NISN <span class="text-danger">*</span></label>
          <div class="col-sm-2">
                        <input type="text" class="form-control" id="nisn" name="nisn" value="" maxlength="10">
          </div>
        </div>

        <div class="form-group">
          <label for="tempat_lahir" class="col-sm-3 control-label">Tempat Lahir <span class="text-danger">*</span></label>
          <div class="col-sm-3">
                        <input type="text" class="form-control" id="tempat_lahir" name="tempat_lahir" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="tgl_lahir" class="col-sm-3 control-label">Tanggal Lahir <span class="text-danger">*</span></label>
          <div class="col-sm-2">
                        <input type="text" class="form-control datepicker" id="tgl_lahir" name="tgl_lahir" value="01-01-1991">
          </div>
        </div>

        <div class="form-group">
          <label for="agama" class="col-sm-3 control-label">Agama <span class="text-danger">*</span></label>
          <div class="col-sm-2">
                        
            <select name="agama" id="agama" class="form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="Islam">Islam</option>
<option value="Kristen">Kristen</option>
<option value="Katolik">Katolik</option>
<option value="Hindu">Hindu</option>
<option value="Buddha">Buddha</option>
</select>

          </div>
        </div>    

        <div class="form-group">
          <label for="alamat" class="col-sm-3 control-label">Alamat Lengkap <span class="text-danger">*</span></label>
          <div class="col-sm-5">
                        <textarea class="form-control" rows="3" placeholder="" id="alamat" name="alamat">  </textarea>
          </div>
        </div>

        <div class="form-group">
          <label for="kota2" class="col-sm-3 control-label">Kota / Kabupaten <span class="text-danger">*</span></label>
          <div class="col-sm-4">
                        <input type="text" class="form-control searchkota" id="kota2" name="kota" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="provinsi" class="col-sm-3 control-label">Provinsi<span class="text-danger">*</span></label>
          <div class="col-sm-4">
            
            
            <select name="provinsi" id="provinsi" class="form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="ACEH">ACEH</option>
<option value="BALI">BALI</option>
<option value="BANTEN">BANTEN</option>
<option value="BENGKULU">BENGKULU</option>
<option value="DI YOGYAKARTA">DI YOGYAKARTA</option>
<option value="DKI JAKARTA">DKI JAKARTA</option>
<option value="GORONTALO">GORONTALO</option>
<option value="JAMBI">JAMBI</option>
<option value="JAWA BARAT">JAWA BARAT</option>
<option value="JAWA TENGAH">JAWA TENGAH</option>
<option value="JAWA TIMUR">JAWA TIMUR</option>
<option value="KALIMANTAN BARAT">KALIMANTAN BARAT</option>
<option value="KALIMANTAN SELATAN">KALIMANTAN SELATAN</option>
<option value="KALIMANTAN TENGAH">KALIMANTAN TENGAH</option>
<option value="KALIMANTAN TIMUR">KALIMANTAN TIMUR</option>
<option value="KALIMANTAN UTARA">KALIMANTAN UTARA</option>
<option value="KEPULAUAN BANGKA BELITUNG">KEPULAUAN BANGKA BELITUNG</option>
<option value="KEPULAUAN RIAU">KEPULAUAN RIAU</option>
<option value="LAMPUNG">LAMPUNG</option>
<option value="MALUKU">MALUKU</option>
<option value="MALUKU UTARA">MALUKU UTARA</option>
<option value="NUSA TENGGARA BARAT">NUSA TENGGARA BARAT</option>
<option value="NUSA TENGGARA TIMUR">NUSA TENGGARA TIMUR</option>
<option value="PAPUA">PAPUA</option>
<option value="PAPUA BARAT">PAPUA BARAT</option>
<option value="RIAU">RIAU</option>
<option value="SULAWESI BARAT">SULAWESI BARAT</option>
<option value="SULAWESI SELATAN">SULAWESI SELATAN</option>
<option value="SULAWESI TENGAH">SULAWESI TENGAH</option>
<option value="SULAWESI TENGGARA">SULAWESI TENGGARA</option>
<option value="SULAWESI UTARA">SULAWESI UTARA</option>
<option value="SUMATERA BARAT">SUMATERA BARAT</option>
<option value="SUMATERA SELATAN">SUMATERA SELATAN</option>
<option value="SUMATERA UTARA">SUMATERA UTARA</option>
</select>

