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kuriyantoadi

tambah-siswa

kuriyantoadi
Apr 6th, 2020
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  1. <!DOCTYPE html>
  2. <html lang="en">
  3. <head>
  4.   <title>PPDB SMKN 1 Kragilan</title>
  5.   <meta charset="utf-8">
  6.   <meta name="viewport" content="width=device-width, initial-scale=1">
  7.   <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.1/css/bootstrap.min.css">
  8.   <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
  9.   <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.1/js/bootstrap.min.js"></script>
  10. </head>
  11. <body>
  12.  
  13. <div class="container">
  14.  
  15.   <div class="container-fluid">
  16.     <div class="row">
  17.         <div class="col-md-3">
  18.             <center><img class="img-fluid" alt="Bootstrap Image Preview" src="../../images/logo-smkn1.png" />
  19.         </div>
  20.         <div class="col-md-6">
  21.       <center><h3>Form Pendaftaran Calon Peserta Didik</h3></center>
  22.       <center><h3>SMK Negeri 1 Kragilan</h3></center>
  23.       <center><h3>Program Studi Rekayasa Perangkat Lunak</h3></center><br>
  24.         </div>
  25.         <div class="col-md-3">
  26.         </div>
  27.     </div>
  28. </div>
  29.  
  30.   <form class="form-horizontal" action="tambah-rpl.php" method="post" enctype="multipart/form-data">
  31.     <div class="form-group">
  32.       <label class="control-label col-sm-2" for="email">Nomor Pendaftaran :</label>
  33.       <div class="col-sm-6">
  34.         <input type="text" class="form-control" name="nomor_pendaftaran" value="" >
  35.       </div>
  36.     </div>
  37.     <div class="form-group">
  38.       <label class="control-label col-sm-2" for="email">Tanggal Pendaftaran :</label>
  39.       <div class="col-sm-6">
  40.         <input type="text" class="form-control" name="tgl_pendfataran" value="<?php echo date('d-m-Y'); ?>" readonly>
  41.       </div>
  42.     </div>
  43.     <div class="form-group">
  44.       <label class="control-label col-sm-2" for="email">Kompetensi Keahlian :</label>
  45.       <div class="col-sm-6">
  46.         <input type="text" class="form-control"   placeholder=" " name="kompetensi_keahlian" value="Rekayasa Perangkat Lunak" readonly>
  47.       </div>
  48.     </div>
  49.  
  50.     <br><h4>A. DATA ASAL SEKOLAH CALON PESERTA DIDIK</h4>
  51.     <div class="form-group">
  52.       <label class="control-label col-sm-2" for="email">Nama Asal Sekolah :</label>
  53.       <div class="col-sm-6">
  54.         <input type="text" class="form-control"   placeholder="Nama Asal Sekolah" name="asal_sekolah">
  55.       </div>
  56.     </div>
  57.     <div class="form-group">
  58.       <label class="control-label col-sm-2" for="email">NPSN Sekolah Asal :</label>
  59.       <div class="col-sm-6">
  60.         <input type="number" class="form-control"   placeholder="NPSN Sekolah Asal" name="npsn_sekolah">
  61.       </div>
  62.     </div>
  63.  
  64.     <br><h4>B. IDENTITAS CALON PESERTA DIDIK</h4>
  65.     <div class="form-group">
  66.       <label class="control-label col-sm-2" for="email">NISN :</label>
  67.       <div class="col-sm-6">
  68.         <input type="number" class="form-control"   placeholder="NISN" name="nisn">
  69.       </div>
  70.     </div>
  71.     <div class="form-group">
  72.       <label class="control-label col-sm-2" for="email">Nama Calon Peserta Didik :</label>
  73.       <div class="col-sm-6">
  74.         <input type="text" class="form-control"   placeholder="Nama" name="nama_siswa">
  75.       </div>
  76.     </div>
  77.     <div class="form-group">
  78.       <label class="control-label col-sm-2" for="email">Jenis Kelamin :</label>
  79.       <div class="col-sm-2">
  80.         <select name="jenis_kelamin" class="form-control" id="exampleFormControlSelect1">
  81.               <option value="laki-laki">Laki-laki</option>
  82.               <option value="perempuan">Perempuan</option>
  83.             </select>
  84.      </div>
  85.     </div>
  86.     <div class="form-group">
  87.       <label class="control-label col-sm-2" for="email">Tempat Lahir :</label>
  88.       <div class="col-sm-6">
  89.         <input type="text" class="form-control"   placeholder="Tempat Lahir" name="tempat_lahir">
  90.       </div>
  91.     </div>
  92.     <div class="form-group">
  93.       <label class="control-label col-sm-2" for="email">Tanggal Lahir :</label>
  94.       <div class="col-sm-3">
  95.         <input type="date" class="form-control" name="tgl_lahir">
  96.       </div>
  97.       (Bulan/Tanggal/Tahun)
  98.     </div>
  99.     <div class="form-group">
  100.       <label class="control-label col-sm-2" for="email">Tahun lulus :</label>
  101.       <div class="col-sm-6">
  102.         <input type="number" class="form-control"   placeholder="Tahun lulus" name="tahun_lulus">
  103.       </div>
  104.     </div>
  105.  
