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File: test2.php
<!DOCTYPE html>
<html>
<head>
  <meta charset="utf-8">
  <meta http-equiv="X-UA-Compatible" content="IE=edge">
  <title>PENDAFTARAN</title>
  <!-- Tell the browser to be responsive to screen width -->
  <meta content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no" name="viewport">
  <!-- Bootstrap 3.3.5 -->
  <link rel="stylesheet" href="http://form.poltekpos.ac.id/bootstrap/css/bootstrap.min.css">
  <!-- Font Awesome -->
  <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/font-awesome/4.4.0/css/font-awesome.min.css">
  <!-- Ionicons -->
  <link rel="stylesheet" href="https://code.ionicframework.com/ionicons/2.0.1/css/ionicons.min.css">
  <!-- jvectormap -->
  <link rel="stylesheet" href="http://form.poltekpos.ac.id/plugins/jvectormap/jquery-jvectormap-1.2.2.css">
  <!-- Theme style -->
  <link rel="stylesheet" href="http://form.poltekpos.ac.id/dist/css/AdminLTE.min.css">
  <!-- AdminLTE Skins. Choose a skin from the css/skins
       folder instead of downloading all of them to reduce the load. -->
  <link rel="stylesheet" href="http://form.poltekpos.ac.id/dist/css/skins/_all-skins.min.css">

  <link rel="stylesheet" href="http://form.poltekpos.ac.id/assets/css/bootstrap-datepicker.css">

  <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/animate.css/3.5.2/animate.min.css">
  
  <!-- Bootstrap time Picker -->
  <!-- <link rel="stylesheet" href="http://form.poltekpos.ac.id/plugins/timepicker/bootstrap-timepicker.min.css"> -->

  <!-- jQuery 2.1.4 -->
  <script src="http://form.poltekpos.ac.id//plugins/jQuery/jQuery-2.1.4.min.js"></script>

  <!-- HTML5 Shim and Respond.js IE8 support of HTML5 elements and media queries -->
  <!-- WARNING: Respond.js doesn't work if you view the page via file:// -->
  <!--[if lt IE 9]>
  <script src="https://oss.maxcdn.com/html5shiv/3.7.3/html5shiv.min.js"></script>
  <script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script>
  <![endif]-->
  <style type="text/css">
  h3.btn-menu {
    margin: 10px;
  }
  .badge {
    padding: 6px 10px;
    font-size: 14px;
    border-radius: 5px;
  }
  .datepicker {
    z-index: 10000 !important;
  }
  .skin-yellow-light .main-header .navbar {
    background-color: #f76a00 !important;
  }
  .skin-yellow-light .main-footer {
    background: #05376c !important;
    color: #fff !important;
  }
  .content-header {
    margin-bottom: 20px;
  }

  .small-box h3 {
    font-size: 32px !important;
  }
  .left_0 {
    padding-left: 0px !important;
  }
  .x-form {
    float: none !important;
    padding-left: 0px !important;
  }
  .easy-autocomplete{
    width: 100% !important;
  }

  .dtitle {
    font-size: 20px;
    color: #ff3100;
  }

  @media (min-width: 768px){
    .dtitle {
      margin: 20px;
    }
  }
  .text-danger {
    color: #ff0000 !important;
  }
  .callout h4 {
    font-size: 32px;
  }
  html { 
    background: url(http://form.poltekpos.ac.id/assets/images/img3.jpeg) no-repeat center center fixed;
    -webkit-background-size: cover;
    -moz-background-size: cover;
    -o-background-size: cover;
    background-size: cover;
  }
  body {
    background-color: transparent !important;
  } 

  .skin-yellow-light .wrapper {
    background-color: transparent !important;
  }

  .content-wrapper {
    background: rgba(255, 255, 255, 0.1);
  }

  .content-header>h1 {
    font-weight: 600;
  }
  .bg-aqua {
    background-color: #05376c !important;
    color: #e8e8e8 !important;
  }
  .bg-aqua:hover {
    background-color: #0f529a !important;
    color: #fff !important;
  }
  .small-box>.inner {
    text-align: center;
  }

  .content-header>.breadcrumb>li>a {
    color: #fff !important;
  }
  .breadcrumb>.active {
    color: #fff !important;
  }
  .breadcrumb>li+li:before {
    color: #fff !important;
  }
  .skin-yellow-light .content-wrapper, .skin-yellow-light .main-footer {
    border-left: none !important;
  }
  .main-footer {
    border-top: 1px solid #333 !important;
  }
  .print-only {
    display: none;
  }

