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PHP Decode
<script> var prefilldata = []; <?php $batchid = uniqid ("FORMPREREG",true);..
Decoded Output download
<script>
var prefilldata = [];
<?php
$batchid = uniqid ("FORMPREREG",true);
?>
</script>
<style>
.mandatory{color:red;font-weight:bold;}
h4 { font-size: 16px; margin:0;}
.expd input{
width:auto;
}
.pt {
width:28%;
}
.pt2 {
width:19%;
}
.emplomenttext{
display:none;
font-weight:bold;
}
</style>
<?php session_start(); ?>
<script>
<?php
$sql="select * from pre_reg_form where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
if(mysqli_num_rows($result)>0){
$sql="select * from pre_reg_form where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
//$row = mysqli_fetch_assoc($result);
while($rec= mysqli_fetch_assoc($result)){
foreach ($rec as $key => $value) {
${$key} = $value;
echo "
prefilldata[\"$key\"] = \"".str_replace("
","",nl2br($rec[$key]))."\";
";
}
}
//@extract($rec);
$isedit="false";
$rfld=$id;
if(mysqli_num_rows($result)>0){
$isedit="true";
$s=1;
$sql="select * from pre_reg_edu_detail where batchid='$batchid' order by rowid";
$result1 = mysqli_query($GLOBALS["link"], $sql);
while($row1 = mysqli_fetch_assoc($result1)){
foreach ($row1 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row1[$key]))."\";
";
}
$s++;
//@extract($row1);
}
$s=1;
$sql="select * from pre_reg_prof_detail where batchid='$batchid' order by rowid";
$result2 = mysqli_query($GLOBALS["link"], $sql);
while($row2 = mysqli_fetch_assoc($result2)){
foreach ($row2 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row2[$key]))."\";
";
}
$s++;
//@extract($row2);
}
$s=1;
$sql="select * from pre_reg_exp_detail where batchid='$batchid' order by rowid";
$result3 = mysqli_query($GLOBALS["link"], $sql);
while($row3 = mysqli_fetch_assoc($result3)){
foreach ($row3 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row3[$key]))."\";
";
}
$s++;
//@extract($row3);
}
$s=1;
$sql="select * from iiici_editing_entry where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
while($row4 = mysqli_fetch_assoc($result4)){
foreach ($row4 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row4[$key]))."\";
";
}
$s++;
//@extract($row4);
}
}
}
else{
$sql="select * from pre_reg_form_temp where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
//$row = mysqli_fetch_assoc($result);
while($rec= mysqli_fetch_assoc($result)){
foreach ($rec as $key => $value) {
${$key} = $value;
echo "
prefilldata[\"$key\"] = \"".str_replace("
","",nl2br($rec[$key]))."\";
";
}
}
//@extract($rec);
$isedit="false";
$rfld=$id;
if(mysqli_num_rows($result)>0){
$isedit="true";
$s=1;
$sql="select * from pre_reg_edu_detail_temp where batchid='$batchid' order by rowid";
$result1 = mysqli_query($GLOBALS["link"], $sql);
while($row1 = mysqli_fetch_assoc($result1)){
foreach ($row1 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row1[$key]))."\";
";
}
$s++;
//@extract($row1);
}
$s=1;
$sql="select * from pre_reg_prof_detail_temp where batchid='$batchid' order by rowid";
$result2 = mysqli_query($GLOBALS["link"], $sql);
while($row2 = mysqli_fetch_assoc($result2)){
foreach ($row2 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row2[$key]))."\";
";
}
$s++;
//@extract($row2);
}
$s=1;
$sql="select * from pre_reg_exp_detail_temp where batchid='$batchid' order by rowid";
$result3 = mysqli_query($GLOBALS["link"], $sql);
while($row3 = mysqli_fetch_assoc($result3)){
foreach ($row3 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row3[$key]))."\";
";
}
$s++;
//@extract($row3);
}
$s=1;
$sql="select * from iiici_editing_entry_temp where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
while($row4 = mysqli_fetch_assoc($result4)){
foreach ($row4 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row4[$key]))."\";
";
}
$s++;
//@extract($row4);
}
}
}
?>
// $('.chk_size').on('change', function() {
// alert('comingggg');
// });
</script>
<script>
// jQuery(document).ready(function(){ //
function frm_validate(){
var membertitle=$('#membertitle').val();
var membername=$('#membername').val();
var fathersname=$('#fathersname').val();
var date_of_birth=$('#date_of_birth').val();
var place_of_birth=$('#place_of_birth').val();
var panno = $('#panno').val();
var btnpan1=$('#btnpan1').val();
var adharno=$('#adharno').val();
var btnadhar1=$('#btnadhar1').val();
var state=$('#state').val();
var city=$('#city').val();
var pin = $('#pin').val();
var btnaddress1=$('#btnaddress1').val();
var address_of_correspondence=$('#address_of_correspondence').val();
var permanent_address=$('#permanent_address').val();
var pstate=$('#pstate').val();
var pcity=$('#pcity').val();
var ppin=$('#ppin').val();
var btnpaddress1 = $('#btnpaddress1').val();
var emailid=$('#emailid').val();
var mobileno=$('#mobileno').val();
var landline=$('#landline').val();
var dinRadioNo=$('#dinRadioNo').val();
var din_pic1 = $('#din_pic1').val();
var score=$('#score').val();
var btnscore1=$('#btnscore1').val();
var qual_1=$('#qual_1').val();
var prof_year_1=$('#prof_year_1').val();
var inst_1=$('#inst_1').val();
var mrn_1=$('#mrn_1').val();
var dateofenrollment_1=$('#dateofenrollment_1').val();
var qual_2=$('#qual_2').val();
var prof_year_2=$('#prof_year_2').val();
var inst_2=$('#inst_2').val();
var mrn_2=$('#mrn_2').val();
var dateofenrollment_2=$('#dateofenrollment_2').val();
var qual_3=$('#qual_3').val();
var prof_year_3=$('#prof_year_3').val();
var inst_3=$('#inst_3').val();
var mrn_3=$('#mrn_3').val();
var dateofenrollment_3=$('#dateofenrollment_3').val();
var Limited_Insolvency_Examination=$('#Limited_Insolvency_Examination').val();
var Limited_Insolvency_Examination1=$('#Limited_Insolvency_Examination1').val();
var insolvency_exam_date=$('#insolvency_exam_date').val();
var Limited_Insolvency_Examination3=$('#Limited_Insolvency_Examination3').val();
var btnlimited_pic1=$('#btnlimited_pic1').val();
var btnlimited_pic1 = $('#btnlimited_pic1').val();
var ispracticeemployment1=$('#ispracticeemployment1').val();
var years_in_employment=$('#years_in_employment').val();
var years_in_practice=$('#years_in_practice').val();
var prof_address=$('#prof_address').val();
var pccity=$('#pccity').val();
var pcpin = $('#pcpin').val();
var btnprof_address1=$('#btnprof_address1').val();
var isconvict=$('#isconvict').val();
var iscriminalproceedings=$('#iscriminalproceedings').val();
var isundischaredbankrupt=$('#isundischaredbankrupt').val();
var isIcaiCouncilorRVO=$('#isIcaiCouncilorRVO').val();
var Professional = $('#Professional').val();
var Professional1=$('#Professional1').val();
var Professional2=$('#Professional2').val();
var Professional3=$('#Professional3').val();
var additionalInfo=$('#additionalInfo').val();
var btnyear4 = $('#btnyear4').val();
var btnyear5=$('#btnyear5').val();
var btnyear6=$('#btnyear6').val();
var paymentfrom=$('#paymentfrom').val();
var affirm1=$('#affirm1').val();
var affirm2=$('#affirm2').val();
var affirm3=$('#affirm3').val();
var affirm4=$('#affirm4').val();
var affirm5 = $('#affirm5').val();
var payment_recd = $('#payment_recd').val();
document.getElementById('membertitle').style.borderColor ="";
document.getElementById('membername').style.borderColor ="";
document.getElementById('fathersname').style.borderColor ="";
document.getElementById('date_of_birth').style.borderColor ="";
document.getElementById('place_of_birth').style.borderColor ="";
document.getElementById('panno').style.borderColor ="";
// document.getElementById('btnpan1').style.borderColor ="";
document.getElementById('adharno').style.borderColor ="";
// document.getElementById('btnadhar1').style.borderColor ="";
document.getElementById('address_of_correspondence').style.borderColor ="";
document.getElementById('state').style.borderColor ="";
document.getElementById('city').style.borderColor ="";
document.getElementById('pin').style.borderColor ="";
// document.getElementById('btnaddress1').style.borderColor ="";
document.getElementById('permanent_address').style.borderColor ="";
document.getElementById('pstate').style.borderColor ="";
document.getElementById('pcity').style.borderColor ="";
document.getElementById('ppin').style.borderColor ="";
// document.getElementById('btnpaddress1').style.borderColor ="";
document.getElementById('emailid').style.borderColor ="";
document.getElementById('mobileno').style.borderColor ="";
document.getElementById('score').style.borderColor ="";
// document.getElementById('btnscore1').style.borderColor ="";
document.getElementById('qual_1').style.borderColor ="";
document.getElementById('prof_year_1').style.borderColor ="";
document.getElementById('inst_1').style.borderColor ="";
document.getElementById('mrn_1').style.borderColor ="";
document.getElementById('dateofenrollment_1').style.borderColor ="";
document.getElementById('Limited_Insolvency_Examination').style.borderColor ="";
document.getElementById('Limited_Insolvency_Examination1').style.borderColor ="";
document.getElementById('insolvency_exam_date').style.borderColor ="";
document.getElementById('Limited_Insolvency_Examination3').style.borderColor ="";
//document.getElementById('btnlimited_pic1').style.borderColor ="";
document.getElementById('years_in_employment').style.borderColor ="";
document.getElementById('years_in_practice').style.borderColor ="";
document.getElementById('prof_address').style.borderColor ="";
document.getElementById('pccity').style.borderColor ="";
document.getElementById('pcpin').style.borderColor ="";
// document.getElementById('btnprof_address1').style.borderColor ="";
document.getElementById('isconvict').style.borderColor ="";
document.getElementById('iscriminalproceedings').style.borderColor ="";
document.getElementById('isundischaredbankrupt').style.borderColor ="";
document.getElementById('isIcaiCouncilorRVO').style.borderColor ="";
document.getElementById('Professional').style.borderColor ="";
document.getElementById('Professional1').style.borderColor ="";
document.getElementById('Professional2').style.borderColor ="";
document.getElementById('Professional3').style.borderColor ="";
document.getElementById('additionalInfo').style.borderColor ="";
// document.getElementById('btnyear4').style.borderColor ="";
// document.getElementById('btnyear5').style.borderColor ="";
// document.getElementById('btnyear6').style.borderColor ="";
document.getElementById('paymentfrom').style.borderColor ="";
document.getElementById('affirm1').style.borderColor ="";
document.getElementById('affirm2').style.borderColor ="";
document.getElementById('affirm3').style.borderColor ="";
document.getElementById('affirm4').style.borderColor ="";
document.getElementById('payment_recd').style.borderColor ="";
// document.getElementById("membername").required = true;
if(membertitle == ''){
document.getElementById("membertitle").style.borderColor = "red";
document.getElementById("membertitle").focus();
// alert("Please Compleate Payment First!");
return false;
}
else if(membername == ''){
document.getElementById("membername").style.borderColor = "red";
document.getElementById("membername").focus();
//alert("Please Compleate Payment First!");
return false;
}
else if(fathersname == ''){
document.getElementById("fathersname").style.borderColor = "red";
document.getElementById("fathersname").focus();
return false;
}
else if(date_of_birth == ''){
document.getElementById("date_of_birth").style.borderColor = "red";
document.getElementById("date_of_birth").focus();
return false;
}
else if(place_of_birth == ''){
document.getElementById("place_of_birth").style.borderColor = "red";
document.getElementById("place_of_birth").focus();
return false;
}
else if(panno == ''){
document.getElementById("panno").style.borderColor = "red";
document.getElementById("panno").focus();
return false;
}
else if(btnpan1 == ''){
document.getElementById("btnpan1").style.borderColor = "red";
document.getElementById("btnpan1").focus();
return false;
}
else if(adharno == ''){