          </div>
        </div>

        <div class="form-group">
          <label for="kode_pos" class="col-sm-3 control-label">Kode Pos <span class="text-danger">*</span></label>
          <div class="col-sm-9">          
                        <div class="col-sm-2 x-form">
              <input type="text" class="form-control" id="kode_pos" name="kode_pos" value="" maxlength="5">
            </div>
          </div>
        </div>

        <div class="form-group">
          <label for="telepon" class="col-sm-3 control-label">No. Telephone/HP <span class="text-danger">*</span></label>
          <div class="col-sm-3">
                        <input type="text" class="form-control" id="telepon" name="telephone" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="no_ktp" class="col-sm-3 control-label">No KPT/NIK</label>
          <div class="col-sm-3">
                        <input type="text" class="form-control" id="no_ktp" name="no_ktp" value="" maxlength="16">
          </div>
        </div>

        <div class="form-group">
          <label for="bbm_line" class="col-sm-3 control-label">Pin BBM/ ID Line </label>
          <div class="col-sm-3">
                        <input type="text" class="form-control" id="bbm_line" name="bbm_line" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="email" class="col-sm-3 control-label">Alamat Email <span class="text-danger">*</span></label>
          <div class="col-sm-4">
                        <input type="text" class="form-control" id="email" name="email" value="">
          </div>
        </div>

        <br>

        <h3 class="dtitle">Data Orang Tua</h3>

        <div class="form-group">
          <label for="nama_ayah_kandung" class="col-sm-3 control-label">Nama Ayah Kandung<span class="text-danger">*</span></label>
          <div class="col-sm-4">
                        <input type="text" class="form-control" id="nama_ayah_kandung" name="nama_ayah_kandung" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="nama_ibu_kandung" class="col-sm-3 control-label">Nama Ibu Kandung<span class="text-danger">*</span></label>
          <div class="col-sm-4">
                        <input type="text" class="form-control" id="nama_ibu_kandung" name="nama_ibu_kandung" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="pekerjaan_orang_tua_wali" class="col-sm-3 control-label">Pekerjaan Orang Tua/Wali <span class="text-danger">*</span></label>
          <div class="col-sm-9">
                      
            <div class="col-sm-3 x-form">

              
              <select name="pekerjaan_orang_tua_wali" id="pekerjaan_orang_tua_wali" class="form-control" onclick="setPekerjaan(this.value,'reg_pekerjaan_lain')">
<option value="" selected="selected">-- Pilih --</option>
<option value="PNS">PNS</option>
<option value="BUMN / BUMD">BUMN / BUMD</option>
<option value="TNI / POLRI">TNI / POLRI</option>
<option value="Swasta">Swasta</option>
<option value="Pensiunan">Pensiunan</option>
<option value="lainnya">Lainnya</option>
</select>

            </div>

            
            <div class="col-sm-5 x-form" id="reg_pekerjaan_lain" style="display: none; margin-top: 15px;">
              <input type="text" class="form-control" id="pekerjaan_orang_tua_wali_lain" name="pekerjaan_orang_tua_wali_lain" value="">
            </div>

          </div>
        </div>

        <div class="form-group">
          <label for="penghasilan_orang_tua_wali" class="col-sm-3 control-label">Penghasilan Orang Tua / Bulan <span class="text-danger">*</span></label>
          <div class="col-sm-9">
            
            <div class="col-sm-4 x-form">

              
              <select name="penghasilan_orang_tua_wali" id="penghasilan_orang_tua_wali" class="form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="Kurang dari 1 Juta">< 1 Juta</option>
<option value="1 Juta s/d 2,5 Juta">1 Juta s/d 2,5 Juta</option>
<option value="2,5 Juta s/d 5 Juta">2,5 Juta s/d 5 Juta</option>
<option value="5 Juta s/d 10 Juta">5 Juta s/d 10 Juta</option>
<option value="10 Juta s/d 15 Juta">10 Juta s/d 15 Juta</option>
<option value="Lebih dari 15 Juta">> 15 Juta</option>
</select>

            </div>
          </div>
        </div>

        <div class="form-group">
          <label for="alamat_orangtua" class="col-sm-3 control-label">Alamat Orang Tua/Wali <span class="text-danger">*</span></label>
          <div class="col-sm-5">
                        <textarea class="form-control" rows="3" placeholder="" id="alamat_orangtua" name="alamat_orang_tua_wali"></textarea>
          </div>
        </div>