  106.     <br><h4>C. KEPENDUDUKAN CALON PESERTA DIDIK</h4>
  107.     <div class="form-group">
  108.       <label class="control-label col-sm-2" for="email">NIK :</label>
  109.       <div class="col-sm-6">
  110.         <input type="number" class="form-control"   placeholder="NIK siswa dari KK" name="nik">
  111.       </div>
  112.     </div>
  113.     <div class="form-group">
  114.       <label class="control-label col-sm-2" for="email">Nomor Kartu keluarga (KK) :</label>
  115.       <div class="col-sm-6">
  116.         <input type="number" class="form-control"   placeholder="Nomor KK" name="no_kk">
  117.       </div>
  118.     </div>
  119.     <div class="form-group">
  120.       <label class="control-label col-sm-2" for="email">Tanggl Diterbitkan KK :</label>
  121.       <div class="col-sm-3">
  122.         <input type="date" class="form-control"   placeholder="Tanggal KK terbit" name="tgl_kk">
  123.       </div>
  124.       (Bulan/Tanggal/Tahun)
  125.     </div>
  126.  
  127.     <br><h4>D. DATA ALAMAT TEMPAT TINGGAL SESUAI KK CALON PESERTA DIDIK</h4>
  128.     <div class="form-group">
  129.       <label class="control-label col-sm-2" for="email">Kabupaten/Kota :</label>
  130.       <div class="col-sm-6">
  131.         <input type="text" class="form-control"   placeholder="Kabupaten/Kota" name="kota">
  132.       </div>
  133.     </div>
  134.     <div class="form-group">
  135.       <label class="control-label col-sm-2" for="email">Kecamatan :</label>
  136.       <div class="col-sm-6">
  137.         <input type="text" class="form-control"   placeholder="Kecamatan" name="kecamatan">
  138.       </div>
  139.     </div>
  140.     <div class="form-group">
  141.       <label class="control-label col-sm-2" for="email">Kelurahan/Desa :</label>
  142.       <div class="col-sm-6">
  143.         <input type="text" class="form-control"   placeholder="Kelurahan/Desa" name="kelurahan">
  144.       </div>
  145.     </div>
  146.     <div class="form-group">
  147.       <label class="control-label col-sm-2" for="email">Kode POS :</label>
  148.       <div class="col-sm-6">
  149.         <input type="number" class="form-control"   placeholder="Kode POS" name="kode_pos">
  150.       </div>
  151.     </div>
  152.     <div class="form-group">
  153.       <label class="control-label col-sm-2" for="email">Alamat :</label>
  154.       <div class="col-sm-6">
  155.         <input type="text" class="form-control"   placeholder="Alamat" name="alamat">
  156.       </div>
  157.     </div>
  158.     <div class="form-group">
  159.       <label class="control-label col-sm-2" for="email">RT :</label>
  160.       <div class="col-sm-6">
  161.         <input type="number" class="form-control"   placeholder="RT" name="rt">
  162.       </div>
  163.     </div>
  164.     <div class="form-group">
  165.       <label class="control-label col-sm-2" for="email">RW :</label>
  166.       <div class="col-sm-6">
  167.         <input type="number" class="form-control"   placeholder="RW" name="rw">
  168.       </div>
  169.     </div>
  170.     <div class="form-group">
  171.       <label class="control-label col-sm-2" for="email">Jarak Alamat Siswa ke Sekolah :</label><b>Meter</b>
  172.       <div class="col-sm-4">
  173.         <input type="number" class="form-control"   placeholder="Jarak Rumah Ke Sekolah" name="jarak_kesekolah">
  174.       </div>
  175.     </div>
  176.     <h6><b>Informasi</h6>
  177.     <h6>1. Jarak alamat siswa ke sekolah bisa dicek dengan google maps</h6>
  178.     <h6>2. Sekolah adalah SMK Negeri 1 Kragilan</h6>
  179.     <h6>3. Contoh pengisian 1000 <b>tidak perlu ditulis Meter</h6>
  180.     <h6>4. Jarak harus ditulis dalam satuan meter</h6>
  181.  
  182.     <br><h4>D. DATA ORANG TUA/WALI CALON PSERTA DIDIK</h4>
  183.     <div class="form-group">
  184.       <label class="control-label col-sm-2" for="email">Nama Orang Tua/Wali :</label>
  185.       <div class="col-sm-6">
  186.         <input type="text" class="form-control"   placeholder="Nama Orang Tua" name="nama_org_tua">
  187.       </div>
  188.     </div>
  189.     <div class="form-group">
  190.       <label class="control-label col-sm-2" for="email">Pekerjaan Orang Tua/Wali :</label>
  191.       <div class="col-sm-6">
  192.         <input type="text" class="form-control"   placeholder="Pekerjaan Orang Tua" name="pekerjaan_org_tua">
  193.       </div>
  194.     </div>
  195.     <div class="form-group">
  196.       <label class="control-label col-sm-2" for="email">PKH/KKS/KIP/Jamsosda<br>(Diisi jika memiliki) :</label>
  197.       <div class="col-sm-6">
  198.         <input type="text" class="form-control"   placeholder="PKH/KKS/KIP/Jamsosda" name="kip">
  199.       </div>
  200.     </div>
  201.  