document.getElementById("adharno").style.borderColor = "red";
document.getElementById("adharno").focus();
return false;
}
else if(btnadhar1 == ''){
document.getElementById("btnadhar1").style.borderColor = "red";
document.getElementById("btnadhar1").focus();
return false;
}
else if(address_of_correspondence == ''){
document.getElementById("address_of_correspondence").style.borderColor = "red";
document.getElementById("address_of_correspondence").focus();
return false;
}
else if(state == ''){
document.getElementById("state").style.borderColor = "red";
document.getElementById("state").focus();
return false;
}
else if(city == ''){
document.getElementById("city").style.borderColor = "red";
document.getElementById("city").focus();
return false;
}
else if(pin == ''){
document.getElementById("pin").style.borderColor = "red";
document.getElementById("pin").focus();
return false;
}
else if(btnaddress1 == ''){
document.getElementById("btnaddress1").style.borderColor = "red";
document.getElementById("btnaddress1").focus();
return false;
}
else if(permanent_address == ''){
document.getElementById("permanent_address").style.borderColor = "red";
document.getElementById("permanent_address").focus();
return false;
}
else if(pstate == ''){
document.getElementById("pstate").style.borderColor = "red";
document.getElementById("pstate").focus();
return false;
}
else if(pcity == ''){
document.getElementById("pcity").style.borderColor = "red";
document.getElementById("pcity").focus();
return false;
}
else if(ppin == ''){
document.getElementById("ppin").style.borderColor = "red";
document.getElementById("ppin").focus();
return false;
}
else if(btnpaddress1 == ''){
document.getElementById("btnpaddress1").style.borderColor = "red";
document.getElementById("btnpaddress1").focus();
return false;
}
else if(emailid == ''){
document.getElementById("emailid").style.borderColor = "red";
document.getElementById("emailid").focus();
return false;
}
else if(mobileno == ''){
document.getElementById("mobileno").style.borderColor = "red";
document.getElementById("mobileno").focus();
return false;
}
else if(score == ''){
document.getElementById("score").style.borderColor = "red";
document.getElementById("score").focus();
return false;
}
else if(btnscore1 == ''){
document.getElementById("btnscore1").style.borderColor = "red";
document.getElementById("btnscore1").focus();
return false;
}
else if(qual_1 == ''){
document.getElementById("qual_1").style.borderColor = "red";
document.getElementById("qual_1").focus();
return false;
}
else if(prof_year_1 == ''){
document.getElementById("prof_year_1").style.borderColor = "red";
document.getElementById("prof_year_1").focus();
return false;
}
else if(inst_1 == ''){
document.getElementById("inst_1").style.borderColor = "red";
document.getElementById("inst_1").focus();
return false;
}
else if(mrn_1 == ''){
document.getElementById("mrn_1").style.borderColor = "red";
document.getElementById("mrn_1").focus();
return false;
}
else if(dateofenrollment_1 == ''){
document.getElementById("dateofenrollment_1").style.borderColor = "red";
document.getElementById("dateofenrollment_1").focus();
return false;
}
else if(Limited_Insolvency_Examination == ''){
document.getElementById("Limited_Insolvency_Examination").style.borderColor = "red";
document.getElementById("Limited_Insolvency_Examination").focus();
return false;
}
else if(Limited_Insolvency_Examination1 == ''){
document.getElementById("Limited_Insolvency_Examination1").style.borderColor = "red";
document.getElementById("Limited_Insolvency_Examination1").focus();
return false;
}
else if(insolvency_exam_date == ''){
document.getElementById("insolvency_exam_date").style.borderColor = "red";
document.getElementById("insolvency_exam_date").focus();
return false;
}
else if(Limited_Insolvency_Examination3 == ''){
document.getElementById("Limited_Insolvency_Examination3").style.borderColor = "red";
document.getElementById("Limited_Insolvency_Examination3").focus();
return false;
}
else if(btnlimited_pic1 == ''){
document.getElementById("btnlimited_pic1").style.borderColor = "red";
document.getElementById("btnlimited_pic1").focus();
return false;
}
else if(years_in_employment == ''){
document.getElementById("years_in_employment").style.borderColor = "red";
document.getElementById("years_in_employment").focus();
return false;
}
else if(years_in_practice == ''){
document.getElementById("years_in_practice").style.borderColor = "red";
document.getElementById("years_in_practice").focus();
return false;
}
else if(prof_address == ''){
document.getElementById("prof_address").style.borderColor = "red";
document.getElementById("prof_address").focus();
return false;
}
else if(pccity == ''){
document.getElementById("pccity").style.borderColor = "red";
document.getElementById("pccity").focus();
return false;
}
else if(pcpin == ''){
document.getElementById("pcpin").style.borderColor = "red";
document.getElementById("pcpin").focus();
return false;
}
else if(btnprof_address1 == ''){
document.getElementById("btnprof_address1").style.borderColor = "red";
document.getElementById("btnprof_address1").focus();
return false;
}
else if(isconvict == ''){
document.getElementById("isconvict").style.borderColor = "red";
document.getElementById("isconvict").focus();
return false;
}
else if(iscriminalproceedings == ''){
document.getElementById("iscriminalproceedings").style.borderColor = "red";
document.getElementById("iscriminalproceedings").focus();
return false;
}
else if(isundischaredbankrupt == ''){
document.getElementById("isundischaredbankrupt").style.borderColor = "red";
document.getElementById("isundischaredbankrupt").focus();
return false;
}
else if(isIcaiCouncilorRVO == ''){
document.getElementById("isIcaiCouncilorRVO").style.borderColor = "red";
document.getElementById("isIcaiCouncilorRVO").focus();
return false;
}
// else if(Professional == 'Yes'){
// document.getElementById("Professional").style.borderColor = "red";
// document.getElementById("Professional").focus();
// return false;
// }
// else if(Professional1 == ''){
// document.getElementById("Professional1").style.borderColor = "red";
// document.getElementById("Professional1").focus();
// return false;
// }
// else if(Professional2 == ''){
// document.getElementById("Professional2").style.borderColor = "red";
// document.getElementById("Professional2").focus();
// return false;
// }
// else if(Professional3 == ''){
// document.getElementById("Professional3").style.borderColor = "red";
// document.getElementById("Professional3").focus();
// return false;
// }
else if(additionalInfo == ''){
document.getElementById("additionalInfo").style.borderColor = "red";
document.getElementById("additionalInfo").focus();
alert("Please enter additional information!");
return false;
}
else if(btnyear4 == ''){
document.getElementById("btnyear4").style.borderColor = "red";
document.getElementById("btnyear4").focus();
return false;
}
else if(btnyear5 == ''){
document.getElementById("btnyear5").style.borderColor = "red";
document.getElementById("btnyear5").focus();
return false;
}
else if(btnyear6 == ''){
document.getElementById("btnyear6").style.borderColor = "red";
document.getElementById("btnyear6").focus();
return false;
}
else if(payment_recd == ''){
document.getElementById("payment_recd").style.borderColor = "red";
document.getElementById("payment_recd").focus();
alert("Please Compleate Payment First!");
return false;
}
else if(paymentfrom == ''){
document.getElementById("paymentfrom").style.borderColor = "red";
document.getElementById("paymentfrom").focus();
return false;
}
else if(affirm1 == ''){
document.getElementById("affirm1").style.borderColor = "red";
document.getElementById("affirm1").focus();
return false;
}
else if(affirm2 == ''){
document.getElementById("affirm2").style.borderColor = "red";
document.getElementById("affirm2").focus();
return false;
}
else if(affirm3 == ''){
document.getElementById("affirm3").style.borderColor = "red";
document.getElementById("affirm3").focus();
return false;
}
else if(affirm4 == ''){
document.getElementById("affirm4").style.borderColor = "red";
document.getElementById("affirm4").focus();
return false;
}
else if(affirm5 == ''){
document.getElementById("affirm5").style.borderColor = "red";
document.getElementById("affirm5").focus();
return false;
}
else{
document.activeElement?.blur();
document.getElementById("bsave").type = "submit";
$('#bsave').click();
}
}
// });
</script>
<?php
if($isedit=='true'){
// echo "Before Edit Template";
include("edittemplate.php");
}
else
{
include("template.php");
}
if($form_pic!='')
{
$display="none";
}
else
{
$display="";
}
if($memberpic!='' && $membername!='' && $date_of_birth!='' && $fathersname!='' && $form_pic=='')
{
$footer="block!important";
$display="none";
$dis="none";
}
if($memberpic=='' && $membername=='' && $date_of_birth=='' && $fathersname=='' && $transaction_id=='')
{
$footer="";
$display="";
$dis="";
}
if($memberpic!='' && $membername!='' && $date_of_birth!='' && $fathersname!='' && $transaction_id=='')
{
$footer="";
$display="";
$dis="";
}
if($memberpic!='' && $membername!='' && $date_of_birth!='' && $fathersname!='' && $transaction_id!='' && $form_pic=='')
{
$footer="block";
$display="none";
$dis="none";
}
?>
<form class="needs-validation" novalidate method="POST" action="" enctype="multipart/form-data" >
<input type="hidden" name="isedit" value="<?=$isedit?>">
<input type="hidden" name="batchid" value="<?=$batchid?>">
<input type="hidden" name="mode" value="<?=$mode?>">
<input type="hidden" name="submode" value="<?=$submode?>">
<script>
$(document).ready(function() {
$("#btnmemberpic1").change(function () {
var fileInput = document.getElementById('btnmemberpic1');
var filePath = fileInput.value;
var file_size = $("#btnmemberpic1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnpan1").change(function () {
var fileInput = document.getElementById('btnpan1');
var filePath = fileInput.value;
var file_size = $("#btnpan1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnadhar1").change(function () {
var fileInput = document.getElementById('btnadhar1');
var filePath = fileInput.value;
var file_size = $("#btnadhar1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<table width="1000px"cellspacing="3" cellpadding="3" border="1" id="maintable" style="border-collapse:collapse;margin:auto;">
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>Indian Institute of Insolvency Professionals of ICAI(IIIPI)</b></font>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>Enrolment Form</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>With</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>Application for Pre-Registration Educational Course</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>
[Under Regulation 5(b) of the Insolvency and Bankruptcy Board of India(Insolvency Professionals)<br>(Amendment) Regulations, 2018)]</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="3">
<p><b>To</b></p>
<p><b>The Managing Director,<br>
Indian Institute of Insolvency Professionals of ICAI</b>
</p>
<br>
<td>
<?php
if(!empty($memberpic))
{
echo "<img src='images/".$memberpic."' height='100' width='100'><br>
<input type='hidden' name='memberpic' id='memberpic' value='".$memberpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='memberpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<img src="images/avtar.jpg" id="memberpic" name="memberpic" height="100" width="100"><br>
<input type="file" name="btnmemberpic" id="btnmemberpic1" size="1" >';
}
?>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<p><b>Subject: Application for Enrolment as professional member and Pre-Registration Education Course</b></p>
<p>Sir,</p>
<p>I,...<?=$membername?>...have passed the Limited Insolvency Examination of Insolvency and
Bankruptcy Board of India(IBBI) on...<?=$insolvency_exam_date?>...A copy of my Certificate is attached.
