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- <?php include("header.php");?>
- <?php
- if($_SESSION['user_role'] == ''){
- $_SESSION['error'] = "Please select a User Role";
- header('Location:'.SITE_URL.'register');
- }
- if($_POST['submit']){
- $error = false;
- if($_POST['password'] != $_POST['password1']){
- $pwdError = "Password do not match";
- $error = true;
- }
- if($_POST['password'] == ''){
- $pwdError = "Password can not be blank";
- $error = true;
- }
- function isValidEmail($email){
- $pattern = "^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,3})$";
- if (eregi($pattern, $email)){
- return true;
- }
- else {
- return false;
- }
- }
- function checkEmailExistence($email){
- $result = mysql_query("SELECT count(email) FROM `users` WHERE `email` ='".$email."'");
- if(!$result)
- return true;
- else
- return false;
- }
- if(!isValidEmail($_POST['email'])){
- $emailError = "Not a valid email address";
- $error = true;
- } else {
- if(!checkEmailExistence($_POST['email']))
- $emailError = "Email Already Exist";
- $error = true;
- }
- if($_POST['email'] != $_POST['email']){
- $pwdError = "Emails do not match";
- $error = true;
- }
- if(!$error){
- if($user->register()){
- header("Location:register_step3");
- }
- /*else if($user->register()===false){
- echo "User with this Email Id already exist";
- }*/
- else
- echo "User not Created";
- }
- }
- ?>
- <div class="report_section">
- <div class="report_content_section">
- <div class="r_step_01">
- <div class="r_step_01_inner">
- <form method="post" action="register_step2" enctype="multipart/form-data" >
- <p class="span_text03">Creat an Account : Expert</p>
- <div class="member_register">
- <ul>
- <li><a href="register">1. Membership</a></li>
- <li><a class="active" href="register_step2">2. Register</a></li>
- </ul>
- </div>
- <div style="width: 920px;" class="mem_reg_container">
- <p><strong>Register As Expert</strong></p>
- <div class="r_a_e">
- <fieldset class="fldset"><legend><strong>Account Details</strong></legend>
- <div class="c_f_tree">
- <div class="r_a_e_div">Email</div>
- <div class="careers_input">
- <input type="text" class="careers_input" name="email">
- <?php echo $emailError;?>
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Confirm Email</div>
- <div class="careers_input"><input type="text" class="careers_input" name="email1"><?php echo $emailError;?></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Password</div>
- <div class="careers_input"><input type="password" class="careers_input" name="password"><?php echo $pwdError;?></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Confirm New Password</div>
- <div class="careers_input"><input type="password" class="careers_input" name="password1"><?php echo $pwdError;?></div>
- </div>
- </fieldset>
- </div>
- <div class="r_a_e">
- <fieldset class="fldset"><legend><strong>Details</strong></legend>
- <div class="c_f_tree">
- <div class="r_a_e_div">First Name</div>
- <div class="careers_input">
- <input type="text" class="careers_input" name="first_name">
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Last Name</div>
- <div class="careers_input"><input type="text" class="careers_input" name="last_name"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Phone</div>
- <div class="careers_input"><input type="text" class="careers_input" name="phone"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Company</div>
- <div class="careers_input"><input type="text" class="careers_input" name="company"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Street Address</div>
- <div class="personal_input"><input type="text" class="personal_input" name="street1"></div>
- <div class="personal_input"><input type="text" class="personal_input" name="street2"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">City</div>
- <div class="personal_input">
- <select name="city" class="" id="departCity_dom1" commonvalid="departDest_dom1">
- <option value="0">---Select City---</option>
- <option value="BLR">Bangalore</option>
- <option value="MAA">Chennai</option>
- <option value="DEL">New Delhi</option>
- <option value="GOI">Goa</option>
- <option value="HYD">Hyderabad</option>
- <option value="CCU">Kolkata</option>
- <option value="BOM">Mumbai</option>
- <option value="PNQ">Pune</option>
- <option value="">------------------------</option>
- <option value="IXA">Agartala</option>
- <option value="AGX">Agatti Island</option>
- <option value="AGR">Agra</option>