  202.     <br><h4>E. INPUT SCAN BERKAS CALON PERSERTA DIDIK</h4>
  203.  
  204.     <div class="form-group">
  205.       <label class="control-label col-sm-2" >SKHUN </label>
  206.       <div class="col-sm-6">
  207.         <input type="file" name="pdf_skhun" accept="application/pdf" class="form-control-file" >
  208.       </div>
  209.     </div>
  210.     <div class="form-group">
  211.       <label class="control-label col-sm-2" >Surat Sehat dari Dokter </label>
  212.       <div class="col-sm-6">
  213.         <input type="file" name="pdf_surat_dokter" accept="application/pdf" class="form-control-file" >
  214.       </div>
  215.     </div>
  216.     <div class="form-group">
  217.       <label class="control-label col-sm-2" >Kartu Keluarga (KK) </label>
  218.       <div class="col-sm-6">
  219.         <input type="file" name="pdf_kk" accept="application/pdf" class="form-control-file">
  220.       </div>
  221.     </div>
  222.     <div class="form-group">
  223.       <label class="control-label col-sm-2" >Akta Kelahiran </label>
  224.       <div class="col-sm-6">
  225.         <input type="file" name="pdf_akta" accept="application/pdf" class="form-control-file" >
  226.       </div>
  227.     </div>
  228.     <div class="form-group">
  229.       <label class="control-label col-sm-2" >Photo </label>
  230.       <div class="col-sm-6">
  231.         <input type="file" name="pdf_photo" accept="application/pdf" class="form-control-file" >
  232.       </div>
  233.     </div>
  234.     <div class="form-group">
  235.       <label class="control-label col-sm-2" >SwaPhoto dan KK </label>
  236.       <div class="col-sm-6">
  237.         <input type="file" name="pdf_swa_kk" accept="application/pdf" class="form-control-file">
  238.       </div>
  239.     </div>
  240.     <div class="form-group">
  241.       <label class="control-label col-sm-2" >Piagram 1 </label>
  242.       <div class="col-sm-6">
  243.         <input type="file" name="pdf_piagam1" accept="application/pdf" class="form-control-file" >
  244.       </div>
  245.     </div>
  246.     <div class="form-group">
  247.       <label class="control-label col-sm-2" >Piagram 2</label>
  248.       <div class="col-sm-6">
  249.         <input type="file" name="pdf_piagam2" accept="application/pdf" class="form-control-file" >
  250.       </div>
  251.     </div>
  252.     <div class="form-group">
  253.       <label class="control-label col-sm-2" >Piagram 3 </label>
  254.       <div class="col-sm-6">
  255.         <input type="file" name="pdf_piagam3" accept="application/pdf" class="form-control-file" >
  256.       </div>
  257.     </div>
  258.     <h6><b>Informasi :</h6>
  259.     <h6>1. File harus dengan format <b>.pdf</b> dengan ukuran maksimal <b>500 kb</b></h6>
  260.     <h6>2. Piagam boleh dikosongkan</h6>
  261.     <h6>3. Piagam hasil perlombaan dan/atau penghargaan di bidang akademik maupun non akademik</h6>
  262.  
  263.     <br><h4>F. INPUT NILAI UJIAN NASIOANAL PESERTA DIDIK</h4>
  264.     <div class="form-group">
  265.       <label class="control-label col-sm-2" >Nilai Bahasa Indonesia </label>
  266.       <div class="col-sm-3">
  267.         <input type="number" class="form-control"   placeholder="Nilai Bahasa Indonesia" name="un_bind">
  268.       </div>
  269.     </div>
  270.     <div class="form-group">
  271.       <label class="control-label col-sm-2">Nilai Bahasa Inggris </label>
  272.       <div class="col-sm-3">
  273.         <input type="number" class="form-control"   placeholder="Nilai Bahasa Inggris" name="un_bing">
  274.       </div>
  275.     </div>
  276.     <div class="form-group">
  277.       <label class="control-label col-sm-2">Nilai Matematika </label>
  278.       <div class="col-sm-3">
  279.         <input type="number" class="form-control"   placeholder="Nilai Matematika" name="un_mtk">
  280.       </div>
  281.     </div>
  282.     <div class="form-group">
  283.       <label class="control-label col-sm-2">Nilai IPA </label>
  284.       <div class="col-sm-3">
  285.         <input type="number" class="form-control"   placeholder="Nilai IPA" name="un_ipa">
  286.       </div>
  287.     </div>
  288.  
  289.  
  290.     <div class="form-group">
  291.       <div class="col-sm-offset-2 col-sm-10">
  292.         <button type="submit" name="upload" value="upload" class="btn btn-default">Submit</button>
  293.       </div>
  294.     </div>
  295.   </form>
  296. </div>
  297.  
  298. </body>
  299. </html>
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