</p>
<p>I now wish to apply for Enrolment with Indian Institute of Insolvency Professionals of ICAI(IIIPI).You are requested to enrol me for the Pre-registration Education Course also.</p>
<p>My details are as under:</p>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="hd">
<h4>A. PERSONAL DETAILS</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td width="20%">1. Title (Mr/Mrs/Ms):<span class="mandatory">*<span></td>
<td width="30%">
<select id="membertitle" name="membertitle" >
<option value="Mr">Mr.</option>
<option value="Mrs">Mrs.</option>
<option value="Ms">Ms.</option>
</select>
</td>
<td width="20%">2. Name:<span class="mandatory" >*<span></td>
<td width="30%"><input type="text" id="membername" name="membername" maxlength="255" value="<?=$membername?>"></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>3. Father's Name:<span class="mandatory">*<span></td>
<td><input type="text" id="fathersname" name="fathersname" value="<?=$fathersname?>"></td>
<td>4. Date of Birth:<span class="mandatory">*<span></td>
<td>
<input type="text" class="datetime" id="date_of_birth" name="date_of_birth" value="<?=$date_of_birth?>" placeholder="dd/mm/yyyy" >
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>5. Place of Birth: <span class="mandatory">*<span></td>
<td>
<input type="text" id="place_of_birth" name="place_of_birth" maxlength="255" value="<?=$place_of_birth?>" >
</td>
<td>6. PAN No.:<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<table>
<tr>
<td>
<input type="text" id="panno" name="panno" maxlength="10" value="<?=$panno?>">
<br><!-- <img src="" width="150" height="70" id="panpic" name="panpic" class="">-->
<?php
if(!empty($panpic))
{
echo $panpic."
<input type='hidden' name='panpic' id='panpic' value='".$panpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='panpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnpan" id="btnpan1" size="10" > <span class="">*<span>';
}
?>
</td>
<td>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>7. AADHAAR No.: <span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<table>
<tr>
<td>
<input type="text" id="adharno" name="adharno" value="<?=$adharno?>" minlength="12" maxlength="12" class="number" > <br><!-- <img src="" width="150" height="70" id="adharpic" name="adharpic" class="">-->
<?php
if(!empty($adharpic))
{
echo $adharpic."
<input type='hidden' name='adharpic' id='adharpic' value='".$adharpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='adharpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnadhar" id="btnadhar1" size="10" > <span class="">*<span>';
}
?>
</td>
<td>
</td>
</tr>
</table>
</td>
<script>
$(document).ready(function() {
$("#btnpassport1").change(function () {
var fileInput = document.getElementById('btnpassport1');
var filePath = fileInput.value;
var file_size = $("#btnpassport1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<td>8. Passport No.:(if available)
<span class="mandatory" style="color:red;font-size:70%"><br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<table>
<input type="text" id="passportno" maxlength="50" name="passportno" value="<?=$passportno?>">
<br><!-- <img src="" width="150" height="70" id="passportpic" name="passportpic" class="">-->
<?php
if(!empty($passportpic))
{
echo $passportpic."
<input type='hidden' name='passportpic' id='passportpic' value='".$passportpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='passportpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnpassport" id="btnpassport1" size="10" >';
}
?>
</td>
<td>
</td>
</tr>
</table>
</td>
</tr>
<script>
$(document).ready(function() {
$("#btnpaddress1").change(function () {
var fileInput = document.getElementById('btnpaddress1');
var filePath = fileInput.value;
var file_size = $("#btnpaddress1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnaddress1").change(function () {
var fileInput = document.getElementById('btnaddress1');
var filePath = fileInput.value;
var file_size = $("#btnaddress1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnprof_address1").change(function () {
var fileInput = document.getElementById('btnprof_address1');
var filePath = fileInput.value;
var file_size = $("#btnprof_address1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr style="display:<?php echo $display;?>">
<td colspan="2">
9. Address for Correspondence:
<h5 style="color:blue">(Note: This shall be recorded as the registered
address)
</h5>
<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span>
</td>
<td colspan="2">
<table cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td colspan="2">
<table>
<tbody>
<tr>
<td>Address:</td>
<td><input type="text" id="address_of_correspondence" maxlength="255" name="address_of_correspondence" value="<?=$address_of_correspondence?>" style="width:99%;" ></td>
</tr>
<tr>
<td>State:</td>
<td>
<select name="state" id="state" >
<?php
$sql="select * from state_master order by statename ";
$result = mysqli_query($GLOBALS["link"], $sql);
while($row = mysqli_fetch_assoc($result)){
if($corresspondence_state==$row['statename'])
echo "<option value='".$row['statename']."' selected>".$row['statename']."</option>";
else
echo "<option value='".$row['statename']."'>".$row['statename']."</option>";
}
?>
</select>
<!--<input type="text" id="state" maxlength="255" name="state" value="=$corresspondence_state" class="pt" > -->
City: <input type="text" id="city" maxlength="255" name="city" value="<?=$corresspondence_city?>" class="pt2" >
Pin: <input type="number" id="pin" name="pin" maxlength="6" value="<?=$corresspondence_pincode?>" class="pt2" onKeyPress="if(this.value.length==6) return false;" />
</td>
</tr>
<tr>
<td></td>
<td><?php
if(!empty($addresspic))
{
echo $addresspic."
<input type='hidden' name='addresspic' id='addresspic' value='".$addresspic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='addresspic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnaddress" id="btnaddress1" size="10" >';
}
?></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">10. Permanent Address:<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td colspan="2">
<table cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td colspan="2">
<table>
<tbody>
<tr>
<td colspan="2"><input type="checkbox" id="chkobox" name="chkobox"><span style="">Same as Correspondence Address</span></td>
</tr>
<tr>
<td>Address:</td>
<td><input type="text" id="permanent_address" maxlength="255" name="permanent_address" value="<?=$permanent_address?>" style="width:99%;" ></td>
</tr>
<tr>
<td>State:</td>
<td>
<select name="pstate" id="pstate" >
<?php
$sql="select * from state_master order by statename ";
$result = mysqli_query($GLOBALS["link"], $sql);
while($row = mysqli_fetch_assoc($result)){
if($permanent_state==$row['statename'])
echo "<option value='".$row['statename']."' selected>".$row['statename']."</option>";
else
echo "<option value='".$row['statename']."'>".$row['statename']."</option>";
}
?>
</select>
<!--<input type="text" id="pstate" name="pstate" value="$permanent_state" class="pt">-->
City: <input type="text" id="pcity" name="pcity" value="<?=$permanent_city?>" class="pt2" >
Pin: <input type="number" pattern="[0-9]{6}" id="ppin" name="ppin" value="<?=$permanent_pincode?>" class="pt2" onKeyPress="if(this.value.length==6) return false;" />
</td>
</tr>
<tr>
<td></td>
<td><?php
if(!empty($paddresspic))
{
echo $paddresspic."
<input type='hidden' name='paddresspic' id='paddresspic' value='".$paddresspic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='paddresspic' class='remove'>Remove</button>
</form>";
}
else
{
echo ' <input type="file" name="btnpaddress" id="btnpaddress1" size="10" >';
}
?></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>
11. E-Mail Address:
<h5 style="color:blue">(Note: This shall be recorded as the registered e-mail address) </h5>
<span class="mandatory">*<span>
</td>
<td><input type="text" id="emailid" maxlength="255" name="emailid" value="<?=$emailid?>" class="email " readonly></td>
<td>
12. Mobile No.:
<h5 style="color:blue">(Note:This shall be recorded as the registered mobile number)</h5>
<span class="mandatory">*<span>
</td>
<td><input type="text" id="mobileno" minlength="10" maxlength="15" name="mobileno" value="<?=$mobileno?>" minlength="10" maxlength="10" readonly></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>13. Landline No.: </td>
<td><input type="text" maxlength="255" id="landline" name="landline" value="<?=$landline?>" class=""></td>
<td>14. GST No.(Individual):</td>
<td>
<select name="gstinstatus" id="gstinstatus" class="valid" aria-invalid="false">
<option value="0">Not Applicable</option>
<option value="1">Yes</option>
</select>
<input type="text" id="gst_no" name="gst_no" value="<?=$gst_no?>" class="">
</td>
</tr>
<!--<tr style="display:<?php echo $display;?>">
<td>14. DIN(if available): <span class="mandatory">*<span></td>
<td>
<table>
<input type="text" id="dinvalue" maxlength="255" name="din" value="<?=$din?>">
<br><!-- <img src="" width="150" height="70" id="passportpic" name="passportpic" class="">
<?php
/*if(!empty($din_pic))
{
echo $din_pic."
<input type='hidden' name='din_pic' id='din_pic' value='".$din_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='din_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="din_pic" id="din_pic" size="10" class="">';
} */
?>
</td>
<td>
</td>
</tr>
</table>
</td>-->
<script>
$(document).ready(function() {
$("#din_pic1").change(function () {
var fileInput = document.getElementById('din_pic1');
var filePath = fileInput.value;
var file_size = $("#din_pic1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnscore1").change(function () {
var fileInput = document.getElementById('btnscore1');
var filePath = fileInput.value;
var file_size = $("#btnscore1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr style="display:<?php echo $display;?>">
<td>15. DIN(if available):
<h5 style="color:blue"> (Note: If No-Kindly attach the self-declaration that you are not holding any DIN)</h5>
<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<?php
if($din_yes_no=="")
{
echo '<span><input type="radio" name="din_yes_no" id="dinRadio" value="Yes" >Yes</input>
<input type="text" id="din" maxlength="255" name="din" value="'.$din.'">
<input type="radio" name="din_yes_no" id="dinRadioNo" value="No" >No</input></span>
';
}
else
{
if($din_yes_no=="Yes")
{
echo '<span><input type="radio" name="din_yes_no" id="dinRadio" value="Yes" checked>Yes</input>
<input type="text" id="din" maxlength="255" name="din" value="'.$din.'">
<input type="radio" name="din_yes_no" id="dinRadioNo" value="No">No</input></span>
';
}
else
{
echo '<span><input type="radio" name="din_yes_no" id="dinRadio" value="Yes">Yes</input>
<input type="text" id="din" maxlength="255" name="din" value="'.$din.'">
<input type="radio" name="din_yes_no" id="dinRadioNo" value="No" checked>No</input></span>
<br>
';
}
}
?>
<?php
// echo"I hereby confirm that I do not have DIN/DPIN";
if(!empty($din_pic))
{
echo $din_pic."
<input type='hidden' name='din_pic' id='din_pic' value='".$din_pic."' readonly >
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='din_pic' class='remove'>Remove</button>
</form> ";
}
else
{
echo '<span class="fileuploaddin"><input type="file" name="din_pic" id="din_pic1" size="10" ></span>';
}
?>
</td>
<td>
16. CIBIL SCORE:(Mandatory )<br/>
<h5 style="color:blue">(Note: score report downloaded from any RBI registered Credit Information)</h5>
<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span>
</td>
<td>
<table class="table" width="50%">
<tr>
<td>
<input type="text" maxlength="255" id="score" name="score" value="<?=$score?>" ><br>
<!-- <img src="" width="150" height="70" id="scorepic" name="scorepic" class="">-->
<?php
if(!empty($scorepic))
{
echo $scorepic."