- <option value="AMD">Ahmedabad</option>
- <option value="AJL">Aizawl</option>
- <option value="IXD">Allahabad</option>
- <option value="ATQ">Amritsar</option>
- <option value="IXU">Aurangabad</option>
- <option value="IXB">Bagdogra</option>
- <option value="BLR">Bangalore</option>
- <option value="IXG">Belgaum</option>
- <option value="BEP">Bellary</option>
- <option value="BLR">Bengaluru</option>
- <option value="BHU">Bhavnagar</option>
- <option value="BHO">Bhopal</option>
- <option value="BBI">Bhubaneshwar</option>
- <option value="BHJ">Bhuj</option>
- <option value="BKB">Bikaner</option>
- <option value="BOM">Bombay</option>
- <option value="CCU">Calcutta</option>
- <option value="CCJ">Calicut</option>
- <option value="IXC">Chandigarh</option>
- <option value="MAA">Chennai</option>
- <option value="COK">Cochin</option>
- <option value="CJB">Coimbatore</option>
- <option value="DED">Dehradun</option>
- <option value="DEL">Delhi</option>
- <option value="DHM">Dharamshala</option>
- <option value="DIB">Dibrugarh</option>
- <option value="DMU">Dimapur</option>
- <option value="DIU">Diu</option>
- <option value="GAY">Gaya</option>
- <option value="GOI">Goa</option>
- <option value="GOP">Gorakhpur</option>
- <option value="GAU">Guwahati</option>
- <option value="GWL">Gwalior</option>
- <option value="HBX">Hubli</option>
- <option value="HYD">Hyderabad</option>
- <option value="IMF">Imphal</option>
- <option value="IDR">Indore</option>
- <option value="JLR">Jabalpur</option>
- <option value="JGB">Jagdalpur</option>
- <option value="JAI">Jaipur</option>
- <option value="IXJ">Jammu</option>
- <option value="JGA">Jamnagar</option>
- <option value="IXW">Jamshedpur</option>
- <option value="VDY">Jindal Vidyanagar</option>
- <option value="JDH">Jodhpur</option>
- <option value="JRH">Jorhat</option>
- <option value="IXY">Kandla</option>
- <option value="KNU">Kanpur</option>
- <option value="HJR">Khajuraho</option>
- <option value="COK">Kochi</option>
- <option value="KLH">Kolhapur</option>
- <option value="CCU">Kolkata</option>
- <option value="KUU">Kulu</option>
- <option value="LTU">Latur</option>
- <option value="IXL">Leh</option>
- <option value="IXI">Lilabari</option>
- <option value="LKO">Lucknow</option>
- <option value="LUH">Ludhiana</option>
- <option value="MAA">Madras</option>
- <option value="IXM">Madurai</option>
- <option value="IXE">Mangalore</option>
- <option value="BOM">Mumbai</option>
- <option value="MYQ">Mysore</option>
- <option value="NAG">Nagpur</option>
- <option value="NDC">Nanded</option>
- <option value="ISK">Nasik</option>
- <option value="DEL">New Delhi</option>
- <option value="PGH">Pantnagar</option>
- <option value="IXP">Pathankot</option>
- <option value="PAT">Patna</option>
- <option value="PBD">Porbandar</option>
- <option value="IXZ">Port Blair</option>
- <option value="PNQ">Pune</option>
- <option value="RPR">Raipur</option>
- <option value="RJA">Rajahmundry</option>
- <option value="RAJ">Rajkot</option>
- <option value="IXR">Ranchi</option>
- <option value="SXV">Salem</option>
- <option value="SHL">Shillong</option>
- <option value="SLV">Shimla</option>
- <option value="SSE">Sholapur</option>
- <option value="IXS">Silchar</option>
- <option value="SXR">Srinagar</option>
- <option value="STV">Surat</option>
- <option value="TEZ">Tezpur</option>
- <option value="TRV">Thiruvananthapuram</option>
- <option value="TRZ">Tiruchirapally</option>
- <option value="TIR">Tirupati</option>
- <option value="TRZ">Trichy</option>
- <option value="TRV">Trivandrum</option>
- <option value="TCR">Tuticorin</option>
- <option value="UDR">Udaipur</option>
- <option value="BDQ">Vadodara</option>
- <option value="VNS">Varanasi</option>
- <option value="VGA">Vijayawada</option>
- <option value="VTZ">Vishakhapatnam</option>
- <option value="VTZ">Vizag</option>
- </select>
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Country</div>
- <div class="personal_input">
- <select name="country">
- <option selected="selected" value="0">Select Country</option>
- <option value="United States">United States</option>
- <option value="United Kingdom">United Kingdom</option>
- <option value="Afghanistan">Afghanistan</option>
- <option value="Albania">Albania</option>
- <option value="Algeria">Algeria</option>
- <option value="American Samoa">American Samoa</option>
- <option value="Andorra">Andorra</option>
- <option value="Angola">Angola</option>
- <option value="Anguilla">Anguilla</option>
