[ Mini Kiebo ]
Server: Windows NT DESKTOP-5B8S0D4 6.2 build 9200 (Windows 8 Professional Edition) i586
Path:
D:
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Backup
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14082024
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Data
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htdocs
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htdocs
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pmb2
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application
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views
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daftar
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Home
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File: form.php
<section class="content"> <div > <center> <img class="logo-poltekpos" src="<?php echo base_url();?>asset/images/logo stikes bhakti pertiwi.png" width="100px" > <?php foreach ($thn->result() as $key) {?> <div style=" font-size: 24px ">FORMULIR PENDAFTARAN</br> SELEKSI PENERIMAAN MAHASISWA BARU TAHUN AKADEMIK <?= $key->tahunPenerimaan;?></div> </center> </div> <?php } ?> <div class="row"> <div class="col-md-1"></div> <div class="col-md-10"> <div id="form_default" class="box box-warning"> <div class="box-body"> <div class="row"> <div class="col-md-12"></div> <div class="box-body"> <?php echo $this->session->flashdata("save");?> <form action="<?php echo base_url();?>alluser/savePendaftaran" class=" form-horizontal" method="post" accept-charset="utf-8"> <div id="step1"> <center><h3 class="dtitle"> Data Calon Mahasiswa</h3></center> <br><br> <div class="form-group"> <label for="nama_lengkap" class="col-sm-3 control-label">Prodi / Jurusan <span class="text-danger">*</span></label> <div class="col-sm-6"> <select name="jurusan" class="form-control" id="jurusan" required=""> <option value="" selected="selected"></option> <?php foreach ($jurusan->result() as $key) {?> <option value="<?php echo $key->kd_jurusan;?>"><?php echo $key->jurusan;?></option> <?php } ?> </select> <small id="emailHelp" class="form-text text-muted">pilih program studi yang diminati.</small> </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-6"> <input type="text" class="form-control" id="nama" name="nama_lengkap" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi nama lengkap sesuai dengan kartu identitas.</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">Tinggi Badan <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="tbd" maxlength="10" value="" required=""> <small class="form-text text-muted">isi ukuran tinggi badan (contoh: 170 cm)</small> </div> </div> <div class="form-group"> <label for="tempat_lahir" class="col-sm-3 control-label">Berat Badan <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="bbd" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi berat badan (contoh: 55 Kg)</small> </div> </div> <div class="form-group"> <label for="tgl_lahir" class="col-sm-3 control-label">Tempat Lahir <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="tempat" placeholder="Jakarta" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi Tempat lahir sesuai dengan kartu keluarga.</small> </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-6"> <input type="text" class="form-control datepicker" name="ttl" placeholder="Contoh: 01-01-1991" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi tanggal lahir sesuai dengan kartu keluarga.</small> </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-6"> <select name="agama" class="form-control" value="" required=""> <option value="" selected="selected"></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> <small id="emailHelp" class="form-text text-muted">isi agama sesuai dengan kartu identitas.</small> </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-6"> <textarea class="form-control" rows="3" placeholder="" id="alamat" name="alamat" required=""></textarea> <small id="emailHelp" class="form-text text-muted">isi alamat tempat tinggal sesuai dengan kartu identitas.</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">Kota / Kabupaten <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control searchkota" name="kota" vvalue="" required=""> <small id="emailHelp" class="form-text text-muted">isi nama kota / kabupaten / desa / dusun, sesuai dengan kartu identitas.</small> </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-6"> <select name="provinsi" class="form-control" value="" required=""> <option value="" selected="selected"></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> <small id="emailHelp" class="form-text text-muted">pilih nama provinsi sesuai dengan kartu identitas.