<input type='hidden' name='scorepic' id='scorepic' value='".$scorepic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='scorepic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnscore" id="btnscore1" size="10" > <span class="mandatory">*<span>';
}
?>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>B. EDUCATIONAL, PROFESSIONAL AND VALUATION EXAMINATION QUALIFICATIONS</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>1. Educational Qualifications </h4>
<span>[Please provide educational qualifications from Bachelor's degree onwards]</span>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table class="table" width="100%">
<thead>
<tr>
<th width="5%">Sl.No.</th>
<th width="25%">Educational Qualification</th>
<th width="10%">Year of Passing</th>
<th width="30%">University/College</th>
<th width="10%">Remarks, if any</th>
<th width="20%">Attachment
<span style="color:red;font-size:70%">[Max upload JPG/JPEG/PNG/PDF size 2MB]</span></th>
</tr>
</thead>
<tbody class="eduBody">
</tbody>
<tfoot>
<tr>
<td colspan="4"></td>
<td colspan="2" align="right">
<input type="hidden" name="eduBodyRowCount" id="eduBodyRowCount" value="">
<button type="button" class="removeRow" datafld="eduBody">Remove last row</button>
<button type="button" class="addRow" datafld="eduBody">Add Row</button>
</td>
</tr>
</tfoot>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<h4>2. Professional Qualifications:</h4><br/>
<h5 style="color:blue">(Note: ACA/ACS/ACMA / Bar Council Membership certificate -attachment required, For Lawyers- Degree of Graduation /<br/>
Final year passing Mark sheet-attachment required)
</h5>
<span class="mandatory">*<span>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table class="table" width="100%">
<thead>
<tr>
<th width="5%">Sl.No.</th>
<th>Professional Qualifications</th>
<th>Year of Passing</th>
<th>University/Institute</th>
<th>Membership No. (if applicable)</th>
<th>Date of enrolment</th>
<th>Date of Certificate of Practice</th>
<th>Remarks, if any</th>
<th>Attachment
<span style="color:red;font-size:70%">[Max upload JPG/JPEG/PNG/PDF size 2MB]</span></th>
</tr>
</thead>
<tbody class="profBody">
</tbody>
<tfoot>
<tr>
<td colspan="8"></td>
<td colspan="2" align="right">
<input type="hidden" name="profBodyRowCount" id="profBodyRowCount" value="">
<button type="button" class="removeRow" datafld="profBody">Remove last row</button>
<button type="button" class="addRow" datafld="profBody">Add Row</button>
</td>
</tr>
</tfoot>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<h4>3. Insolvency Qualifications <span class="mandatory">*<span></h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="6">
<?php
$sql="select * from pre_reg_form where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
if(mysqli_num_rows($result)>0){
$sql="select * from iiici_editing_entry where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
}
else{
$sql="select * from iiici_editing_entry_temp where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
}
if($row4 = mysqli_fetch_assoc($result4)){
// foreach ($row4 as $key => $value) {
// ${$key} = $value;
// $k='_'.$s;
// echo "
// prefilldata[\"$key$k\"] = \"".str_replace("
","",nl2br($row4[$key]))."\";
// ";
// }
// $s++;
//@extract($row4);
/*$set_isIcaiCouncilorRVO=$row4['isIcaiCouncilorRVO'];
$set_isIcaiCouncilorRVOdetails = $row4['isundischaredbankruptdetails'];
$set_InsolvencyProfessional= $row4['InsolvencyProfessional'];
$set_DateofApplication = $row4['dateofapplication'];
$set_NameoftheIPA = $row4['nameofipa'];
$set_ReasonofRejection = $row4['reasonofrejection'];
$set_DateofRejection = $row4['dateofrejection'];*/
$set_limitedWhetherPassed = $row4['limitedWhetherPassed'];
$set_limitedInstitute = $row4['limitedInstitute'];
$set_limitedMarks = $row4['limitedMarks'];
$set_limitedDateOfPassing = $row4['limitedDateOfPassing'];
$set_limitedRemarks = $row4['limitedRemarks'];
$set_limited_pic=$row4['btnlimited_pic'];
$set_graduateWhetherPassed = $row4['graduateWhetherPassed'];
$set_graduateInstitute = $row4['graduateInstitute'];
$set_graduateMarks = $row4['graduateMarks'];
$set_graduateDateOfPassing = $row4['graduateDateOfPassing'];
$set_graduateRemarks = $row4['graduateRemarks'];
$set_graduate_pic=$row4['btngraduate_pic'];
}
?>
<table class="table" width="100%">
<tr>
<th width="2%">Sl.No.</th>
<th>Name of the examination/programme</th>
<th>Whether passed
(Yes / No)
</th>
<th>Name of the institute/organisation</th>
<th>Marks (%) /Grade/Class</th>
<th>Date of passing</th>
<th>Remarks, if any</th>
<th>Attachment
<span style="color:red;font-size:70%">[Max upload JPG/JPEG/PNG/PDF size 2MB]</span></th>
</tr>
<!-- <script>
function newFu() {
document.getElementById("Limited Insolvency Examination").disabled = true;
document.getElementById("Limited Insolvency Examination1").disabled = true;
document.getElementById("insolvency_exam_date").disabled = true;
document.getElementById("Limited Insolvency Examination3").disabled = true;
}
function dnewFu() {
document.getElementById("Limited Insolvency Examination").disabled = false;
document.getElementById("Limited Insolvency Examination1").disabled = false;
document.getElementById("insolvency_exam_date").disabled = false;
document.getElementById("Limited Insolvency Examination3").disabled = false;
}
</script>
<script src="https://code.jquery.com/ui/1.10.4/jquery-ui.js">
</script>
<!--<script>
$(document).ready(function() {
$("#ofrejection").datepicker({
changeYear:true,
yearRange: "2020:"
});
});
</script>-->
<script>
$(document).ready(function() {
$("#btnlimited_pic1").change(function () {
var fileInput = document.getElementById('btnlimited_pic1');
var filePath = fileInput.value;
var file_size = $("#btnlimited_pic1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr >
<td >1</td>
<td>Limited Insolvency Examination</td>
<!--<td><span>
<input type="radio" name="Whetherpassed" id="whether" value="Yes" onclick="dnewFu()" <?php if($set_limitedWhetherPassed == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="Whetherpassed" id="whether" onclick="newFu()" value="No" <?php if($set_limitedWhetherPassed == 'No'){?> checked <?php } ?>> No</span>
</td>-->
<td></td>
<td> <input type="varchar" name="institute/organisation" maxlength="255" id="Limited_Insolvency_Examination" value="<?=$set_limitedInstitute?>" size="25" ></td>
<td><input type="varchar" name="Grade/Class" maxlength="2" id="Limited_Insolvency_Examination1" value="<?=$set_limitedMarks?>" size="17" ></td>
<td><!--<input type="text" name="dateof" id="ofrejection" value="<?=$set_limitedDateOfPassing?>" class="form-control datetime dp" readonly >-->
<input type="text" name="dateof" id="insolvency_exam_date" value="<?=$set_limitedDateOfPassing?>" class="form-control datetime dp" readonly ></td>
<td><input type="varchar" name="Remarksif" maxlength="255" id="Limited_Insolvency_Examination3" value="<?=$set_limitedRemarks?>" size="12" ></td>
<td colspan="2">
<!-- <img src="" width="100" height="100" id="insolvency_exam_pic" name="insolvency_exam_pic">-->
<?php
if(!empty($limited_pic))
{
echo $limited_pic."
<input type='hidden' name='limited_pic' id='limited_pic' value='".$limited_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='limited_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnlimited_pic" id="btnlimited_pic1" class="form-control "> <span class="mandatory">*<span>';
}
?>
</td>
</tr>
<script>
function newF() {
document.getElementById("Graduate Insolvency Programme").disabled = true;
document.getElementById("Graduate Insolvency Programme1").disabled = true;
document.getElementById("Graduate").disabled = true;
document.getElementById("Graduate Insolvency Programme3").disabled = true;
document.getElementById("btngraduate_pic").disabled = true;
}
function dnewF() {
document.getElementById("Graduate Insolvency Programme").disabled = false;
document.getElementById("Graduate Insolvency Programme1").disabled = false;
document.getElementById("Graduate").disabled = false;
document.getElementById("Graduate Insolvency Programme3").disabled = false;
document.getElementById("btngraduate_pic").disabled = false;
}
</script>
<tr>
<td>2</td>
<td>Graduate Insolvency Programme</td>
<td><span>
<input type="radio" name="Whetherpassedor" id=" Insolvency Programme" value="Yes" onclick="dnewF()" <?php if($set_graduateWhetherPassed == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="Whetherpassedor" id="Insolvency Programme" onclick="newF()" value="No" <?php if($set_graduateWhetherPassed == 'No'){?> checked <?php } ?>> No</span>
</td>
<td> <input type="varchar" name="institute/organisations" maxlength="255" " <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate Insolvency Programme" value="<?=$set_graduateInstitute?>" size="25"></td>
<td><input type="varchar" name="Grade/Classp" maxlength="2" <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate Insolvency Programme1" value="<?=$set_graduateMarks?>" size="17"></td>
<td><input type="text" name="dateofp" <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate" value="<?=$set_graduateDateOfPassing?>" class="form-control datetime dp" ></td>
<td> <input type="varchar" name="Remarksi" maxlength="255" <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate Insolvency Programme3" value="<?=$set_graduateRemarks?>" size="12"></td>
<td colspan="2">
<?php
if(!empty($graduate_pic))
{
echo $graduate_pic."
<input type='hidden' name='graduate_pic' id='graduate_pic' value='".$graduate_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='graduate_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btngraduate_pic" id="btngraduate_pic" class="form-control "> <span class=""><span>';
}
?>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>C. WORK EXPERIENCE</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">1. Are you presently in practice / employment? <span class="mandatory" >*<span></td>
<?php
if($ispracticeemployment=="")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice" > Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment"> Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others"> Others
<input type="text" name="oth" id="oth" value="'.$oth.'" >
<br>
<span class="emplomenttext">I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</span>
</td>';
}
else
{
if($ispracticeemployment=="Practice")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice" checked> Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment"> Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others"> Others
<input type="text" name="oth" id="oth" value="'.$oth.'"><br>
<span class="emplomenttext">I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</span>
</td>';
}
if($ispracticeemployment=="Employment")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice"> Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment" checked> Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others"> Others
<input type="text" name="oth" id="oth" value="'.$oth.'">
<br>
<span class="emplomenttext_new"><b>I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</b></span>
</td>';
}
if($ispracticeemployment=="Others")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice"> Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment" > Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others" checked> Others
<input type="text" name="oth" id="oth" value="'.$oth.'">
<br>
<span class="emplomenttext">I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</span>
</td>';
}
}
?>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">2. Number of years in employment (in years and months):<span class="mandatory">*<span></td>
<td colspan="2"><input type="text" id="years_in_employment" name="years_in_employment" value="<?=$years_in_employment?>" ></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">3. Number of years in practice (in years and months): <span class="mandatory">*<span> </td>
<td colspan="2"><input type="text" maxlength="255" id="years_in_practice" name="years_in_practice" value="<?=$years_in_practice?>" ></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">
<h4>4. Professional Correspondence Address: <span class="mandatory">*<span></h4>
</td>
<td colspan="2">
<table cellpadding="0" cellspacing="0" width="100%">
<tr>
<td ><input type="checkbox" id="pchkobox" name="pchkobox"> Same as Correspondence </td>
<td ><input type="checkbox" id="pchkobox1" name="pchkobox1">Same as Permanent Address</td>
</tr>
<tr>
<td colspan="2">
<table>
<tr>
<td>Address:</td>
<td><input type="text" maxlength="255" name="prof_address" id="prof_address" value="<?=$prof_address?>" style="width:99%;" ></td>
</tr>
<td>State:</td>
<td>
<select name="pcstate" id="pcstate" >
<?php
$sql="select * from state_master order by statename ";
$result = mysqli_query($GLOBALS["link"], $sql);
while($row = mysqli_fetch_assoc($result)){
if($professional_state==$row['statename'])
echo "<option value='".$row['statename']."' selected>".$row['statename']."</option>";
else
echo "<option value='".$row['statename']."'>".$row['statename']."</option>";
}
?>
</select>
<!--<input style="width:28%;" type="text" name="pcstate" id="pcstate" value=""> -->
City: <input type="text" name="pccity" id="pccity" value="<?=$professional_city?>" class="pt2" >
Pin: <input type="text" name="pcpin" id="pcpin" value="<?=$professional_pincode?>" class="pt2" maxlength="6" pattern="[0-9]{6}">
</td>
</tr>
<tr>
<td></td>
<td><?php
if(!empty($prof_address_pic))
{
echo $prof_address_pic."
