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- <!--view register_online_step_1-->
- <?php echo validation_errors(); ?>
- <?php
- echo form_open("online_registration/cstep_1/submit");
- echo form_hidden('step',1);
- ?>
- <div style="margin:0;padding:0;display:inline">
- <input name="_method" type="hidden" value="put" />
- <input name="authenticity_token" type="hidden" value="GDAdB83svR2Fk7x02LxZ6iZy0I90d7JVM8TICeV7MsI=" />
- </div>
- <div class="toolbar">
- <button class="blue" value="Save">
- <span>Save</span>
- </button>
- <div class="clear"></div>
- </div>
- <div class="tabbar">
- <ul>
- <li>
- <a href="#" rel="personal_information">Personal information</a>
- </li>
- <li>
- <a href="#" rel="singapore_address">Singapore address</a>
- </li>
- <li>
- <a href="#" rel="overseas_address">Overseas address</a>
- </li>
- </ul>
- <div class="clear"></div>
- </div>
- <div class="detail">
- <div class="section" id="personal_information">
- <hr/>
- <fieldset>
- <legend>
- <span>Personal information</span>
- </legend>
- <ul>
- <li>
- <span style="width: 50%;">
- <?php
- echo form_label('First name', 'enrollment_first_name',array('class' => 'main'));
- $enrollment_first_name = array("name" => "enrollment_first_name","id" => "enrollment_first_name","maxlength" => "255","size" => "30");
- echo form_input($enrollment_first_name);
- echo form_label('Last name', 'enrollment_last_name',array('class' => 'main'));
- $enrollment_last_name = array("name" => "enrollment_last_name","id" => "enrollment_last_name","maxlength" => "255","size" => "30");
- echo form_input($enrollment_last_name);
- echo form_label('Chinese name', 'enrollment_chinese_name',array('class' => 'main'));
- $enrollment_chinese_name = array("name" => "enrollment_chinese_name","id" => "enrollment_chinese_name","maxlength" => "255","size" => "30");
- echo form_input($enrollment_chinese_name);
- echo form_label('Citizenship', 'enrollment_citizenship',array('class' => 'main'));
- $enrollment_citizenship = array("name" => "enrollment_citizenship","id" => "enrollment_citizenship","maxlength" => "255","size" => "30");
- echo form_input($enrollment_citizenship);
- echo form_label('Passport/ FIN No', 'enrollment_passport_fin_no',array('class' => 'main'));
- $enrollment_passport_fin_no = array("name" => "enrollment_passport_fin_no","id" => "enrollment_passport_fin_no","maxlength" => "255","size" => "30");
- echo form_input($enrollment_passport_fin_no);
- echo form_label('NRIC', 'enrollment_nric',array('class' => 'main'));
- $enrollment_nric = array("name" => "enrollment_nric","id" => "enrollment_nric","maxlength" => "255","size" => "30");
- echo form_input($enrollment_nric);
- echo form_label('Religion', 'enrollment_religion',array('class' => 'main'));
- $religion_option = array(
- "Christianity"=>"Christianity",
- "Buddhism"=>"Buddhism",
- "Hinduism"=>"Hinduism",
- "Islam"=>"Islam",
- "Other"=>"Other");
- echo form_dropdown("enrollment_religion", $religion_option, "Christianity");
- echo form_label('Gender', 'enrollment_gender',array('class' => 'main'));
- $enrollment_gender = array("name" => "enrollment_gender","id" => "enrollment_gender","value" => "male");
- echo "<p>". form_radio($enrollment_gender). "male";
- echo "       ";
- $enrollment_gender = array("name" => "enrollment_gender","id" => "enrollment_gender","value" => "female");
- echo form_radio($enrollment_gender). "female" . "</p>";