  @media print
  {    
    .no-print, .no-print *
    {
      display: none !important;
    }
    .print-only{
      display: block !important;
    }
  }
  </style>


</head>

<body class="hold-transition skin-yellow-light layout-top-nav">

    <div class="wrapper">

      <header class="main-header">
        <nav class="navbar navbar-static-top">
          <div class="container">
            <div class="navbar-header">
              <a href="http://pmb.poltekpos.ac.id" class="navbar-brand"><b>PMB</b></a>
              <button type="button" class="navbar-toggle collapsed" data-toggle="collapse" data-target="#navbar-collapse">
                <i class="fa fa-bars"></i>
              </button>
            </div>
            <!-- Collect the nav links, forms, and other content for toggling -->
            <div class="collapse navbar-collapse pull-left" id="navbar-collapse">
              <ul class="nav navbar-nav">
                <li class="active"><a href="http://form.poltekpos.ac.id/">Home</a></li>
                <li><a href="http://form.poltekpos.ac.id/pengumuman">Pengumuman Kelulusan</a></li>
                <li><a href="http://form.poltekpos.ac.id/pengumuman">Her-Registrasi</a></li>
              </ul>
            </div>
            <!-- /.navbar-collapse -->

            <!-- Navbar Right Menu -->
              <div class="navbar-custom-menu">
                <ul class="nav navbar-nav">
                  <!-- Messages: style can be found in dropdown.less-->
                  <!-- User Account Menu -->

                </ul>
              </div><!-- /.navbar-custom-menu -->
          </div><!-- /.container-fluid -->
        </nav>
      </header>
      <!-- Full Width Column -->
      <div class="content-wrapper">
        <div class="container">
          <!-- Content Header (Page header) -->
          <section class="content-header">

            <div class="row" style="margin: 15px 0 30px 0;">
              <div class="col-md-1"></div>
              <div class="col-md-10" style="text-align: center;">

              

                <img class="logo-poltekpos" src="http://form.poltekpos.ac.id/assets/images/poltekpos.png" width="288px" > &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                <img class="logo-stimlog" src="http://form.poltekpos.ac.id/assets/images/stimlog.png" style='display: none;'>                

              </div>
            </div> 
            
            
            <h1>
              <center> PMB (Penerimaan Mahasiswa Baru) 2018 / 2019 </center>
            </h1>

            <ol class="breadcrumb hidden-xs">
              <li><a href="#"><i class="fa fa-home"></i> Home</a></li>
              <li class="active">Pendaftaran</li>
            </ol>
          </section>

          <!-- Main content -->
          <section class="content">

            <div class="print-only">
              <center>
                <img class="logo-poltekpos" src="http://form.poltekpos.ac.id/assets/images/poltekpos.png" width="258px" > &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                <img class="logo-stimlog" src="http://form.poltekpos.ac.id/assets/images/stimlog.png" width="258px" style='display: none;'>
                <h5> <b>PMB (Penerimaan Mahasiswa Baru) 2018 / 2019</b> </h5>
              </center> 
            </div>

          <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-header with-border">
                                <center><h3 class="box-title"> <marquee direction="left" scrollamount="2" align="center">Silahkan Pilih Jalur Kemudian Pilih Next </marquee> </h3></center>
                              </div>
              <div class="box-body">
              	<div class="row">
              		<div class="col-md-12">  

                              				

                  

                  <div class="row">
                  <div class="col-md-12" style="text-align: center;">
                    <label onclick="setLogo(1)">
                        <div class="hidden">
                    <input type="radio" name="perguruan_tinggi_val" value="POLTEKPOS" checked="" class="icheck"> &nbsp;&nbsp;
                    </div>
                    <!-- <img src="http://form.poltekpos.ac.id/assets/images/pmb-poltekpos.jpeg" alt="POLTEKPOS" style="border-radius: 10px;border: 1px solid #dedede;padding: 9px 12px;background: #f7f7f7;cursor: pointer;"> -->
                  </label>
                  </div>

                  <!-- <div class="col-md-6" style="text-align: center;">
                    <label onclick="setLogo(2)">
                    <input type="radio" name="perguruan_tinggi_val" value="STIMLOG" class="icheck"> &nbsp;&nbsp;
                    <img src="http://form.poltekpos.ac.id/assets/images/pmb-stml.jpeg" alt="STIMLOG" style="border-radius: 10px;border: 1px solid #dedede;padding: 9px 12px;background: #f7f7f7;cursor: pointer;">
                  </label>
                  </div> -->
                  </div>        
                  <br>   
                  