- <option value="Antarctica">Antarctica</option>
- <option value="Antigua and Barbuda">Antigua and Barbuda</option>
- <option value="Argentina">Argentina</option>
- <option value="Armenia">Armenia</option>
- <option value="Aruba">Aruba</option>
- <option value="Australia">Australia</option>
- <option value="Austria">Austria</option>
- <option value="Azerbaijan">Azerbaijan</option>
- <option value="Bahamas">Bahamas</option>
- <option value="Bahrain">Bahrain</option>
- <option value="Bangladesh">Bangladesh</option>
- <option value="Barbados">Barbados</option>
- <option value="Belarus">Belarus</option>
- <option value="Belgium">Belgium</option>
- <option value="Belize">Belize</option>
- <option value="Benin">Benin</option>
- <option value="Bermuda">Bermuda</option>
- <option value="Bhutan">Bhutan</option>
- <option value="Bolivia">Bolivia</option>
- <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
- <option value="Botswana">Botswana</option>
- <option value="Bouvet Island">Bouvet Island</option>
- <option value="Brazil">Brazil</option>
- <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
- <option value="Brunei Darussalam">Brunei Darussalam</option>
- <option value="Bulgaria">Bulgaria</option>
- <option value="Burkina Faso">Burkina Faso</option>
- <option value="Burundi">Burundi</option>
- <option value="Cambodia">Cambodia</option>
- <option value="Cameroon">Cameroon</option>
- <option value="Canada">Canada</option>
- <option value="Cape Verde">Cape Verde</option>
- <option value="Cayman Islands">Cayman Islands</option>
- <option value="Central African Republic">Central African Republic</option>
- <option value="Chad">Chad</option>
- <option value="Chile">Chile</option>
- <option value="China">China</option>
- <option value="Christmas Island">Christmas Island</option>
- <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
- <option value="Colombia">Colombia</option>
- <option value="Comoros">Comoros</option>
- <option value="Congo">Congo</option>
- <option value="Congo, The Democratic Republic of The">Congo, The Democratic Republic of The</option>
- <option value="Cook Islands">Cook Islands</option>
- <option value="Costa Rica">Costa Rica</option>
- <option value="Cote D'ivoire">Cote D'ivoire</option>
- <option value="Croatia">Croatia</option>
- <option value="Cuba">Cuba</option>
- <option value="Cyprus">Cyprus</option>
- <option value="Czech Republic">Czech Republic</option>
- <option value="Denmark">Denmark</option>
- <option value="Djibouti">Djibouti</option>
- <option value="Dominica">Dominica</option>
- <option value="Dominican Republic">Dominican Republic</option>
- <option value="Ecuador">Ecuador</option>
- <option value="Egypt">Egypt</option>
- <option value="El Salvador">El Salvador</option>
- <option value="Equatorial Guinea">Equatorial Guinea</option>
- <option value="Eritrea">Eritrea</option>
- <option value="Estonia">Estonia</option>
- <option value="Ethiopia">Ethiopia</option>
- <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
- <option value="Faroe Islands">Faroe Islands</option>
- <option value="Fiji">Fiji</option>
- <option value="Finland">Finland</option>
- <option value="France">France</option>
- <option value="French Guiana">French Guiana</option>
- <option value="French Polynesia">French Polynesia</option>
- <option value="French Southern Territories">French Southern Territories</option>
- <option value="Gabon">Gabon</option>
- <option value="Gambia">Gambia</option>
- <option value="Georgia">Georgia</option>
- <option value="Germany">Germany</option>
- <option value="Ghana">Ghana</option>
- <option value="Gibraltar">Gibraltar</option>
- <option value="Greece">Greece</option>
- <option value="Greenland">Greenland</option>
- <option value="Grenada">Grenada</option>
- <option value="Guadeloupe">Guadeloupe</option>
- <option value="Guam">Guam</option>
- <option value="Guatemala">Guatemala</option>
- <option value="Guinea">Guinea</option>
- <option value="Guinea-bissau">Guinea-bissau</option>
- <option value="Guyana">Guyana</option>
- <option value="Haiti">Haiti</option>
- <option value="Heard Island and Mcdonald Islands">Heard Island and Mcdonald Islands</option>
- <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
- <option value="Honduras">Honduras</option>
- <option value="Hong Kong">Hong Kong</option>
- <option value="Hungary">Hungary</option>
- <option value="Iceland">Iceland</option>
- <option value="India">India</option>