</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">No. Tlp Rumah <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="telephone" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi nomor telp yang bisa dihubungi (contoh: 021 7888-4853)</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">No Hp <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="no_hp" value="" required="" maxlength="16"> <small id="emailHelp" class="form-text text-muted">isi nomor hadnphone aktif yang bisa dihubungi (contoh: 0813-1234-5678)</small> </div> </div> <div class="form-group"> <label for="bbm_line" class="col-sm-3 control-label">Profil Sosial Media <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="facbook" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi Silahkan ini nama profil facebook / instagram.</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">Whatsapp <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="whatsapp" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi nomor WhatsApp aktif yang bisa dihubungi (contoh: 0813-1234-5678)</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">Email <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="email" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi alamat e-mail aktif.</small> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label">Asal Sekolah <span class="text-danger">*</span></label> <div class="col-sm-6"> <input type="text" class="form-control" name="asalSekolah" value="" required=""> <small id="emailHelp" class="form-text text-muted">isi nama asal sekolah pendidikan terakhir saat ini</small> </div> </div> <center><h4 class="dtitle"> Terimakasih telah mendaftar melalui website Resmi kami, <br> silahkan klik tombol dibawah ini untuk melanjutkan. </h4></center> </div> <br> <?php foreach ($thn->result() as $key) {?> <input type="hidden" class="form-control" id="nama" name="thn_ajar" value="<?= $key->tahunPenerimaan;?>"> <center><input type="submit" value="Submit Form" class="btn btn-info submit"></center> </form> </div> <?php } ?> <script type="text/javascript"> function step1(){ $("#step1").show(); $("#step2").hide(); $(".next1").show(); $(".next2").hide(); $(".submit").hide(); } function step2(){ $("#step2").show(); $("#step1").hide(); $(".next1").hide(); $(".next2").show(); $(".submit").show(); } </script> <a href="#" onclick="back();" class="btn-back btn btn-info" style="display: none;"> <i class="fa fa-fw fa-long-arrow-left"></i> Cancel </a> </div> </div> </section><!-- /.content --> </div><!-- /.container --> </div><!-- /.content-wrapper --> <script type="text/javascript"> function setForm(){ $("#form_default").hide(); var section = $('input[name=jalur]:checked').val(); var perguruan_tinggi = $('input[name=perguruan_tinggi_val]:checked').val(); $("#form_" + section).show(); $('.btn-back').show(); $("input[name=perguruan_tinggi]").val(perguruan_tinggi); if (perguruan_tinggi == "POLTEKPOS"){ $(".program_poltekpos").show(); $(".program_stimlog").hide(); } if (perguruan_tinggi == "STIMLOG"){ $(".program_poltekpos").hide(); $(".program_stimlog").show(); } } function back(){ $("#form_default").show(); $("#form_pmdk").hide(); $('.btn-back').hide(); $(".more-info").show(); resetForm(); } function goTo(url){ document.location = url; } function setPekerjaan(val,elem){ if (val == 'lainnya') { $("#"+elem).show(); } else { $("#"+elem).hide(); } } function setJurusan(val,elem){ if (val == 'lainnya') { $("#"+elem).show(); } else { $("#"+elem).hide(); } } $( document ).ready(function() { }); $(document).ready(function(){ $('input[type="radio"]').iCheck({ checkboxClass: 'icheckbox_square-red', radioClass: 'iradio_square-red', increaseArea: '20%' // optional }); $('input[type="checkbox"]').iCheck({ checkboxClass: 'icheckbox_square-red', radioClass: 'iradio_square-red', increaseArea: '20%' // optional }); $('input[name="jurusan"]').on('ifChanged', function(event){ // alert(event.value); console.log(event); var str = event.target.value; if (str.toLowerCase() == 'lainnya') { $("#pmdk_jurusan_lain").show(); $("#reg_jurusan_lain").show(); $("#mandiri_jurusan_lain").show(); $("#undangan_jurusan_lain").show(); } else { $("#pmdk_jurusan_lain").hide(); $("#reg_jurusan_lain").hide(); $("#mandiri_jurusan_lain").hide(); $("#undangan_jurusan_lain").hide(); } }); $('input[name="informasi_kampus[]"]').on('ifChecked', function(event){ console.log(event); var str = event.target.value; if (str.toLowerCase() == 'lainnya') { $(".informasi_kampus_lain").prop('disabled', false); } }); $('input[name="informasi_kampus[]"]').on('ifUnchecked', function(event){ console.log(event); var str = event.target.value; if (str.toLowerCase() == 'lainnya') { $(".informasi_kampus_lain").prop('disabled', true); } }); }); </script> <script type="text/javascript"> $(document).ready(function(){ $(".datepicker").datepicker({ format: 'dd-mm-yyyy', }); var options = { url: function(phrase) { return "" + phrase; }, getValue: "name" }; $(".searchkota").easyAutocomplete(options); $(".searchkota2").easyAutocomplete(options); }); </script>