<input type='hidden' name='prof_address_pic' id='prof_address_pic' value='".$prof_address_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='prof_address_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnprof_address" id="btnprof_address1" class="form-control" >';
}
?> </td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<h4>5. Experience Details:<span class="mandatory">*<span></h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table class="table" width="100%">
<thead>
<tr>
<th >S.No.</th>
<th >From Date</th>
<th >To Date</th>
<th >Employment / Practice</th>
<th >If employed, Name of Employer and Designation</th>
<th >If in practice, practice as Advocate/Chartered Accountant/Company Secretary/Cost Accountant</th>
<th >Area of work</th>
<th >Attachment
<span style="color:red;font-size:70%">(Max upload JPG/JPEG/PNG/PDF size 2MB)</span></th>
</tr>
</thead>
<tbody class="experienceBody expd">
</tbody>
<tfoot>
<tr>
<td colspan="6"></td>
<td colspan="2" align="right">
<input type="hidden" name="experienceBodyRowCount" id="experienceBodyRowCount" value="">
<button type="button" class="removeRow" datafld="experienceBody">Remove last row</button>
<button type="button" class="addRow" datafld="experienceBody">Add Row</button>
</td>
</tr>
</tfoot>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>D. ADDITIONAL INFORMATION</h4>
</td>
</tr>
<script>
function disab()
{
document.getElementById("isconvictdetails").disabled = true;
}
function enab()
{
document.getElementById("isconvictdetails").disabled = false;
}
</script>
<tr style="display:<?php echo $display;?>">
<td><span class="mandatory">*</span> 1. Have you ever been convicted for an offence? </td>
<td>
<input type="radio" name="isconvict" id="isconvict" value="Yes" onclick="enab()" <?php if($isconvict == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="isconvict" id="isconvict" value="No" onclick="disab()" <?php if($isconvict == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($isconvict == 'No'){?> disabled <?php } ?> name="isconvictdetails" id="isconvictdetails" value="<?=$isconvictdetails?>" size="10"></span>
<?php
/*if($isconvict=="")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" onclick="disab()" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" onclick="enab()"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="" size="10"></span>';
}
else
{
if($isconvict=="Yes")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" checked> Yes
<input type="radio" name="isconvict" id="isconvict" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="'.$isconvictdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" checked> No</span><br>';
}
}*/
?>
</td>
<?php
/* if($isconvict=="")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" onclick="Function()"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="" size="10"></span>';
}
else
{
if($isconvict=="Yes")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" checked> Yes
<input type="radio" name="isconvict" id="isconvict" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="'.$isconvictdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" > No</span><br>';
}
}*/
?>
</td>
<script>
function enable()
{
document.getElementById("iscriminalproceedingsdetails").disabled = true;
}
function disable()
{
document.getElementById("iscriminalproceedingsdetails").disabled = false;
}
</script>
<td><span class="mandatory">*</span> 2. Are any criminal proceedings pending against you? </td>
<td>
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="Yes" onclick="disable()" <?php if($iscriminalproceedings == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="No" onclick="enable()" <?php if($iscriminalproceedings == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($iscriminalproceedings == 'No'){?> disabled <?php } ?> name="iscriminalproceedingsdetails" id="iscriminalproceedingsdetails" value="<?=$iscriminalproceedingsdetails?>" size="10"></span>
<?php
/*if($iscriminalproceedings=="")
{
echo '<span><input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" onclick="disable()" value="Yes" > Yes
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" onclick="enable()" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="iscriminalproceedingsdetails" maxlength="255" id="iscriminalproceedingsdetails" value="" size="10"></span>';
}
else
{
if($iscriminalproceedings=="Yes")
{
echo '<span><input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="Yes" checked> Yes <input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="iscriminalproceedingsdetails" maxlength="255" id="iscriminalproceedingsdetails" value="'.$iscriminalproceedingsdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="Yes"> Yes
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="No" checked> No</span><br>';
}
}*/
?>
</td>
</tr>
<script>
function fun()
{
document.getElementById("isundischaredbankruptdetails").disabled = true;
}
function dfun()
{
document.getElementById("isundischaredbankruptdetails").disabled = false;
}
</script>
<tr style="display:<?php echo $display;?>">
<td><span class="mandatory">*</span> 3. Have you ever been declared as an insolvent/bankrupt, or applied to be declared so? </td>
<td>
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="Yes" onclick="dfun()" <?php if($isundischaredbankrupt == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="No" onclick="fun()" <?php if($isundischaredbankrupt == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($isundischaredbankrupt == 'No'){?> disabled <?php } ?> name="isundischaredbankruptdetails" id="isundischaredbankruptdetails" value="<?=$isundischaredbankruptdetails?>" size="10"></span>
<?php
/*if($isundischaredbankrupt=="")
{
echo '<span><input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" onclick="dfun()" value="Yes" > Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" onclick="fun()" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isundischaredbankruptdetails" id="type" maxlength="255" value="" size="10"></span>';
}
else
{
if($isundischaredbankrupt=="Yes")
{
echo '<span><input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="Yes" checked> Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isundischaredbankruptdetails" id="isundischaredbankruptdetails" maxlength="255" value="'.$isundischaredbankruptdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="Yes"> Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="No" checked> No</span><br>';
}
}*/
?>
</td>
<script>
function enabl()
{
document.getElementById("types").disabled = true;
//document.getElementById("types").setAttribute('disabled') = 'disabled';
}
function disabl()
{
document.getElementById("types").disabled = false;
}
</script>
<td><span class="mandatory">*</span>4. Is there any disciplinary proceeding pending against you or has been taken against you at any time
in the preceding three years by the ICAI, ICSI, ICAI (Cost), Bar Council or RVO?
</td>
<td>
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes" onclick="disabl()" <?php if($isIcaiCouncilorRVO == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No" onclick="enabl()" <?php if($isIcaiCouncilorRVO == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($isIcaiCouncilorRVO == 'No'){?> disabled <?php } ?> name="isIcaiCouncilorRVOdetails" id="types" value="<?=$isIcaiCouncilorRVOdetails?>" size="10"></span>
<?php
/*if($isIcaiCouncilorRVO=="")
{
echo '<span><input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes" onclick="disabl()" > Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No" onclick="enabl()"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isIcaiCouncilorRVOdetails" id="ICAI" maxlength="255" value="" size="10"></span>';
}
else
{
if($isIcaiCouncilorRVO=="Yes")
{
echo '<span><input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes" checked> Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isIcaiCouncilorRVOdetails" id="isIcaiCouncilorRVOdetails" maxlength="255" value="'.$isIcaiCouncilorRVOdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes"> Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No" checked> No</span><br>';
}
}*/
?>
</td>
</tr>
</tr>
<tr style="display:<?php echo $display;?>">
<td><span class="mandatory">*</span>5.Have your ever applied for Enrollment with any Insolvency Professional Agency? </td>
<td>
<script>
function newFuncti() {
document.getElementById("Professional").disabled = true;
document.getElementById("Professional1").disabled = true;
document.getElementById("Professional2").disabled = true;
document.getElementById("Professional3").disabled = true;
}
function dnewFuncti() {
document.getElementById("Professional").disabled = false;
document.getElementById("Professional1").disabled = false;
document.getElementById("Professional2").disabled = false;
document.getElementById("Professional3").disabled = false;
}
</script>
<span><input type="radio" name="professional_agency" id="Professional" onclick="dnewFuncti()" value="Yes" <?php if($InsolvencyProfessional == 'Yes'){?> checked <?php } ?> > Yes
<input type="radio" name="professional_agency" id="Professional" value="No" onclick="newFuncti(this)" <?php if($InsolvencyProfessional == 'No'){?> checked <?php } ?> > No</span><br>
<span>If Yes, please give details: </br>
<table class="table" border="1px">
<tr>
<th align="left">Date of application:</th>
<!--<th> <input type="longtext" name="dateofapplication" id="Professional" value="<?=$DateofApplication?>" class="form-control datetime dp" ></th>
<th > <input type="longtext" name="dateofapplication" id="Professional" value="<?=$DateofApplication?>" class="form-control datetime dp" ></th>-->
<th > <input type="longtext" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="dateofapplication" id="Professional" value="<?=$DateofApplication?>" class="form-control datetime dp" readonly ></th>
</tr>
<tr>
<th align="left"> Name of the IPA:</th>
<th><input type="text" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="nameofipa" id="Professional1" value="<?=$NameoftheIPA?>" ></th>
</tr>
<tr>
<th align="left">Reason of Rejection:</th>
<th><input type="text" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="reasonofrejection" id="Professional2" value="<?=$ReasonofRejection?>" ></th>
</tr>
<tr>
<th align="left"> Date of rejection:</th>
<!--<th><input type="longtext" name="dateofrejection" id="Professional3" value="<?=$DateofRejection?>" class="form-control datetime dp" ></th>-->
<th><input type="longtext" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="dateofrejection" id="Professional3" value="<?=$DateofRejection?>" class="form-control datetime dp" readonly ></th>
</tr>
</table>
</span>
<?php
/* if($InsolvencyProfessional=="")
{
echo '<span><input type="radio" name="professional_agency" id="Professional " onclick="dnewFuncti()" value="Yes" > Yes
<input type="radio" name="professional_agency" id="Professional " value="No" onclick="newFuncti()" > No</span><br>
<span>If Yes, please give details: </br>
<table class="table" border="2px">
<tr>
<th align="left">Date of application:</th>
<th> <input type="longtext" name="dateofapplication" id="Professional" value="'.$DateofApplication.'" class="form-control datetime dp" readonly ></th>
</tr>
<tr>
<th align="left"> Name of the IPA:</th>
<th><input type="text" name="nameofipa" id="Professional1" value="'.$NameoftheIPA.'" ></th>
</tr>
<tr>
<th align="left">Reason of Rejection:</th>
<th><input type="text" name="reasonofrejection" id="Professional2" value="'.$ReasonofRejection.'" ></th>
</tr>
<tr>
<th align="left"> Date of rejection:</th>
<th><input type="longtext" name="dateofrejection" id="Professional3" value="'.$DateofRejection.'" class="form-control datetime dp" readonly ></th>
</tr>
</table>
</span>';
}
else
{
if($InsolvencyProfessional=="Yes")
{
echo '<span><input type="radio" name="professional_agency" id="Professional Agency" value="Yes" checked> Yes
<input type="radio" name="professional_agency" id="Professional Agency" value="No" > No</span><br>
<span>If Yes, please give details:</br>
<table border="2px">
<tr>
<th align="left">Date of application:</th>
<th><input type="longtext" name="dateofapplication" id="insolvency_exam_date" value="'.$DateofApplication.'" class="form-control datetime dp" readonly ></th></tr>
<tr>
<th align="left"> Name of the IPA:</th>
<th><input type="text" name="nameofipa" id="isundischaredbankruptdetails" value="'. $NameoftheIPA.'" ></th></tr>
<tr>
<th align="left">Reason of Rejection:</th>
<th><input type="text" name="reasonofrejection" id="isundischaredbankruptdetails" value="'.$ReasonofRejection.'" ></th></tr>
<tr>
<th align="left"> Date of rejection:</th>
<th><input type="longtext" name="dateofrejection" id="dateofrejection" value="'. $DateofRejection.'" class="form-control datetime dp" readonly ></th>
</tr>
</table>
</span>';
}
else
{
echo '<span><input type="radio" name="professional_agency" id="Professional Agency" value="Yes"> Yes
<input type="radio" name="professional_agency" id="Professional Agency" value="No" checked> No</span><br>';
}
}*/
?>
</td>
<td ><b class="mandatory">*</b> 6. Please provide any additional information that may be relevant for your application. </td>
<td> <textarea id="additionalInfo" name="additionalInfo" ><?=$additionalInfo?></textarea></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>E. ATTACHMENTS <span class="mandatory">*<span></h4>
</td>
</tr>
<script>
$(document).ready(function() {
$("#btnyear4").change(function () {
var fileInput = document.getElementById('btnyear4');
var filePath = fileInput.value;
var file_size = $("#btnyear4")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnyear5").change(function () {
var fileInput = document.getElementById('btnyear5');
var filePath = fileInput.value;
var file_size = $("#btnyear5")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnyear6").change(function () {
var fileInput = document.getElementById('btnyear6');
var filePath = fileInput.value;
var file_size = $("#btnyear6")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
1. Financial statement/ Income-tax-Returns for the last three years(Copy of Acknowledgement).
<table class="table" width="50%">
<tr>
<thead>
<th>Sl.No.</th>
<th>Year</th>
<th>Attach Proof<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></th>
</thead>
</tr>
<tbody >
<tr>
<td align="center">1.</td>
<td align="center">
<?php
echo '<select name="year1" id="year1">';
$from=date("Y");
while($from!=2014)
{
$tmp=$from.'-'.($from+1);
if($year1==$tmp)
{
echo "<option value='".$from.'-'.($from+1)."' selected>".$from.'-'.($from+1)."</option>";
}
else
{
echo "<option value='".$from.'-'.($from+1)."'>".$from.'-'.($from+1)."</option>";
}
$from=$from-1;
}
echo '</select>';
?>
</td>
<td align="center">
<?php
if(!empty($year1pic))
{
echo $year1pic."