- <option value="Indonesia">Indonesia</option>
- <option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
- <option value="Iraq">Iraq</option>
- <option value="Ireland">Ireland</option>
- <option value="Israel">Israel</option>
- <option value="Italy">Italy</option>
- <option value="Jamaica">Jamaica</option>
- <option value="Japan">Japan</option>
- <option value="Jordan">Jordan</option>
- <option value="Kazakhstan">Kazakhstan</option>
- <option value="Kenya">Kenya</option>
- <option value="Kiribati">Kiribati</option>
- <option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
- <option value="Korea, Republic of">Korea, Republic of</option>
- <option value="Kuwait">Kuwait</option>
- <option value="Kyrgyzstan">Kyrgyzstan</option>
- <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
- <option value="Latvia">Latvia</option>
- <option value="Lebanon">Lebanon</option>
- <option value="Lesotho">Lesotho</option>
- <option value="Liberia">Liberia</option>
- <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
- <option value="Liechtenstein">Liechtenstein</option>
- <option value="Lithuania">Lithuania</option>
- <option value="Luxembourg">Luxembourg</option>
- <option value="Macao">Macao</option>
- <option value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option>
- <option value="Madagascar">Madagascar</option>
- <option value="Malawi">Malawi</option>
- <option value="Malaysia">Malaysia</option>
- <option value="Maldives">Maldives</option>
- <option value="Mali">Mali</option>
- <option value="Malta">Malta</option>
- <option value="Marshall Islands">Marshall Islands</option>
- <option value="Martinique">Martinique</option>
- <option value="Mauritania">Mauritania</option>
- <option value="Mauritius">Mauritius</option>
- <option value="Mayotte">Mayotte</option>
- <option value="Mexico">Mexico</option>
- <option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
- <option value="Moldova, Republic of">Moldova, Republic of</option>
- <option value="Monaco">Monaco</option>
- <option value="Mongolia">Mongolia</option>
- <option value="Montserrat">Montserrat</option>
- <option value="Morocco">Morocco</option>
- <option value="Mozambique">Mozambique</option>
- <option value="Myanmar">Myanmar</option>
- <option value="Namibia">Namibia</option>
- <option value="Nauru">Nauru</option>
- <option value="Nepal">Nepal</option>
- <option value="Netherlands">Netherlands</option>
- <option value="Netherlands Antilles">Netherlands Antilles</option>
- <option value="New Caledonia">New Caledonia</option>
- <option value="New Zealand">New Zealand</option>
- <option value="Nicaragua">Nicaragua</option>
- <option value="Niger">Niger</option>
- <option value="Nigeria">Nigeria</option>
- <option value="Niue">Niue</option>
- <option value="Norfolk Island">Norfolk Island</option>
- <option value="Northern Mariana Islands">Northern Mariana Islands</option>
- <option value="Norway">Norway</option>
- <option value="Oman">Oman</option>
- <option value="Pakistan">Pakistan</option>
- <option value="Palau">Palau</option>
- <option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
- <option value="Panama">Panama</option>
- <option value="Papua New Guinea">Papua New Guinea</option>
- <option value="Paraguay">Paraguay</option>
- <option value="Peru">Peru</option>
- <option value="Philippines">Philippines</option>
- <option value="Pitcairn">Pitcairn</option>
- <option value="Poland">Poland</option>
- <option value="Portugal">Portugal</option>
- <option value="Puerto Rico">Puerto Rico</option>
- <option value="Qatar">Qatar</option>
- <option value="Reunion">Reunion</option>
- <option value="Romania">Romania</option>
- <option value="Russian Federation">Russian Federation</option>
- <option value="Rwanda">Rwanda</option>
- <option value="Saint Helena">Saint Helena</option>
- <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
- <option value="Saint Lucia">Saint Lucia</option>
- <option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
- <option value="Saint Vincent and The Grenadines">Saint Vincent and The Grenadines</option>
- <option value="Samoa">Samoa</option>
- <option value="San Marino">San Marino</option>
- <option value="Sao Tome and Principe">Sao Tome and Principe</option>
- <option value="Saudi Arabia">Saudi Arabia</option>
- <option value="Senegal">Senegal</option>
- <option value="Serbia and Montenegro">Serbia and Montenegro</option>
- <option value="Seychelles">Seychelles</option>
- <option value="Sierra Leone">Sierra Leone</option>
