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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Student Registration Form</title>
<style>
body {
font-family: Arial, sans-serif;
background-color: #d6f0f9;
display: flex;
justify-content: center;
align-items: center;
height: 100vh;
margin: 0;
}
.form-container {
background-color: #fff;
padding: 20px;
border-radius: 8px;
box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);
width: 350px;
}
.form-container h2 {
text-align: center;
color: #007bff;
margin-bottom: 20px;
}
.form-container label {
display: block;
margin-bottom: 8px;
font-weight: bold;
}
.form-container input[type="text"],
.form-container input[type="date"],
.form-container input[type="email"],
.form-container input[type="tel"],
.form-container select {
width: 100%;
padding: 8px;
margin-bottom: 15px;
border: 1px solid #ccc;
border-radius: 4px;
}
.form-container input[type="radio"] {
margin-right: 10px;
}
.form-container .file-upload {
margin-bottom: 15px;
}
.form-container button {
width: 100%;
padding: 10px;
background-color: #007bff;
color: white;
border: none;
border-radius: 4px;
cursor: pointer;
}
.form-container button:hover {
background-color: #0056b3;
}
</style>
</head>
<body>
<div class="form-container">
<h2>XYZ College/School</h2>
<p style="text-align: center; margin-top: -15px; margin-bottom: 20px;">Student Registration Form</p>
<form action="#">
<label for="image">Student Image <small>(less than 5 MB)</small></label>
<input type="file" id="image" name="image" class="file-upload" accept="image/*" required>
<label for="student-name">Student Name</label>
<input type="text" id="student-name" name="student-name" placeholder="Full Name" required>
<label for="father-name">Father's Name</label>
<input type="text" id="father-name" name="father-name" placeholder="Father's Full Name" required>
<label for="mother-name">Mother's Name</label>
<input type="text" id="mother-name" name="mother-name" placeholder="Mother's Full Name" required>
<label>Gender</label>
<input type="radio" id="male" name="gender" value="Male" required>
<label for="male" style="display: inline;">Male</label>
<input type="radio" id="female" name="gender" value="Female">
<label for="female" style="display: inline;">Female</label>
<input type="radio" id="other" name="gender" value="Other">
<label for="other" style="display: inline;">Other</label>
<label for="dob">Date of Birth</label>
<input type="date" id="dob" name="dob" required>
<label for="email">E-mail</label>
<input type="email" id="email" name="email" placeholder="email@xyz.com" required>
<label for="level">Level</label>
<select id="level" name="level" required>
<option value="High School">High School</option>
<option value="Undergraduate">Undergraduate</option>
<option value="Postgraduate">Postgraduate</option>
</select>
<label for="department">Department</label>
<select id="department" name="department" required>
<option value="Electrical Engineering">Electrical Engineering</option>
<option value="Computer Science">Computer Science</option>
<option value="Mechanical Engineering">Mechanical Engineering</option>
</select>
<label for="tel">Tel/Mobile</label>
<input type="tel" id="tel" name="tel" placeholder="XXX XXX XXXX" required>
<button type="submit">Submit</button>
</form>
</div>
</body>
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