- echo form_label('Marital status', 'enrollment_marital',array('class' => 'main'));
- $enrollment_marital = array("name" => "enrollment_marital","id" => "enrollment_marital","value" => "single");
- echo "<p>". form_radio($enrollment_marital). "single";
- echo "       ";
- $enrollment_marital = array("name" => "enrollment_marital","id" => "enrollment_marital","value" => "married");
- echo form_radio($enrollment_marital). "married" . "</p>";
- echo form_label('Date of birth', 'enrollment_dob',array('class' => 'main'));
- $enrollment_dob = array("name" => "enrollment_dob","id" => "enrollment_dob","maxlength" => "255","size" => "30");
- echo form_input($enrollment_dob);
- echo form_label('Race', 'enrollment_race',array('class' => 'main'));
- $enrollment_race = array("name" => "enrollment_race","id" => "enrollment_race","maxlength" => "255","size" => "30");
- echo form_input($enrollment_race);
- ?>
- </span>
- <div class="clear"></div>
- </li>
- </ul>
- </fieldset>
- </div>
- <div class="section" id="singapore_address">
- <hr />
- <fieldset>
- <legend>
- <span>Singapore address</span>
- </legend>
- <ul>
- <li>
- <span style="width: 50%;">
- <?php
- echo form_label('Block', 'sg_address_block',array('class' => 'main'));
- $sg_address_block = array("name" => "sg_address_block","id" => "sg_address_block","maxlength" => "255","size" => "30");
- echo form_input($sg_address_block);
- echo form_label('Street', 'sg_address_street',array('class' => 'main'));
- $sg_address_street = array("name" => "sg_address_street","id" => "sg_address_street","maxlength" => "255","size" => "30");
- echo form_input($sg_address_street);
- echo form_label('Unit', 'sg_address_unit',array('class' => 'main'));
- $sg_address_unit = array("name" => "sg_address_unit","id" => "sg_address_unit","maxlength" => "255","size" => "30");
- echo form_input($sg_address_unit);
- echo form_label('Building', 'sg_address_building',array('class' => 'main'));
- $sg_address_building = array("name" => "sg_address_building","id" => "sg_address_building","maxlength" => "255","size" => "30");
- echo form_input($sg_address_building);
- echo form_label('Post code', 'sg_address_post_code',array('class' => 'main'));
- $sg_address_post_code = array("name" => "sg_address_post_code","id" => "sg_address_post_code","maxlength" => "255","size" => "30");
- echo form_input($sg_address_post_code);
- echo form_label('Telephone', 'sg_address_telephone',array('class' => 'main'));
- $sg_address_telephone = array("name" => "sg_address_telephone","id" => "sg_address_telephone","maxlength" => "255","size" => "30");
- echo form_input($sg_address_telephone);
- echo form_label('Handphone', 'sg_address_handphone',array('class' => 'main'));
- $sg_address_handphone = array("name" => "sg_address_handphone","id" => "sg_address_handphone","maxlength" => "255","size" => "30");
- echo form_input($sg_address_handphone);
- echo form_label('Email', 'sg_address_email',array('class' => 'main'));
- $sg_address_email = array("name" => "sg_address_email","id" => "sg_address_email","maxlength" => "255","size" => "30");
- echo form_input($sg_address_email);
- ?>
- </span>
- <div class="clear"></div>
- </li>
- </ul>
- </fieldset>
- </div>
- <div class="section" id="overseas_address">
- <hr />
- <fieldset>
- <legend>
- <span>Overseas address</span>
- </legend>
- <ul>
- <li>
- <span style="width: 50%;">
- <?php
- echo form_label('Address', 'overseas_address_address',array('class' => 'main'));