- <option value="Singapore">Singapore</option>
- <option value="Slovakia">Slovakia</option>
- <option value="Slovenia">Slovenia</option>
- <option value="Solomon Islands">Solomon Islands</option>
- <option value="Somalia">Somalia</option>
- <option value="South Africa">South Africa</option>
- <option value="South Georgia and The South Sandwich Islands">South Georgia and The South Sandwich Islands</option>
- <option value="Spain">Spain</option>
- <option value="Sri Lanka">Sri Lanka</option>
- <option value="Sudan">Sudan</option>
- <option value="Suriname">Suriname</option>
- <option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
- <option value="Swaziland">Swaziland</option>
- <option value="Sweden">Sweden</option>
- <option value="Switzerland">Switzerland</option>
- <option value="Syrian Arab Republic">Syrian Arab Republic</option>
- <option value="Taiwan, Province of China">Taiwan, Province of China</option>
- <option value="Tajikistan">Tajikistan</option>
- <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
- <option value="Thailand">Thailand</option>
- <option value="Timor-leste">Timor-leste</option>
- <option value="Togo">Togo</option>
- <option value="Tokelau">Tokelau</option>
- <option value="Tonga">Tonga</option>
- <option value="Trinidad and Tobago">Trinidad and Tobago</option>
- <option value="Tunisia">Tunisia</option>
- <option value="Turkey">Turkey</option>
- <option value="Turkmenistan">Turkmenistan</option>
- <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
- <option value="Tuvalu">Tuvalu</option>
- <option value="Uganda">Uganda</option>
- <option value="Ukraine">Ukraine</option>
- <option value="United Arab Emirates">United Arab Emirates</option>
- <option value="United Kingdom">United Kingdom</option>
- <option value="United States">United States</option>
- <option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
- <option value="Uruguay">Uruguay</option>
- <option value="Uzbekistan">Uzbekistan</option>
- <option value="Vanuatu">Vanuatu</option>
- <option value="Venezuela">Venezuela</option>
- <option value="Viet Nam">Viet Nam</option>
- <option value="Virgin Islands, British">Virgin Islands, British</option>
- <option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
- <option value="Wallis and Futuna">Wallis and Futuna</option>
- <option value="Western Sahara">Western Sahara</option>
- <option value="Yemen">Yemen</option>
- <option value="Zambia">Zambia</option>
- <option value="Zimbabwe">Zimbabwe</option>
- </select>
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div"> </div>
- <div class="personal_input">
- <!--<a href="#"><img border="0" src="static/images/no_pre.jpg" class="no_img" alt=""></a> -->
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Update Photo</div>
- <div class="personal_input"><input type="file" name="photo" class="careers_input"></div>
- </div>
- </fieldset>
- </div>
- <?php if($_POST['user_role']==1){?>
- <fieldset class="fldset"><legend><strong>Account Details</strong></legend>
- <div class="c_f_tree">
- <div class="r_a_e_div">Email</div>
- <div class="careers_input">
- <input type="text" class="careers_input" name="email">
- <?php echo $emailError;?>
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Confirm Email</div>
- <div class="careers_input"><input type="text" class="careers_input" name="email1"><?php echo $emailError;?></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Password</div>
- <div class="careers_input"><input type="password" class="careers_input" name="password"><?php echo $pwdError;?></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Confirm New Password</div>
- <div class="careers_input"><input type="password" class="careers_input" name="password1"><?php echo $pwdError;?></div>
- </div>
- </fieldset>
- </div>
- <div class="r_a_e">
- <fieldset class="fldset"><legend><strong>Details</strong></legend>
- <div class="c_f_tree">
- <div class="r_a_e_div">Salutation</div>
- <div class="careers_input">
- <input type="text" class="careers_input" name="salutation" size="8">
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">First Name *</div>
- <div class="careers_input">
- <input type="text" class="careers_input" name="first_name">
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Middle Name</div>
- <div class="careers_input"><input type="text" class="careers_input" name="middle_name"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Last Name *</div>