<input type='hidden' name='year1pic' id='year1pic' value='".$year1pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='year1pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnyear1" id="btnyear4" class="form-control" >';
}
?>
<!-- <img src="" width="70" height="90" id="year1pic" name="year1pic"><br>-->
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td align="center">2.</td>
<td align="center">
<?php
echo '<select name="year2" id="year2">';
$from=date("Y");
while($from!=2014)
{
$tmp=$from.'-'.($from+1);
if($year2==$tmp)
{
echo "<option value='".$from.'-'.($from+1)."' selected>".$from.'-'.($from+1)."</option>";
}
else
{
echo "<option value='".$from.'-'.($from+1)."'>".$from.'-'.($from+1)."</option>";
}
$from=$from-1;
}
echo '</select>';
?>
</td>
<td align="center">
<!-- <img src="" width="70" height="90" id="year2pic" name="year2pic"><br>-->
<?php
if(!empty($year2pic))
{
echo $year2pic."
<input type='hidden' name='year2pic' id='year2pic' value='".$year2pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='year2pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnyear2" id="btnyear5" class="form-control" >';
}
?>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td align="center">3.</td>
<td align="center">
<?php
echo '<select name="year3" id="year3">';
$from=date("Y");
while($from!=2014)
{
$tmp=$from.'-'.($from+1);
if($year3==$tmp)
{
echo "<option value='".$from.'-'.($from+1)."' selected>".$from.'-'.($from+1)."</option>";
}
else
{
echo "<option value='".$from.'-'.($from+1)."'>".$from.'-'.($from+1)."</option>";
}
$from=$from-1;
}
echo '</select>';
?>
</td>
<td align="center">
<!--<img src="" width="70" height="90" id="year3pic" name="year3pic"><br>-->
<?php
if(!empty($year3pic))
{
echo $year3pic."
<input type='hidden' name='year3pic' id='year3pic' value='".$year3pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='year3pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnyear3" id="btnyear6" class="form-control" >';
}
?>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">2. Enrolment Fees: <span class="mandatory">*</span></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table width="100%">
<tr>
<td style="width:20%;">a). Payment of Fees: </td>
<td >Transaction ID:
<input type="text" name="payment_recd" id="payment_recd" readonly>
<input type="hidden" name="paymentfees" id="paymentfees" value="<?=$paymentfees?>">
</td>
<td id="pstatus">
Payment From: <span class="mandatory">*<span>
<select name="paymentfrom" id="paymentfrom" >
<option value="0">--Select--</option>
<?php
if($paymentfrom=='CA')
{
echo "<option value='CA' selected>Chartered Accountant</option>";
}
else{
echo "<option value='CA'>Chartered Accountant</option>";
}
if($paymentfrom=='Ot')
{
echo "<option value='Others' selected>Others</option>";
}
else{
echo "<option value='Others'>Others</option>";
}
?>
</select>
<button type="button" id="pymnt">Payment</button>
</td>
<td></td>
<td></td>
</tr>
</table>
</td>
<!-- <img src="" width="70" height="90" id="evidence_pic" name="evidence_pic"><br>-->
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>F. UNDERSTANDING</h4>
<p>I understand and agree that my enrolment with IIIPI and attending of Pre-registration course does not entitle me to the registration, which is subject to my complying with various requirements of IBBI and satisfactory completion of Pre-Registration Course.</p>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>G. AFFIRMATIONS</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">1. <span class="mandatory">*</span>
<input class="form-check-input " type="checkbox" id="affirm1" name="affirm1" value="1" <?php echo ($affirm1)?'checked':''; ?> > Copies of documents, required as of this application form have been attached/uploaded.<br> I undertake to furnish any additional information/documents as and when called for.
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">2. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm2" name="affirm2" value="1" <?php echo ($affirm2)?'checked':''; ?> > I am not disqualified from being enrolled as a professional member with any Insolvency<br> Professional Agency under the Insolvency and Bankruptcy Board of India (Insolvency <br> Professionals) Regulations,2016.</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">3. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm3" name="affirm3" value="1" <?php echo ($affirm3)?'checked':''; ?> > I hereby certify and declare that i am not an undischarged insolvent/bankrupt and have not made <br>any application to be adjudged so under the laws of any jurisdiction. </td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">4. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm4" name="affirm4" value="1" <?php echo ($affirm4)?'checked':''; ?> >This application and the information furnished by me along with this application is true and
complete. If found false or misleading at any stage, my enrolment shall be summarily
cancelled.
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">5. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm5" name="affirm5" value="1" <?php echo ($affirm5)?'checked':''; ?> >I hereby undertake to comply with the requirements of the Insolvency and Bankruptcy Code,2016,the rules, regulations,guidlines and circulars issued thereunder, the bye-laws of the indian institute of Insolvency Professionals of ICAI (IIIPI) with which I am enrolled, and the resolutions passed, and directions given by the Board and the Governing Board of IIIPI. </td>
</tr>
<tr>
<td colspan="4" align="center">
<?php
if(empty($form_pic))
{
echo'<button type="submit" name="save_as_draft" id="save_as_draft" value="save_as_draft" style="display:'.$dis.'"><b>Save As Draft</b></button> ';
echo'<button type="button" name="bsave" id="bsave" value="bsave" onclick="return frm_validate();" style="display:'.$dis.'"><b>Submit</b></button>';
}
?>
<button type='submit' name="formcopy" id="formcopy" value="Formcopy" ><b>Download PDF Application</b></button>
<!--<button type='submit' name="formcopy" id="formcopy" value="Formcopy" ><b>Submit</b></button>-->
</td>
</tr>
<tr style="display:<?php echo $display.$footer;?>">
<td colspan="4">
<table width="100%">
<tr>
<td width="30%">Upload signed Copy of enrollment form:<span class="mandatory">*<span></td>
<td>
<?php
if(!empty($form_pic))
{
echo $form_pic."
<input type='hidden' name='form_pic' id='form_pic' value='".$form_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
</form>";
/* <button type='submit' name='removeimg' id='removeimg' value='form_pic' class='remove'>Remove</button> */
}
else
{
echo '<input type="file" name="btnform" id="btnform" class="form-control">';
}
?>
</td>
</tr>
<tr>
<td>Place:<span class="mandatory"><span></td>
<td><input type="text" maxlength="255" id="place" name="place" value="<?=$place?>" ></td>
</tr>
<tr>
<td>Date:</td>
<td><input type="text" maxlength="255" id="formdate" name="formdate" value="<?=date("d-m-Y")?>" readonly></td>
</tr>
</table>
</td>
</tr>
<!--
<tr>
<td colspan="4"><hr></td>
</tr>
<tr>
<td colspan="4">
<p align="center"><b>FOR OFFICE USE ONLY</b></p>
</td>
</tr>
<tr>
<td colspan="4">
<table width="100%">
<tr>
<td width="25%">1. Date of Receipt of Application:</td>
<td><input type="text" maxlength="255" name="date_of_receipt" id="date_of_receipt"></td>
</tr>
<tr>
<td>2. Receipt Number:</td>
<td><input type="text" maxlength="255" name="receiptno" id="receiptno"></td>
</tr>
<tr>
<td>3. Enrolment Number:</td>
<td><input type="text" maxlength="255" name="enrolmentno" id="enrolmentno"></td>
</tr>
<tr>
<td>4. Date of Issue:</td>
<td><input type="text" name="date_of_issue" id="date_of_issue" class="datetime"></td>
</tr>
</table>
</td>
</tr>
<tr>
<td colspan="4" align="right"><b>Signature</b></td>
</tr>
-->
<tr style="display:<?php echo $display.$footer;?>">
<td colspan="4" align="center">
<input type="hidden" name="relatefld" id="relatefld" value="<?=$rfld?>" class="">
<?php
if($form_pic!='')
{
/* echo '<button type="submit" class="btn btn-primary btn-lg" value="Submit" name="submit" id="submit" ><b>Final Upload</b></button>'; */
}
else
{
echo '<button type="submit" class="btn btn-primary btn-lg" value="Submit" name="submit" id="submit" disabled><b>Final Upload</b></button>';
}
?>
</td>
</tr>
</table>
</form>Did this file decode correctly?