- $overseas_address_address = array("name" => "overseas_address_address","id" => "overseas_address_address","maxlength" => "255","size" => "30");
- echo form_input($overseas_address_address);
- echo form_label('City', 'overseas_address_city',array('class' => 'main'));
- $overseas_address_city = array("name" => "overseas_address_city","id" => "overseas_address_city","maxlength" => "255","size" => "30");
- echo form_input($overseas_address_city);
- echo form_label('State', 'overseas_address_state',array('class' => 'main'));
- $overseas_address_state = array("name" => "overseas_address_state","id" => "overseas_address_state","maxlength" => "255","size" => "30");
- echo form_input($overseas_address_state);
- echo form_label('Province', 'overseas_address_province',array('class' => 'main'));
- $overseas_address_province = array("name" => "overseas_address_province","id" => "overseas_address_province","maxlength" => "255","size" => "30");
- echo form_input($overseas_address_province);
- echo form_label('Country', 'overseas_address_country',array('class' => 'main'));
- $country_option = array(
- "AF"=>"Afghanistan",
- "AL"=>"Albania",
- "DZ"=>"Algeria",
- "AD"=>"Andorra",
- "AO"=>"Angola",
- "AI"=>"Anguilla",
- "AQ"=>"Antarctica",
- "AG"=>"Antigua and Barbuda",
- "AR"=>"Argentina",
- "AM"=>"Armenia",
- "AW"=>"Aruba",
- "AU"=>"Australia",
- "AT"=>"Austria",
- "AZ"=>"Azerbaijan",
- "BS"=>"Bahamas",
- "BH"=>"Bahrain",
- "BD"=>"Bangladesh",
- "BB"=>"Barbados",
- "BY"=>"Belarus",
- "BE"=>"Belgium",
- "BZ"=>"Belize",
- "BJ"=>"Benin",
- "BM"=>"Bermuda",
- "BT"=>"Bhutan",
- "BO"=>"Bolivia",
- "BA"=>"Bosnia and Herzegovina",
- "BW"=>"Botswana",
- "BR"=>"Brazil",
- "IO"=>"British Indian Ocean",
- "BN"=>"Brunei",
- "BG"=>"Bulgaria",
- "BF"=>"Burkina Faso",
- "BI"=>"Burundi",
- "KH"=>"Cambodia",
- "CM"=>"Cameroon",
- "CA"=>"Canada",
- "CV"=>"Cape Verde",
- "KY"=>"Cayman Islands",
- "CF"=>"Central African Republic",
- "TD"=>"Chad",
- "CL"=>"Chile",
- "CN"=>"China",
- "CX"=>"Christmas Island",
- "CC"=>"Cocos (Keeling) Islands",
- "CO"=>"Colombia",
- "KM"=>"Comoros",
- "CD"=>"Congo, Democratic Republic of the",
- "CG"=>"Congo, Republic of the",
- "CK"=>"Cook Islands",
- "CR"=>"Costa Rica",
- "HR"=>"Croatia",
- "CY"=>"Cyprus",
- "CZ"=>"Czech Republic",
- "DK"=>"Denmark",
- "DJ"=>"Djibouti",
- "DM"=>"Dominica",
- "DO"=>"Dominican Republic",
- "TL"=>"East Timor",
- "EC"=>"Ecuador",
- "EG"=>"Egypt",
- "SV"=>"El Salvador",
- "GQ"=>"Equatorial Guinea",
- "ER"=>"Eritrea",
- "EE"=>"Estonia",
- "ET"=>"Ethiopia",
- "FK"=>"Falkland Islands (Malvinas)",
- "FO"=>"Faroe Islands",
- "FJ"=>"Fiji",
- "FI"=>"Finland",
- "FR"=>"France",
- "GF"=>"French Guiana",
- "PF"=>"French Polynesia",
- "GA"=>"Gabon",
- "GM"=>"Gambia",
- "GE"=>"Georgia",
- "DE"=>"Germany",
- "GH"=>"Ghana",
- "GI"=>"Gibraltar",
- "GR"=>"Greece",
- "GL"=>"Greenland",
- "GD"=>"Grenada",
- "GP"=>"Guadeloupe",
- "GT"=>"Guatemala",
- "GN"=>"Guinea",
- "GW"=>"Guinea-Bissau",
- "GY"=>"Guyana",
- "HT"=>"Haiti",
- "HN"=>"Honduras",
- "HK"=>"Hong Kong",
- "HU"=>"Hungary",
- "IS"=>"Iceland",
- "IN"=>"India",
- "ID"=>"Indonesia",
- "IE"=>"Ireland",
- "IL"=>"Israel",
- "IT"=>"Italy",
- "CI"=>"Ivory Coast (Côte d\'Ivoire)",
- "JM"=>"Jamaica",
- "JP"=>"Japan",
- "JO"=>"Jordan",
- "KZ"=>"Kazakhstan",
- "KE"=>"Kenya",
- "KI"=>"Kiribati",
- "KR"=>"Korea, South",
- "KW"=>"Kuwait",
- "KG"=>"Kyrgyzstan",
- "LA"=>"Laos",