- <div class="careers_input"><input type="text" class="careers_input" name="last_name"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Pronunciation </div>
- <div class="careers_input"><input type="text" class="careers_input" name="pronunciation"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Suffix </div>
- <div class="careers_input"><input type="text" class="careers_input" name="suffix" size="8"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Preferred Name </div>
- <div class="careers_input"><input type="text" class="careers_input" name="preferred_name" ></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Street Address</div>
- <div class="personal_input"><input type="text" class="personal_input" name="street1"></div>
- <div class="personal_input"><input type="text" class="personal_input" name="street2"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Postal Box</div>
- <div class="careers_input"><input type="text" class="careers_input" name="postal_box"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">City *</div>
- <div class="careers_input"><input type="text" class="careers_input" name="city"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Phone</div>
- <div class="careers_input"><input type="text" class="careers_input" name="phone"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Company</div>
- <div class="careers_input"><input type="text" class="careers_input" name="company"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">U.S state</div>
- <div class="personal_input">
- <select name="city" class="" id="departCity_dom1" commonvalid="departDest_dom1">
- <option value="0">---Select City---</option>
- <option value="BLR">Bangalore</option>
- <option value="MAA">Chennai</option>
- <option value="DEL">New Delhi</option>
- <option value="GOI">Goa</option>
- <option value="HYD">Hyderabad</option>
- <option value="CCU">Kolkata</option>
- <option value="BOM">Mumbai</option>
- <option value="PNQ">Pune</option>
- <option value="">------------------------</option>
- <option value="IXA">Agartala</option>
- <option value="AGX">Agatti Island</option>
- <option value="AGR">Agra</option>
- <option value="AMD">Ahmedabad</option>
- <option value="AJL">Aizawl</option>
- <option value="IXD">Allahabad</option>
- <option value="ATQ">Amritsar</option>
- <option value="IXU">Aurangabad</option>
- <option value="IXB">Bagdogra</option>
- <option value="BLR">Bangalore</option>
- <option value="IXG">Belgaum</option>
- <option value="BEP">Bellary</option>
- <option value="BLR">Bengaluru</option>
- <option value="BHU">Bhavnagar</option>
- <option value="BHO">Bhopal</option>
- <option value="BBI">Bhubaneshwar</option>
- <option value="BHJ">Bhuj</option>
- <option value="BKB">Bikaner</option>
- <option value="BOM">Bombay</option>
- <option value="CCU">Calcutta</option>
- <option value="CCJ">Calicut</option>
- <option value="IXC">Chandigarh</option>
- <option value="MAA">Chennai</option>
- <option value="COK">Cochin</option>
- <option value="CJB">Coimbatore</option>
- <option value="DED">Dehradun</option>
- <option value="DEL">Delhi</option>
- <option value="DHM">Dharamshala</option>
- <option value="DIB">Dibrugarh</option>
- <option value="DMU">Dimapur</option>
- <option value="DIU">Diu</option>
- <option value="GAY">Gaya</option>
- <option value="GOI">Goa</option>
- <option value="GOP">Gorakhpur</option>
- <option value="GAU">Guwahati</option>
- <option value="GWL">Gwalior</option>
- <option value="HBX">Hubli</option>
- <option value="HYD">Hyderabad</option>
- <option value="IMF">Imphal</option>
- <option value="IDR">Indore</option>
- <option value="JLR">Jabalpur</option>
- <option value="JGB">Jagdalpur</option>
- <option value="JAI">Jaipur</option>
- <option value="IXJ">Jammu</option>
- <option value="JGA">Jamnagar</option>
- <option value="IXW">Jamshedpur</option>
- <option value="VDY">Jindal Vidyanagar</option>
- <option value="JDH">Jodhpur</option>
- <option value="JRH">Jorhat</option>
- <option value="IXY">Kandla</option>
- <option value="KNU">Kanpur</option>
- <option value="HJR">Khajuraho</option>
- <option value="COK">Kochi</option>
- <option value="KLH">Kolhapur</option>
- <option value="CCU">Kolkata</option>
- <option value="KUU">Kulu</option>
- <option value="LTU">Latur</option>
- <option value="IXL">Leh</option>
- <option value="IXI">Lilabari</option>
- <option value="LKO">Lucknow</option>
- <option value="LUH">Ludhiana</option>
- <option value="MAA">Madras</option>