Original Code
<script>
var prefilldata = [];
<?php
$batchid = uniqid ("FORMPREREG",true);
?>
</script>
<style>
.mandatory{color:red;font-weight:bold;}
h4 { font-size: 16px; margin:0;}
.expd input{
width:auto;
}
.pt {
width:28%;
}
.pt2 {
width:19%;
}
.emplomenttext{
display:none;
font-weight:bold;
}
</style>
<?php session_start(); ?>
<script>
<?php
$sql="select * from pre_reg_form where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
if(mysqli_num_rows($result)>0){
$sql="select * from pre_reg_form where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
//$row = mysqli_fetch_assoc($result);
while($rec= mysqli_fetch_assoc($result)){
foreach ($rec as $key => $value) {
${$key} = $value;
echo "
prefilldata[\"$key\"] = \"".str_replace("\r\n","",nl2br($rec[$key]))."\";
";
}
}
//@extract($rec);
$isedit="false";
$rfld=$id;
if(mysqli_num_rows($result)>0){
$isedit="true";
$s=1;
$sql="select * from pre_reg_edu_detail where batchid='$batchid' order by rowid";
$result1 = mysqli_query($GLOBALS["link"], $sql);
while($row1 = mysqli_fetch_assoc($result1)){
foreach ($row1 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row1[$key]))."\";
";
}
$s++;
//@extract($row1);
}
$s=1;
$sql="select * from pre_reg_prof_detail where batchid='$batchid' order by rowid";
$result2 = mysqli_query($GLOBALS["link"], $sql);
while($row2 = mysqli_fetch_assoc($result2)){
foreach ($row2 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row2[$key]))."\";
";
}
$s++;
//@extract($row2);
}
$s=1;
$sql="select * from pre_reg_exp_detail where batchid='$batchid' order by rowid";
$result3 = mysqli_query($GLOBALS["link"], $sql);
while($row3 = mysqli_fetch_assoc($result3)){
foreach ($row3 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row3[$key]))."\";
";
}
$s++;
//@extract($row3);
}
$s=1;
$sql="select * from iiici_editing_entry where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
while($row4 = mysqli_fetch_assoc($result4)){
foreach ($row4 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row4[$key]))."\";
";
}
$s++;
//@extract($row4);
}
}
}
else{
$sql="select * from pre_reg_form_temp where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
//$row = mysqli_fetch_assoc($result);
while($rec= mysqli_fetch_assoc($result)){
foreach ($rec as $key => $value) {
${$key} = $value;
echo "
prefilldata[\"$key\"] = \"".str_replace("\r\n","",nl2br($rec[$key]))."\";
";
}
}
//@extract($rec);
$isedit="false";
$rfld=$id;
if(mysqli_num_rows($result)>0){
$isedit="true";
$s=1;
$sql="select * from pre_reg_edu_detail_temp where batchid='$batchid' order by rowid";
$result1 = mysqli_query($GLOBALS["link"], $sql);
while($row1 = mysqli_fetch_assoc($result1)){
foreach ($row1 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row1[$key]))."\";
";
}
$s++;
//@extract($row1);
}
$s=1;
$sql="select * from pre_reg_prof_detail_temp where batchid='$batchid' order by rowid";
$result2 = mysqli_query($GLOBALS["link"], $sql);
while($row2 = mysqli_fetch_assoc($result2)){
foreach ($row2 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row2[$key]))."\";
";
}
$s++;
//@extract($row2);
}
$s=1;
$sql="select * from pre_reg_exp_detail_temp where batchid='$batchid' order by rowid";
$result3 = mysqli_query($GLOBALS["link"], $sql);
while($row3 = mysqli_fetch_assoc($result3)){
foreach ($row3 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row3[$key]))."\";
";
}
$s++;
//@extract($row3);
}
$s=1;
$sql="select * from iiici_editing_entry_temp where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
while($row4 = mysqli_fetch_assoc($result4)){
foreach ($row4 as $key => $value) {
${$key} = $value;
$k='_'.$s;
echo "
prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row4[$key]))."\";
";
}
$s++;
//@extract($row4);
}
}
}
?>
// $('.chk_size').on('change', function() {
// alert('comingggg');
// });
</script>
<script>
// jQuery(document).ready(function(){ //
function frm_validate(){
var membertitle=$('#membertitle').val();
var membername=$('#membername').val();
var fathersname=$('#fathersname').val();
var date_of_birth=$('#date_of_birth').val();
var place_of_birth=$('#place_of_birth').val();
var panno = $('#panno').val();
var btnpan1=$('#btnpan1').val();
var adharno=$('#adharno').val();
var btnadhar1=$('#btnadhar1').val();
var state=$('#state').val();
var city=$('#city').val();
var pin = $('#pin').val();
var btnaddress1=$('#btnaddress1').val();
var address_of_correspondence=$('#address_of_correspondence').val();
var permanent_address=$('#permanent_address').val();
var pstate=$('#pstate').val();
var pcity=$('#pcity').val();
var ppin=$('#ppin').val();
var btnpaddress1 = $('#btnpaddress1').val();
var emailid=$('#emailid').val();
var mobileno=$('#mobileno').val();
var landline=$('#landline').val();
var dinRadioNo=$('#dinRadioNo').val();
var din_pic1 = $('#din_pic1').val();
var score=$('#score').val();
var btnscore1=$('#btnscore1').val();
var qual_1=$('#qual_1').val();
var prof_year_1=$('#prof_year_1').val();
var inst_1=$('#inst_1').val();
var mrn_1=$('#mrn_1').val();
var dateofenrollment_1=$('#dateofenrollment_1').val();
var qual_2=$('#qual_2').val();
var prof_year_2=$('#prof_year_2').val();
var inst_2=$('#inst_2').val();
var mrn_2=$('#mrn_2').val();
var dateofenrollment_2=$('#dateofenrollment_2').val();
var qual_3=$('#qual_3').val();
var prof_year_3=$('#prof_year_3').val();
var inst_3=$('#inst_3').val();
var mrn_3=$('#mrn_3').val();
var dateofenrollment_3=$('#dateofenrollment_3').val();
var Limited_Insolvency_Examination=$('#Limited_Insolvency_Examination').val();
var Limited_Insolvency_Examination1=$('#Limited_Insolvency_Examination1').val();
var insolvency_exam_date=$('#insolvency_exam_date').val();
var Limited_Insolvency_Examination3=$('#Limited_Insolvency_Examination3').val();
var btnlimited_pic1=$('#btnlimited_pic1').val();
var btnlimited_pic1 = $('#btnlimited_pic1').val();
var ispracticeemployment1=$('#ispracticeemployment1').val();
var years_in_employment=$('#years_in_employment').val();
var years_in_practice=$('#years_in_practice').val();
var prof_address=$('#prof_address').val();
var pccity=$('#pccity').val();
var pcpin = $('#pcpin').val();
var btnprof_address1=$('#btnprof_address1').val();
var isconvict=$('#isconvict').val();
var iscriminalproceedings=$('#iscriminalproceedings').val();
var isundischaredbankrupt=$('#isundischaredbankrupt').val();
var isIcaiCouncilorRVO=$('#isIcaiCouncilorRVO').val();
var Professional = $('#Professional').val();
var Professional1=$('#Professional1').val();
var Professional2=$('#Professional2').val();
var Professional3=$('#Professional3').val();
var additionalInfo=$('#additionalInfo').val();
var btnyear4 = $('#btnyear4').val();
var btnyear5=$('#btnyear5').val();
var btnyear6=$('#btnyear6').val();
var paymentfrom=$('#paymentfrom').val();
var affirm1=$('#affirm1').val();
var affirm2=$('#affirm2').val();
var affirm3=$('#affirm3').val();
var affirm4=$('#affirm4').val();
var affirm5 = $('#affirm5').val();
var payment_recd = $('#payment_recd').val();
document.getElementById('membertitle').style.borderColor ="";
document.getElementById('membername').style.borderColor ="";
document.getElementById('fathersname').style.borderColor ="";
document.getElementById('date_of_birth').style.borderColor ="";
document.getElementById('place_of_birth').style.borderColor ="";
document.getElementById('panno').style.borderColor ="";
// document.getElementById('btnpan1').style.borderColor ="";
document.getElementById('adharno').style.borderColor ="";
// document.getElementById('btnadhar1').style.borderColor ="";
document.getElementById('address_of_correspondence').style.borderColor ="";
document.getElementById('state').style.borderColor ="";
document.getElementById('city').style.borderColor ="";
document.getElementById('pin').style.borderColor ="";
// document.getElementById('btnaddress1').style.borderColor ="";
document.getElementById('permanent_address').style.borderColor ="";
document.getElementById('pstate').style.borderColor ="";
document.getElementById('pcity').style.borderColor ="";
document.getElementById('ppin').style.borderColor ="";
// document.getElementById('btnpaddress1').style.borderColor ="";
document.getElementById('emailid').style.borderColor ="";
document.getElementById('mobileno').style.borderColor ="";
document.getElementById('score').style.borderColor ="";
// document.getElementById('btnscore1').style.borderColor ="";
document.getElementById('qual_1').style.borderColor ="";
document.getElementById('prof_year_1').style.borderColor ="";
document.getElementById('inst_1').style.borderColor ="";
document.getElementById('mrn_1').style.borderColor ="";
document.getElementById('dateofenrollment_1').style.borderColor ="";
document.getElementById('Limited_Insolvency_Examination').style.borderColor ="";
document.getElementById('Limited_Insolvency_Examination1').style.borderColor ="";
document.getElementById('insolvency_exam_date').style.borderColor ="";
document.getElementById('Limited_Insolvency_Examination3').style.borderColor ="";
//document.getElementById('btnlimited_pic1').style.borderColor ="";
document.getElementById('years_in_employment').style.borderColor ="";
document.getElementById('years_in_practice').style.borderColor ="";
document.getElementById('prof_address').style.borderColor ="";
document.getElementById('pccity').style.borderColor ="";
document.getElementById('pcpin').style.borderColor ="";
// document.getElementById('btnprof_address1').style.borderColor ="";
document.getElementById('isconvict').style.borderColor ="";
document.getElementById('iscriminalproceedings').style.borderColor ="";
document.getElementById('isundischaredbankrupt').style.borderColor ="";
document.getElementById('isIcaiCouncilorRVO').style.borderColor ="";
document.getElementById('Professional').style.borderColor ="";
document.getElementById('Professional1').style.borderColor ="";
document.getElementById('Professional2').style.borderColor ="";
document.getElementById('Professional3').style.borderColor ="";
document.getElementById('additionalInfo').style.borderColor ="";
// document.getElementById('btnyear4').style.borderColor ="";
// document.getElementById('btnyear5').style.borderColor ="";
// document.getElementById('btnyear6').style.borderColor ="";
document.getElementById('paymentfrom').style.borderColor ="";
document.getElementById('affirm1').style.borderColor ="";
document.getElementById('affirm2').style.borderColor ="";
document.getElementById('affirm3').style.borderColor ="";
document.getElementById('affirm4').style.borderColor ="";
document.getElementById('payment_recd').style.borderColor ="";
// document.getElementById("membername").required = true;
if(membertitle == ''){
document.getElementById("membertitle").style.borderColor = "red";
document.getElementById("membertitle").focus();
// alert("Please Compleate Payment First!");
return false;
}
else if(membername == ''){
document.getElementById("membername").style.borderColor = "red";
document.getElementById("membername").focus();
//alert("Please Compleate Payment First!");
return false;
}
else if(fathersname == ''){
document.getElementById("fathersname").style.borderColor = "red";
document.getElementById("fathersname").focus();
return false;
}
else if(date_of_birth == ''){
document.getElementById("date_of_birth").style.borderColor = "red";
document.getElementById("date_of_birth").focus();
return false;
}
else if(place_of_birth == ''){
document.getElementById("place_of_birth").style.borderColor = "red";
document.getElementById("place_of_birth").focus();
return false;
}
else if(panno == ''){
document.getElementById("panno").style.borderColor = "red";
document.getElementById("panno").focus();
return false;
}
else if(btnpan1 == ''){
document.getElementById("btnpan1").style.borderColor = "red";
document.getElementById("btnpan1").focus();
return false;
}
else if(adharno == ''){
document.getElementById("adharno").style.borderColor = "red";
document.getElementById("adharno").focus();
return false;
}
else if(btnadhar1 == ''){
document.getElementById("btnadhar1").style.borderColor = "red";
document.getElementById("btnadhar1").focus();
return false;
}
else if(address_of_correspondence == ''){
document.getElementById("address_of_correspondence").style.borderColor = "red";
document.getElementById("address_of_correspondence").focus();
return false;
}
else if(state == ''){
document.getElementById("state").style.borderColor = "red";
document.getElementById("state").focus();
return false;
}
else if(city == ''){
document.getElementById("city").style.borderColor = "red";
document.getElementById("city").focus();
return false;
}
else if(pin == ''){
document.getElementById("pin").style.borderColor = "red";
document.getElementById("pin").focus();
return false;
}
else if(btnaddress1 == ''){
document.getElementById("btnaddress1").style.borderColor = "red";
document.getElementById("btnaddress1").focus();
return false;
}
else if(permanent_address == ''){
document.getElementById("permanent_address").style.borderColor = "red";
document.getElementById("permanent_address").focus();
return false;
}
else if(pstate == ''){
document.getElementById("pstate").style.borderColor = "red";
document.getElementById("pstate").focus();
return false;
}
else if(pcity == ''){
document.getElementById("pcity").style.borderColor = "red";
document.getElementById("pcity").focus();
