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Residency_Form_Code.txt
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<!DOCTYPE html>
<!-- <html xml:lang="en-US" lang="en-US"> -->
<head>
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=9; IE=8; IE=7; IE=EDGE" />
<meta name="viewport" content="width=device-width, initial-scale=1" />
<title>Residency Form</title>
<link rel="stylesheet" type="text/css" href="../../Content/ResidencyBundle.css">
<script src="../../Scripts/jquery-2.2.3.min.js" type="text/javascript"></script>
<script src="../../Scripts/ResidencyBundle.js"></script>
<script src="http://malsup.github.com/jquery.form.js"></script>
<link rel="stylesheet" type="text/css" href="../../Content/residency-custom-bootstrap.css">
<!-- The import below does not seem to work 100% unless you include
the integrity and crossorigin tag -->
<script
src="https://code.jquery.com/ui/1.12.0/jquery-ui.min.js"
integrity="sha256-eGE6blurk5sHj+rmkfsGYeKyZx3M4bG+ZlFyA7Kns7E="
crossorigin="anonymous"></script>
<!-- <link rel="stylesheet" href="//code.jquery.com/ui/1.12.1/themes/base/jquery-ui.css">-->
<!-- <script src="https://code.jquery.com/jquery-1.12.4.js"></script>-->
<!-- <script src="https://code.jquery.com/ui/1.12.1/jquery-ui.js"></script>-->
<script>
$( function() {
$( ".datepicker" ).datepicker();
} );
</script>
</head>
<body>
<!-- BEGINNING Leave this in every page -->
<header class="banner">
<div class="container">
<div class="row">
<div class="col-xs-12 col-sm-3">
<a href="/" class="header-logo" title="Florida Atlantic University"> <img id="fau-header" class="img-responsive pull-left" src="../../Content/Images/fau-home-logo.png" /> </a>
</div>
</div>
</div>
</header>
<!-- Navigation -->
<nav id="mainNav" class="navbar navbar-default navbar-custom">
<div class="container">
<div class="navbar-header page-scroll">
<button type="button" class="navbar-toggle" data-toggle="collapse" data-target=".navbar-collapse"> <span class="sr-only">Toggle navigation</span> Menu<i></i> </button> <a class="navbar-brand" id="navtext" href="#page-top">FAU</a> </div>
<!-- Collect the nav links, forms, and other content for toggling -->
<div class="collapse navbar-collapse" id="bs-example-navbar-collapse-1">
<ul class="nav navbar-nav navbar-right">
<li class="hidden">
<a href="#home"></a>
</li>
<li class="page-scroll"> <a href="#">Home</a> </li>
<li class="page-scroll"> <a href="#">Application</a> </li>
<li class="page-scroll"> <a href="#">Login</a> </li>
</ul>
</div>
<!-- /.navbar-collapse -->
</div>
<!-- /.container-fluid -->
</nav>
<!-- END Leave this in every Page -->
<div class="container-fluid body-content">
<!-- OUR FORM -->
<form id="residencyForm" action="process.php" method="POST">
<!-- NAME -->
<div class="row form-group">
<label class="control-label col-md-2 required-field" for="firstname">First Name: </label>
<div class="col-md-2">
<input type="text" class="form-control" name="firstname" placeholder="Jon"> </div>
<label class="control-label col-md-1" for="middlename">Middle Name: </label>
<div class="col-md-2">
<input type="text" class="form-control" name="middlename" placeholder=""> </div>
<label class="control-label col-md-1 required-field" for="lastname">Last Name: </label>
<div class="col-md-2">
<input type="text" class="form-control" name="lastname" placeholder="Snow"> </div>
<label class="control-label col-md-1" for="suffix">Suffix: </label>
<div class="col-md-1">
<select class="form-control" name="suffix">
<option selected>Select One</option>
<option value="Jr">Jr</option>
<option value="Sr">Sr</option>
</select>
</div>
<!-- errors will go here -->
</div>
<!-- EMAIL -->
<div class="row form-group">
<label class="control-label col-md-2 required-field" for="term">Term of Application: </label>
<div class="col-md-1">
<select class="form-control" name="term">
<option selected>Select One</option>
<option value="Fall">Fall</option>
<option value="Spring">Spring</option>
<option value="Summer">Summer</option>
</select>
</div>
<label class="control-label col-md-2 required-field" for="year">Year: </label>
<div class="col-md-2">
<input type="text" class="form-control" name="year" placeholder="2016"> </div>
</div>
<div class="row form-group">
<label class="control-label col-md-2 required-field" for="dob">Date of Birth: </label>
<div class="col-md-1">
<input type="text" class="form-control datepicker" name="dob" placeholder="01/01/2016"> </div>
<!-- errors will go here -->
</div>
<div class="row form-group">
<label class="control-label col-md-2 required-field" for="email">Email: </label>
<div class="col-md-2">
<input type="text" class="form-control" name="email" placeholder="[email protected]"> </div>
<!-- errors will go here -->
</div>
<div class="col-md-5 form-group">
<div class="btn-group pull-right" role="group">
<button type="submit" class="btn btn-success">Submit</button>
<button type="button" class="btn btn-default">Cancel</button>
</div>
</div>
</form>
</div>
<!-- Include out validation.js script -->
<script src="validation.js"></script>
<footer>
<div class="container">
<div class="row">
<div class="col-md-12 text-center footer-text"> An Equal Opportunity/Equal Access Institution © Copyright 2016.
<br/> Florida Atlantic University </div>
</div>
</div>
</footer>
</body>
</html>