- <option value="IXM">Madurai</option>
- <option value="IXE">Mangalore</option>
- <option value="BOM">Mumbai</option>
- <option value="MYQ">Mysore</option>
- <option value="NAG">Nagpur</option>
- <option value="NDC">Nanded</option>
- <option value="ISK">Nasik</option>
- <option value="DEL">New Delhi</option>
- <option value="PGH">Pantnagar</option>
- <option value="IXP">Pathankot</option>
- <option value="PAT">Patna</option>
- <option value="PBD">Porbandar</option>
- <option value="IXZ">Port Blair</option>
- <option value="PNQ">Pune</option>
- <option value="RPR">Raipur</option>
- <option value="RJA">Rajahmundry</option>
- <option value="RAJ">Rajkot</option>
- <option value="IXR">Ranchi</option>
- <option value="SXV">Salem</option>
- <option value="SHL">Shillong</option>
- <option value="SLV">Shimla</option>
- <option value="SSE">Sholapur</option>
- <option value="IXS">Silchar</option>
- <option value="SXR">Srinagar</option>
- <option value="STV">Surat</option>
- <option value="TEZ">Tezpur</option>
- <option value="TRV">Thiruvananthapuram</option>
- <option value="TRZ">Tiruchirapally</option>
- <option value="TIR">Tirupati</option>
- <option value="TRZ">Trichy</option>
- <option value="TRV">Trivandrum</option>
- <option value="TCR">Tuticorin</option>
- <option value="UDR">Udaipur</option>
- <option value="BDQ">Vadodara</option>
- <option value="VNS">Varanasi</option>
- <option value="VGA">Vijayawada</option>
- <option value="VTZ">Vishakhapatnam</option>
- <option value="VTZ">Vizag</option>
- </select>
- </div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Province/Region</div>
- <div class="careers_input"><input type="text" class="careers_input" name="prov_region"></div>
- </div>
- <div class="c_f_tree">
- <div class="r_a_e_div">Country</div>
- <div class="personal_input">
- <select name="country">
- <option selected="selected" value="0">Select Country</option>
- <option value="United States">United States</option>
- <option value="United Kingdom">United Kingdom</option>
- <option value="Afghanistan">Afghanistan</option>
- <option value="Albania">Albania</option>
- <option value="Algeria">Algeria</option>
- <option value="American Samoa">American Samoa</option>
- <option value="Andorra">Andorra</option>
- <option value="Angola">Angola</option>
- <option value="Anguilla">Anguilla</option>
- <option value="Antarctica">Antarctica</option>
- <option value="Antigua and Barbuda">Antigua and Barbuda</option>
- <option value="Argentina">Argentina</option>
- <option value="Armenia">Armenia</option>
- <option value="Aruba">Aruba</option>
- <option value="Australia">Australia</option>
- <option value="Austria">Austria</option>
- <option value="Azerbaijan">Azerbaijan</option>
- <option value="Bahamas">Bahamas</option>
- <option value="Bahrain">Bahrain</option>
- <option value="Bangladesh">Bangladesh</option>
- <option value="Barbados">Barbados</option>
- <option value="Belarus">Belarus</option>
- <option value="Belgium">Belgium</option>
- <option value="Belize">Belize</option>
- <option value="Benin">Benin</option>
- <option value="Bermuda">Bermuda</option>
- <option value="Bhutan">Bhutan</option>
- <option value="Bolivia">Bolivia</option>
- <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
- <option value="Botswana">Botswana</option>
- <option value="Bouvet Island">Bouvet Island</option>
- <option value="Brazil">Brazil</option>
- <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
- <option value="Brunei Darussalam">Brunei Darussalam</option>
- <option value="Bulgaria">Bulgaria</option>
- <option value="Burkina Faso">Burkina Faso</option>
- <option value="Burundi">Burundi</option>
- <option value="Cambodia">Cambodia</option>
- <option value="Cameroon">Cameroon</option>
- <option value="Canada">Canada</option>
- <option value="Cape Verde">Cape Verde</option>
- <option value="Cayman Islands">Cayman Islands</option>
- <option value="Central African Republic">Central African Republic</option>
- <option value="Chad">Chad</option>
- <option value="Chile">Chile</option>
- <option value="China">China</option>
- <option value="Christmas Island">Christmas Island</option>
- <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
- <option value="Colombia">Colombia</option>
- <option value="Comoros">Comoros</option>
- <option value="Congo">Congo</option>
- <option value="Congo, The Democratic Republic of The">Congo, The Democratic Republic of The</option>
- <option value="Cook Islands">Cook Islands</option>