              			
                  <div class="row">
                  <div class="col-md-2"></div>
                    <div class="col-md-10">

                     <form class="form-horizontal">
                      <div class="box-body">
                       <div class="form-group">
                        <label for="inputEmail3" class="col-sm-2 control-label">Pilih Jalur : </label>
                        <div class="col-sm-9">              							
                         <div class="radio">
                           <label>
                            <input type="radio" name="jalur" id="pmdk" value="pmdk" checked=""> 
                             &nbsp;<img src='assets/images/PMDK.png' width="130" height="150" class="img-circle"/>
                           </label>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
                           
                           <label>
                             <input type="radio" name="jalur" id="reguler" value="reguler">
                             &nbsp;<img src='assets/images/Reguler.png'width="130" height="150" class="img-circle"/>
                           </label>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <br></br>
                           <label>
                             <input type="radio" name="jalur" id="undangan" value="undangan">
                             &nbsp;<img src='assets/images/Undangan.png' width="130" height="150" class="img-circle"/>
                           </label>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

                           <label>
                             <input type="radio" name="jalur" id="mandiri" value="mandiri">
                             &nbsp;<img src='assets/images/Mandiri.png' width="130" height="150" class="img-circle"/>
                           </label> 
                         </div>
                       </div>
                     </div>
                   </div>

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

             <div class="box-footer" style="text-align: right;">
               <a href="#" class="btn btn-primary" onclick="setForm();">Next <i class="fa fa-fw fa-angle-right"></i></a>
             </div>

                    
              		</div>
              	</div>

              </div><!-- /.box-body -->
            </div><!-- /.box -->


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

  <form action="http://form.poltekpos.ac.id/index.php/mahasiswa/register_pmdk" 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="pmdk">
  </div>

  
<div id="step1">

  <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_pmdk_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_pmdk_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_pmdk_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_pmdk_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_pmdk_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="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="kota" 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" 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,'pmdk_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="pmdk_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" 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="pmdk_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_sekolah" 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_sekolah" 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 class="form-group">
  <label for="nilai_matematika_3" class="col-sm-3 control-label">Nilai Matematika Smtr 3 <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="nilai_matematika_3" name="nilai_matematika_3" value="" maxlength="5">
    </div>
  </div>

</div>

<div class="form-group">
  <label for="nilai_matematika_4" class="col-sm-3 control-label">Nilai Matematika Smtr 4 <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="nilai_matematika_4" name="nilai_matematika_4" value="" maxlength="5">
    </div>
  </div>
</div>

<div class="form-group">
  <label for="nilai_inggris_3" class="col-sm-3 control-label">Nilai Bahasa Inggris Smtr 3 <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="nilai_inggris_3" name="nilai_inggris_3" value="" maxlength="5">
    </div>
  </div>
</div>

<div class="form-group">
  <label for="nilai_inggris_4" class="col-sm-3 control-label">Nilai Bahasa Inggris Smtr 4 <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="nilai_inggris_4" name="nilai_inggris_4"  value="" maxlength="5">
    </div>
  </div>
</div>

<div id="uploadForm" 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 id="uploadForm_2" class="form-group">
  <label for="photo" class="col-sm-3 control-label">Upload Scan Raport Smtr 3 <span class="text-danger">*</span></label>
  <div class="col-sm-5" style="margin-top: 5px;">
    <input type="file" id="photo" name="raport_semester_3">
  </div>
</div>
<div class="form-group">
  <div class="col-sm-3"></div>
  <div class="col-sm-5">
    <span class="text-danger">Ukuran File Maksimal 2 MB (PDF)</span>
  </div>
</div>

<div id="uploadForm_3" class="form-group">
  <label for="photo" class="col-sm-3 control-label">Upload Scan Raport Smtr 4 <span class="text-danger">*</span></label>
  <div class="col-sm-5" style="margin-top: 5px;">
    <input type="file" id="photo" name="raport_semester_4">
  </div>
</div>
<div class="form-group">
  <div class="col-sm-3"></div>
  <div class="col-sm-5">
    <span class="text-danger">Ukuran File Maksimal 2 MB (PDF)</span>
  </div>
</div>

<div class="form-group" style="margin-bottom: 0;">
  <label for="prestasi" class="col-sm-3 control-label">Upload Scan Surat Rekomendasi dari Sekolah/Guru BK</label>
  <div class="col-sm-5" style="margin-top: 5px;">
    <input type="file" id="prestasi" name="surat_rekomendasi_sekolah">
  </div>
</div>
<div class="form-group">
  <div class="col-sm-3"></div>
  <div class="col-sm-5">
    <span class="text-danger">Ukuran File Maksimal 2 MB (PDF)</span>
  </div>
</div>