      </div>

      <div id="step2_reguler" style="display: none;">

        <h3 class="dtitle">Data Asal Sekolah</h3>

        <div class="form-group">
          <label for="asal_sekolah" class="col-sm-3 control-label">Asal Sekolah SMA/SMK/MA <span class="text-danger">*</span></label>
          <div class="col-sm-5">
                        <input type="text" class="form-control" id="asal_sekolah" name="asal_sekolah" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="jurusan" class="col-sm-3 control-label">Jurusan<span class="text-danger">*</span></label>
          <div class="col-sm-9">
            
            
            <div class="radio">
              <label class="left_0">
                <input type="radio" name="jurusan" value="IPA" checked="">
                &nbsp;IPA
              </label> &nbsp;&nbsp;&nbsp;&nbsp;

              <label>
                <input type="radio" name="jurusan" value="IPS" >
                &nbsp;IPS
              </label> &nbsp;&nbsp;&nbsp;&nbsp;   

              <label>
                <input type="radio" name="jurusan" value="Lainnya" >
                &nbsp;Lainnya
              </label> &nbsp;&nbsp;&nbsp;&nbsp;           
            </div>

            
            <div id="reg_jurusan_lain" class="col-sm-5" style="display: none; margin-top: 15px;padding-left: 0px;">
              <input type="text" class="form-control" id="jurusan" name="jurusan_lain" value="">
            </div>

          </div>
        </div>

        <div class="form-group">
          <label for="alamat_sekolah" class="col-sm-3 control-label">Alamat Lengkap Sekolah<span class="text-danger">*</span></label>
          <div class="col-sm-5">
                        <textarea class="form-control" rows="3" placeholder="" id="alamat_sekolah" name="alamat_sekolah"></textarea>
          </div>
        </div>

        <div class="form-group">
          <label for="kota_sekolah2" class="col-sm-3 control-label">Kota / Kabupaten <span class="text-danger">*</span></label>
          <div class="col-sm-4">
                        <input type="text" class="form-control searchkota" id="kota_sekolah2" name="kota_sekolah" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="provinsi_sekolah" class="col-sm-3 control-label">Provinsi <span class="text-danger">*</span></label>
          <div class="col-sm-4">
            
            <select name="provinsi_sekolah" id="provinsi_sekolah" class="form-control">
<option value="" selected="selected">-- Pilih --</option>
<option value="ACEH">ACEH</option>
<option value="BALI">BALI</option>
<option value="BANTEN">BANTEN</option>
<option value="BENGKULU">BENGKULU</option>
<option value="DI YOGYAKARTA">DI YOGYAKARTA</option>
<option value="DKI JAKARTA">DKI JAKARTA</option>
<option value="GORONTALO">GORONTALO</option>
<option value="JAMBI">JAMBI</option>
<option value="JAWA BARAT">JAWA BARAT</option>
<option value="JAWA TENGAH">JAWA TENGAH</option>
<option value="JAWA TIMUR">JAWA TIMUR</option>
<option value="KALIMANTAN BARAT">KALIMANTAN BARAT</option>
<option value="KALIMANTAN SELATAN">KALIMANTAN SELATAN</option>
<option value="KALIMANTAN TENGAH">KALIMANTAN TENGAH</option>
<option value="KALIMANTAN TIMUR">KALIMANTAN TIMUR</option>
<option value="KALIMANTAN UTARA">KALIMANTAN UTARA</option>
<option value="KEPULAUAN BANGKA BELITUNG">KEPULAUAN BANGKA BELITUNG</option>
<option value="KEPULAUAN RIAU">KEPULAUAN RIAU</option>
<option value="LAMPUNG">LAMPUNG</option>
<option value="MALUKU">MALUKU</option>
<option value="MALUKU UTARA">MALUKU UTARA</option>
<option value="NUSA TENGGARA BARAT">NUSA TENGGARA BARAT</option>
<option value="NUSA TENGGARA TIMUR">NUSA TENGGARA TIMUR</option>
<option value="PAPUA">PAPUA</option>
<option value="PAPUA BARAT">PAPUA BARAT</option>
<option value="RIAU">RIAU</option>
<option value="SULAWESI BARAT">SULAWESI BARAT</option>
<option value="SULAWESI SELATAN">SULAWESI SELATAN</option>
<option value="SULAWESI TENGAH">SULAWESI TENGAH</option>
<option value="SULAWESI TENGGARA">SULAWESI TENGGARA</option>
<option value="SULAWESI UTARA">SULAWESI UTARA</option>
<option value="SUMATERA BARAT">SUMATERA BARAT</option>
<option value="SUMATERA SELATAN">SUMATERA SELATAN</option>
<option value="SUMATERA UTARA">SUMATERA UTARA</option>
</select>