- <option value="Costa Rica">Costa Rica</option>
- <option value="Cote D'ivoire">Cote D'ivoire</option>
- <option value="Croatia">Croatia</option>
- <option value="Cuba">Cuba</option>
- <option value="Cyprus">Cyprus</option>
- <option value="Czech Republic">Czech Republic</option>
- <option value="Denmark">Denmark</option>
- <option value="Djibouti">Djibouti</option>
- <option value="Dominica">Dominica</option>
- <option value="Dominican Republic">Dominican Republic</option>
- <option value="Ecuador">Ecuador</option>
- <option value="Egypt">Egypt</option>
- <option value="El Salvador">El Salvador</option>
- <option value="Equatorial Guinea">Equatorial Guinea</option>
- <option value="Eritrea">Eritrea</option>
- <option value="Estonia">Estonia</option>
- <option value="Ethiopia">Ethiopia</option>
- <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
- <option value="Faroe Islands">Faroe Islands</option>
- <option value="Fiji">Fiji</option>
- <option value="Finland">Finland</option>
- <option value="France">France</option>
- <option value="French Guiana">French Guiana</option>
- <option value="French Polynesia">French Polynesia</option>
- <option value="French Southern Territories">French Southern Territories</option>
- <option value="Gabon">Gabon</option>
- <option value="Gambia">Gambia</option>
- <option value="Georgia">Georgia</option>
- <option value="Germany">Germany</option>
- <option value="Ghana">Ghana</option>
- <option value="Gibraltar">Gibraltar</option>
- <option value="Greece">Greece</option>
- <option value="Greenland">Greenland</option>
- <option value="Grenada">Grenada</option>
- <option value="Guadeloupe">Guadeloupe</option>
- <option value="Guam">Guam</option>
- <option value="Guatemala">Guatemala</option>
- <option value="Guinea">Guinea</option>
- <option value="Guinea-bissau">Guinea-bissau</option>
- <option value="Guyana">Guyana</option>
- <option value="Haiti">Haiti</option>
- <option value="Heard Island and Mcdonald Islands">Heard Island and Mcdonald Islands</option>
- <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
- <option value="Honduras">Honduras</option>
- <option value="Hong Kong">Hong Kong</option>
- <option value="Hungary">Hungary</option>
- <option value="Iceland">Iceland</option>
- <option value="India">India</option>
- <option value="Indonesia">Indonesia</option>
- <option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
- <option value="Iraq">Iraq</option>
- <option value="Ireland">Ireland</option>
- <option value="Israel">Israel</option>
- <option value="Italy">Italy</option>
- <option value="Jamaica">Jamaica</option>
- <option value="Japan">Japan</option>
- <option value="Jordan">Jordan</option>
- <option value="Kazakhstan">Kazakhstan</option>
- <option value="Kenya">Kenya</option>
- <option value="Kiribati">Kiribati</option>
- <option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
- <option value="Korea, Republic of">Korea, Republic of</option>
- <option value="Kuwait">Kuwait</option>
- <option value="Kyrgyzstan">Kyrgyzstan</option>
- <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
- <option value="Latvia">Latvia</option>
- <option value="Lebanon">Lebanon</option>
- <option value="Lesotho">Lesotho</option>
- <option value="Liberia">Liberia</option>
- <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
- <option value="Liechtenstein">Liechtenstein</option>
- <option value="Lithuania">Lithuania</option>
- <option value="Luxembourg">Luxembourg</option>
- <option value="Macao">Macao</option>
- <option value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option>
- <option value="Madagascar">Madagascar</option>
- <option value="Malawi">Malawi</option>
- <option value="Malaysia">Malaysia</option>
- <option value="Maldives">Maldives</option>
- <option value="Mali">Mali</option>
- <option value="Malta">Malta</option>
- <option value="Marshall Islands">Marshall Islands</option>
- <option value="Martinique">Martinique</option>
- <option value="Mauritania">Mauritania</option>
- <option value="Mauritius">Mauritius</option>
- <option value="Mayotte">Mayotte</option>
- <option value="Mexico">Mexico</option>
- <option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
- <option value="Moldova, Republic of">Moldova, Republic of</option>
- <option value="Monaco">Monaco</option>
- <option value="Mongolia">Mongolia</option>
- <option value="Montserrat">Montserrat</option>
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