<div class="form-group" style="margin-bottom: 0;">
  <label for="prestasi" class="col-sm-3 control-label">Upload Scan Sertivikat Prestasi <br> (jika ada)</label>
  <div class="col-sm-5" style="margin-top: 5px;">
    <input type="file" id="prestasi" name="prestasi">
  </div>
</div>
<div class="form-group">
  <div class="col-sm-3"></div>
  <div class="col-sm-5">
    <span class="text-danger">Ukuran File Maksimal 2 MB (PDF)</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">
  <a href="#" class="btn btn-info pull-right next1" onclick="step2();">
    Next <i class="fa fa-fw fa-angle-right"></i>
  </a>
  <a href="#" class="btn btn-default next2" onclick="step1();" style="display: none;">Back</a>
  <input type="submit" value="Submit" class="btn btn-info pull-right submit" style="display: none;">
</div>

</form>

</div>


<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;
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      if (program_studi_4 == program_studi_5){
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    $("#step1").hide();

    $(".next1").hide();
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</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>


<script type="text/javascript">

	function reg_step1(){
		$("#step1_reguler").show();
		$("#step2_reguler").hide();

		$(".next1_reguler").show();
		$(".next2_reguler").hide();
		$(".submit_reguler").hide();
	}

	function reg_step2(){

		var program_studi_1 = $('.program_studi_reguler_1').val();
		var program_studi_2 = $('.program_studi_reguler_2').val();
		var program_studi_3 = $('.program_studi_reguler_3').val();

		var program_studi_4 = $('.program_studi_reguler_4').val();
		var program_studi_5 = $('.program_studi_reguler_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_reguler").show();
		$("#step1_reguler").hide();

		$(".next1_reguler").hide();
		$(".next2_reguler").show();
		$(".submit_reguler").show();
	}

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

		<form action="http://form.poltekpos.ac.id/index.php/mahasiswa/register_undangan" 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="undangan">
		</div>

		

	<div id="step1_undangan">

		<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_undangan_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_undangan_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_undangan_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_undangan_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_undangan_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="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="kota3" 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_undangan" 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="undangan_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_sekolah3" 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 class="form-group">
			<label for="undangan" class="col-sm-3 control-label">Upload Surat Undangan <span class="text-danger">*</span></label>
			<div class="col-sm-5" style="margin-top: 5px;">
				<input type="file" id="undangan" name="undangan">
			</div>
		</div>

		<div class="form-group">
			<div class="col-sm-3"></div>
			<div class="col-sm-5">
				<span class="text-danger">Ukuran File Maksimal 1 MB Dimensi Maksimal 1920 x 1200 (PDF)</span>
			</div>
		</div>

		<div id="uploadForm_undangan" 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 2 MB (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_undangan" onclick="undangan_step2();">
		Next <i class="fa fa-fw fa-angle-right"></i>
	</a>
	<a href="#" class="btn btn-default next2_undangan" onclick="undangan_step1();" style="display: none;">Back</a>
	<button type="submit" class="btn btn-info pull-right submit_undangan" style="display: none;">Submit</button>
</div>

</form>

</div>


<script type="text/javascript">

	function undangan_step1(){
		$("#step1_undangan").show();
		$("#step2_undangan").hide();

		$(".next1_undangan").show();
		$(".next2_undangan").hide();
		$(".submit_undangan").hide();
	}

	function undangan_step2(){

		var program_studi_1 = $('.program_studi_undangan_1').val();
		var program_studi_2 = $('.program_studi_undangan_2').val();
		var program_studi_3 = $('.program_studi_undangan_3').val();

		var program_studi_4 = $('.program_studi_undangan_4').val();
		var program_studi_5 = $('.program_studi_undangan_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_undangan").show();
		$("#step1_undangan").hide();

		$(".next1_undangan").hide();
		$(".next2_undangan").show();
		$(".submit_undangan").show();
	}

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

		<form action="http://form.poltekpos.ac.id/index.php/mahasiswa/register_mandiri" 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="mandiri">
		</div>

		
	<div id="step1_mandiri">

		<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_mandiri_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_mandiri_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_mandiri_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_mandiri_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_mandiri_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="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="kota4" 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_mandiri" 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="mandiri_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_sekolah4" 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>
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					<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;
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