- "LV"=>"Latvia",
- "LB"=>"Lebanon",
- "LS"=>"Lesotho",
- "LI"=>"Liechtenstein",
- "LT"=>"Lithuania",
- "LU"=>"Luxembourg",
- "MO"=>"Macau",
- "MK"=>"Macedonia, Republic of",
- "MG"=>"Madagascar",
- "MW"=>"Malawi",
- "MY"=>"Malaysia",
- "MV"=>"Maldives",
- "ML"=>"Mali",
- "MT"=>"Malta",
- "MH"=>"Marshall Islands",
- "MQ"=>"Martinique",
- "MR"=>"Mauritania",
- "MU"=>"Mauritius",
- "YT"=>"Mayotte",
- "MX"=>"Mexico",
- "FM"=>"Micronesia",
- "MD"=>"Moldova",
- "MC"=>"Monaco",
- "MN"=>"Mongolia",
- "ME"=>"Montenegro",
- "MS"=>"Montserrat",
- "MA"=>"Morocco",
- "MZ"=>"Mozambique",
- "NA"=>"Namibia",
- "NR"=>"Nauru",
- "NP"=>"Nepal",
- "NL"=>"Netherlands",
- "AN"=>"Netherlands Antilles",
- "NC"=>"New Caledonia",
- "NZ"=>"New Zealand",
- "NI"=>"Nicaragua",
- "NE"=>"Niger",
- "NG"=>"Nigeria",
- "NU"=>"Niue",
- "NF"=>"Norfolk Island",
- "NO"=>"Norway",
- "OM"=>"Oman",
- "PK"=>"Pakistan",
- "PS"=>"Palestinian Territory",
- "PA"=>"Panama",
- "PG"=>"Papua New Guinea",
- "PY"=>"Paraguay",
- "PE"=>"Peru",
- "PH"=>"Philippines",
- "PN"=>"Pitcairn Island",
- "PL"=>"Poland",
- "PT"=>"Portugal",
- "QA"=>"Qatar",
- "RE"=>"Réunion",
- "RO"=>"Romania",
- "RU"=>"Russia",
- "RW"=>"Rwanda",
- "SH"=>"Saint Helena",
- "KN"=>"Saint Kitts and Nevis",
- "LC"=>"Saint Lucia",
- "PM"=>"Saint Pierre and Miquelon",
- "VC"=>"Saint Vincent and the Grenadines",
- "WS"=>"Samoa",
- "SM"=>"San Marino",
- "ST"=>"São Tome and Principe",
- "SA"=>"Saudi Arabia",
- "SN"=>"Senegal",
- "RS"=>"Serbia",
- "CS"=>"Serbia and Montenegro",
- "SC"=>"Seychelles",
- "SL"=>"Sierra Leon",
- "SG"=>"Singapore",
- "SK"=>"Slovakia",
- "SI"=>"Slovenia",
- "SB"=>"Solomon Islands",
- "SO"=>"Somalia",
- "ZA"=>"South Africa",
- "GS"=>"South Georgia and the South Sandwich Islands",
- "ES"=>"Spain",
- "LK"=>"Sri Lanka",
- "SR"=>"Suriname",
- "SJ"=>"Svalbard and Jan Mayen",
- "SZ"=>"Swaziland",
- "SE"=>"Sweden",
- "CH"=>"Switzerland",
- "TW"=>"Taiwan",
- "TJ"=>"Tajikistan",
- "TZ"=>"Tanzania",
- "TH"=>"Thailand",
- "TG"=>"Togo",
- "TK"=>"Tokelau",
- "TO"=>"Tonga",
- "TT"=>"Trinidad and Tobago",
- "TN"=>"Tunisia",
- "TR"=>"Turkey",
- "TM"=>"Turkmenistan",
- "TC"=>"Turks and Caicos Islands",
- "TV"=>"Tuvalu",
- "UG"=>"Uganda",
- "UA"=>"Ukraine",
- "AE"=>"United Arab Emirates",
- "GB"=>"United Kingdom",
- "US"=>"United States",
- "UM"=>"United States Minor Outlying Islands",
- "UY"=>"Uruguay",
- "UZ"=>"Uzbekistan",
- "VU"=>"Vanuatu",
- "VA"=>"Vatican City",
- "VE"=>"Venezuela",
- "VN"=>"Vietnam",
- "VG"=>"Virgin Islands, British",
- "WF"=>"Wallis and Futuna",
- "EH"=>"Western Sahara",
- "YE"=>"Yemen",
- "ZM"=>"Zambia",
- "ZW"=>"Zimbabwe");
- echo form_dropdown("overseas_address_country", $country_option, "US");
- echo form_label('Postal code', 'overseas_address_postal_code',array('class' => 'main'));
- $overseas_address_postal_code = array("name" => "overseas_address_postal_code","id" => "overseas_address_postal_code","maxlength" => "255","size" => "30");
- echo form_input($overseas_address_postal_code);
- echo form_label('Telephone', 'overseas_address_telephone',array('class' => 'main'));
- $overseas_address_telephone = array("name" => "overseas_address_telephone","id" => "overseas_address_telephone","maxlength" => "255","size" => "30");
- echo form_input($overseas_address_telephone);
- ?>
- </span>
- <div class="clear"></div>
- </li>
- </ul>
- </fieldset>
- </div>
- </div>
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