          </div>
        </div>

        <div class="form-group">
          <label for="kode_pos_sekolah" class="col-sm-3 control-label">Kode Pos <span class="text-danger">*</span></label>
          <div class="col-sm-9">          
                        <div class="col-sm-2 x-form">
              <input type="text" class="form-control" id="kode_pos_sekolah" name="kode_pos_sekolah"  value="" maxlength="5">
            </div>
          </div>
        </div>

        <div class="form-group">
          <div class="col-sm-12">          
          </div>
        </div>


        <div id="uploadForm_register" class="form-group">
          <label for="photo" class="col-sm-3 control-label">Upload Photo <span class="text-danger">*</span></label>
          <div class="col-sm-5" style="margin-top: 5px;">
            <input type="file" id="photo" name="foto">
          </div>
        </div>
        <div class="form-group">
          <div class="col-sm-3"></div>
          <div class="col-sm-5">
            <span class="text-danger">Ukuran File Photo Maksimal 1 MB Dimensi Maksimal 1920 x 1200 (JPG/PNG)</span>
          </div>
        </div>

        <div class="form-group">
          <div class="col-sm-12">          
          </div>
        </div>

        <div class="form-group">
          <label for="nama_guru" class="col-sm-3 control-label">Nama Guru BK </label>
          <div class="col-sm-3">
                        <input type="text" class="form-control" id="nama_guru" name="guru_bk" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="telepon_guru" class="col-sm-3 control-label">No HP Guru BK </label>
          <div class="col-sm-3">
                        <input type="text" class="form-control" id="telepon_guru" name="hp_guru_bk" value="">
          </div>
        </div>

        <div class="form-group">
          <label for="telepon_guru" class="col-sm-3 control-label">Mengetahui Informasi Kampus dari :</label>
          <div class="col-sm-8">
            
            <div style="margin: 5px 0;">
              <input type="checkbox" name="informasi_kampus[]" value="Website"> Website &nbsp; &nbsp; 
              <input type="checkbox" name="informasi_kampus[]" value="Radio/TV"> Radio/TV &nbsp; &nbsp; 
              <input type="checkbox" name="informasi_kampus[]" value="Media Cetak (Koran) "> Media Cetak (Koran)  &nbsp; &nbsp; 
              <input type="checkbox" name="informasi_kampus[]" value="Media Sosial"> Media Sosial &nbsp; &nbsp;
              <input type="checkbox" name="informasi_kampus[]" value="Brosur"> Brosur
            </div>

            <div style="margin: 5px 0;">
              <input type="checkbox" name="informasi_kampus[]" value="Keluarga/Saudara"> Keluarga/Saudara &nbsp; &nbsp;
              <input type="checkbox" name="informasi_kampus[]" value="Orangtua"> Orangtua &nbsp; &nbsp; 
              <input type="checkbox" name="informasi_kampus[]" value="Teman"> Teman &nbsp; &nbsp;    
            </div>

            <div>
              <div style="float: left;">
                <input type="checkbox" name="informasi_kampus[]" value="Lainnya"> Lainnya &nbsp; &nbsp;
              </div>
              <input type="text" class="form-control informasi_kampus_lain" name="informasi_kampus_lain" value="" disabled="disabled" style="width: 170px; float: left;">
            </div>

          </div>
        </div>

      </div>


    </div>
    <div class="box-footer">
      <!-- <button type="submit" class="btn btn-default">Back</button> -->
      <a href="#" class="btn btn-info pull-right next1_reguler" onclick="reg_step2();">
        Next <i class="fa fa-fw fa-angle-right"></i>
      </a>
      <a href="#" class="btn btn-default next2_reguler" onclick="reg_step1();" style="display: none;">Back</a>
      <button type="submit" class="btn btn-info pull-right submit_reguler" style="display: none;">Submit</button>
    </div>

  </form>

</div>