return false;
}
else if(ppin == ''){
document.getElementById("ppin").style.borderColor = "red";
document.getElementById("ppin").focus();
return false;
}
else if(btnpaddress1 == ''){
document.getElementById("btnpaddress1").style.borderColor = "red";
document.getElementById("btnpaddress1").focus();
return false;
}
else if(emailid == ''){
document.getElementById("emailid").style.borderColor = "red";
document.getElementById("emailid").focus();
return false;
}
else if(mobileno == ''){
document.getElementById("mobileno").style.borderColor = "red";
document.getElementById("mobileno").focus();
return false;
}
else if(score == ''){
document.getElementById("score").style.borderColor = "red";
document.getElementById("score").focus();
return false;
}
else if(btnscore1 == ''){
document.getElementById("btnscore1").style.borderColor = "red";
document.getElementById("btnscore1").focus();
return false;
}
else if(qual_1 == ''){
document.getElementById("qual_1").style.borderColor = "red";
document.getElementById("qual_1").focus();
return false;
}
else if(prof_year_1 == ''){
document.getElementById("prof_year_1").style.borderColor = "red";
document.getElementById("prof_year_1").focus();
return false;
}
else if(inst_1 == ''){
document.getElementById("inst_1").style.borderColor = "red";
document.getElementById("inst_1").focus();
return false;
}
else if(mrn_1 == ''){
document.getElementById("mrn_1").style.borderColor = "red";
document.getElementById("mrn_1").focus();
return false;
}
else if(dateofenrollment_1 == ''){
document.getElementById("dateofenrollment_1").style.borderColor = "red";
document.getElementById("dateofenrollment_1").focus();
return false;
}
else if(Limited_Insolvency_Examination == ''){
document.getElementById("Limited_Insolvency_Examination").style.borderColor = "red";
document.getElementById("Limited_Insolvency_Examination").focus();
return false;
}
else if(Limited_Insolvency_Examination1 == ''){
document.getElementById("Limited_Insolvency_Examination1").style.borderColor = "red";
document.getElementById("Limited_Insolvency_Examination1").focus();
return false;
}
else if(insolvency_exam_date == ''){
document.getElementById("insolvency_exam_date").style.borderColor = "red";
document.getElementById("insolvency_exam_date").focus();
return false;
}
else if(Limited_Insolvency_Examination3 == ''){
document.getElementById("Limited_Insolvency_Examination3").style.borderColor = "red";
document.getElementById("Limited_Insolvency_Examination3").focus();
return false;
}
else if(btnlimited_pic1 == ''){
document.getElementById("btnlimited_pic1").style.borderColor = "red";
document.getElementById("btnlimited_pic1").focus();
return false;
}
else if(years_in_employment == ''){
document.getElementById("years_in_employment").style.borderColor = "red";
document.getElementById("years_in_employment").focus();
return false;
}
else if(years_in_practice == ''){
document.getElementById("years_in_practice").style.borderColor = "red";
document.getElementById("years_in_practice").focus();
return false;
}
else if(prof_address == ''){
document.getElementById("prof_address").style.borderColor = "red";
document.getElementById("prof_address").focus();
return false;
}
else if(pccity == ''){
document.getElementById("pccity").style.borderColor = "red";
document.getElementById("pccity").focus();
return false;
}
else if(pcpin == ''){
document.getElementById("pcpin").style.borderColor = "red";
document.getElementById("pcpin").focus();
return false;
}
else if(btnprof_address1 == ''){
document.getElementById("btnprof_address1").style.borderColor = "red";
document.getElementById("btnprof_address1").focus();
return false;
}
else if(isconvict == ''){
document.getElementById("isconvict").style.borderColor = "red";
document.getElementById("isconvict").focus();
return false;
}
else if(iscriminalproceedings == ''){
document.getElementById("iscriminalproceedings").style.borderColor = "red";
document.getElementById("iscriminalproceedings").focus();
return false;
}
else if(isundischaredbankrupt == ''){
document.getElementById("isundischaredbankrupt").style.borderColor = "red";
document.getElementById("isundischaredbankrupt").focus();
return false;
}
else if(isIcaiCouncilorRVO == ''){
document.getElementById("isIcaiCouncilorRVO").style.borderColor = "red";
document.getElementById("isIcaiCouncilorRVO").focus();
return false;
}
// else if(Professional == 'Yes'){
// document.getElementById("Professional").style.borderColor = "red";
// document.getElementById("Professional").focus();
// return false;
// }
// else if(Professional1 == ''){
// document.getElementById("Professional1").style.borderColor = "red";
// document.getElementById("Professional1").focus();
// return false;
// }
// else if(Professional2 == ''){
// document.getElementById("Professional2").style.borderColor = "red";
// document.getElementById("Professional2").focus();
// return false;
// }
// else if(Professional3 == ''){
// document.getElementById("Professional3").style.borderColor = "red";
// document.getElementById("Professional3").focus();
// return false;
// }
else if(additionalInfo == ''){
document.getElementById("additionalInfo").style.borderColor = "red";
document.getElementById("additionalInfo").focus();
alert("Please enter additional information!");
return false;
}
else if(btnyear4 == ''){
document.getElementById("btnyear4").style.borderColor = "red";
document.getElementById("btnyear4").focus();
return false;
}
else if(btnyear5 == ''){
document.getElementById("btnyear5").style.borderColor = "red";
document.getElementById("btnyear5").focus();
return false;
}
else if(btnyear6 == ''){
document.getElementById("btnyear6").style.borderColor = "red";
document.getElementById("btnyear6").focus();
return false;
}
else if(payment_recd == ''){
document.getElementById("payment_recd").style.borderColor = "red";
document.getElementById("payment_recd").focus();
alert("Please Compleate Payment First!");
return false;
}
else if(paymentfrom == ''){
document.getElementById("paymentfrom").style.borderColor = "red";
document.getElementById("paymentfrom").focus();
return false;
}
else if(affirm1 == ''){
document.getElementById("affirm1").style.borderColor = "red";
document.getElementById("affirm1").focus();
return false;
}
else if(affirm2 == ''){
document.getElementById("affirm2").style.borderColor = "red";
document.getElementById("affirm2").focus();
return false;
}
else if(affirm3 == ''){
document.getElementById("affirm3").style.borderColor = "red";
document.getElementById("affirm3").focus();
return false;
}
else if(affirm4 == ''){
document.getElementById("affirm4").style.borderColor = "red";
document.getElementById("affirm4").focus();
return false;
}
else if(affirm5 == ''){
document.getElementById("affirm5").style.borderColor = "red";
document.getElementById("affirm5").focus();
return false;
}
else{
document.activeElement?.blur();
document.getElementById("bsave").type = "submit";
$('#bsave').click();
}
}
// });
</script>
<?php
if($isedit=='true'){
// echo "Before Edit Template";
include("edittemplate.php");
}
else
{
include("template.php");
}
if($form_pic!='')
{
$display="none";
}
else
{
$display="";
}
if($memberpic!='' && $membername!='' && $date_of_birth!='' && $fathersname!='' && $form_pic=='')
{
$footer="block!important";
$display="none";
$dis="none";
}
if($memberpic=='' && $membername=='' && $date_of_birth=='' && $fathersname=='' && $transaction_id=='')
{
$footer="";
$display="";
$dis="";
}
if($memberpic!='' && $membername!='' && $date_of_birth!='' && $fathersname!='' && $transaction_id=='')
{
$footer="";
$display="";
$dis="";
}
if($memberpic!='' && $membername!='' && $date_of_birth!='' && $fathersname!='' && $transaction_id!='' && $form_pic=='')
{
$footer="block";
$display="none";
$dis="none";
}
?>
<form class="needs-validation" novalidate method="POST" action="" enctype="multipart/form-data" >
<input type="hidden" name="isedit" value="<?=$isedit?>">
<input type="hidden" name="batchid" value="<?=$batchid?>">
<input type="hidden" name="mode" value="<?=$mode?>">
<input type="hidden" name="submode" value="<?=$submode?>">
<script>
$(document).ready(function() {
$("#btnmemberpic1").change(function () {
var fileInput = document.getElementById('btnmemberpic1');
var filePath = fileInput.value;
var file_size = $("#btnmemberpic1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnpan1").change(function () {
var fileInput = document.getElementById('btnpan1');
var filePath = fileInput.value;
var file_size = $("#btnpan1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnadhar1").change(function () {
var fileInput = document.getElementById('btnadhar1');
var filePath = fileInput.value;
var file_size = $("#btnadhar1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<table width="1000px"cellspacing="3" cellpadding="3" border="1" id="maintable" style="border-collapse:collapse;margin:auto;">
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>Indian Institute of Insolvency Professionals of ICAI(IIIPI)</b></font>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>Enrolment Form</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>With</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>Application for Pre-Registration Educational Course</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" valign=top align="center">
<font color="#800000" size=3><b>
[Under Regulation 5(b) of the Insolvency and Bankruptcy Board of India(Insolvency Professionals)<br>(Amendment) Regulations, 2018)]</b>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="3">
<p><b>To</b></p>
<p><b>The Managing Director,<br>
Indian Institute of Insolvency Professionals of ICAI</b>
</p>
<br>
<td>
<?php
if(!empty($memberpic))
{
echo "<img src='images/".$memberpic."' height='100' width='100'><br>
<input type='hidden' name='memberpic' id='memberpic' value='".$memberpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='memberpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<img src="images/avtar.jpg" id="memberpic" name="memberpic" height="100" width="100"><br>
<input type="file" name="btnmemberpic" id="btnmemberpic1" size="1" >';
}
?>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<p><b>Subject: Application for Enrolment as professional member and Pre-Registration Education Course</b></p>
<p>Sir,</p>
<p>I,...<?=$membername?>...have passed the Limited Insolvency Examination of Insolvency and
Bankruptcy Board of India(IBBI) on...<?=$insolvency_exam_date?>...A copy of my Certificate is attached.
</p>
<p>I now wish to apply for Enrolment with Indian Institute of Insolvency Professionals of ICAI(IIIPI).You are requested to enrol me for the Pre-registration Education Course also.</p>
<p>My details are as under:</p>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="hd">
<h4>A. PERSONAL DETAILS</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td width="20%">1. Title (Mr/Mrs/Ms):<span class="mandatory">*<span></td>
<td width="30%">
<select id="membertitle" name="membertitle" >
<option value="Mr">Mr.</option>
<option value="Mrs">Mrs.</option>
<option value="Ms">Ms.</option>
</select>
</td>
<td width="20%">2. Name:<span class="mandatory" >*<span></td>
<td width="30%"><input type="text" id="membername" name="membername" maxlength="255" value="<?=$membername?>"></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>3. Father's Name:<span class="mandatory">*<span></td>
<td><input type="text" id="fathersname" name="fathersname" value="<?=$fathersname?>"></td>
<td>4. Date of Birth:<span class="mandatory">*<span></td>
<td>
<input type="text" class="datetime" id="date_of_birth" name="date_of_birth" value="<?=$date_of_birth?>" placeholder="dd/mm/yyyy" >
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>5. Place of Birth: <span class="mandatory">*<span></td>
<td>
<input type="text" id="place_of_birth" name="place_of_birth" maxlength="255" value="<?=$place_of_birth?>" >
</td>
<td>6. PAN No.:<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<table>
<tr>
<td>
<input type="text" id="panno" name="panno" maxlength="10" value="<?=$panno?>">
<br><!-- <img src="" width="150" height="70" id="panpic" name="panpic" class="">-->
<?php
if(!empty($panpic))
{
echo $panpic."
<input type='hidden' name='panpic' id='panpic' value='".$panpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='panpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnpan" id="btnpan1" size="10" > <span class="">*<span>';
}
?>
</td>
<td>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>7. AADHAAR No.: <span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<table>
<tr>
<td>
<input type="text" id="adharno" name="adharno" value="<?=$adharno?>" minlength="12" maxlength="12" class="number" > <br><!-- <img src="" width="150" height="70" id="adharpic" name="adharpic" class="">-->
<?php
if(!empty($adharpic))
{
echo $adharpic."
<input type='hidden' name='adharpic' id='adharpic' value='".$adharpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='adharpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnadhar" id="btnadhar1" size="10" > <span class="">*<span>';
}
?>
</td>
<td>
</td>
</tr>
</table>
</td>
<script>
$(document).ready(function() {
$("#btnpassport1").change(function () {
var fileInput = document.getElementById('btnpassport1');
var filePath = fileInput.value;
var file_size = $("#btnpassport1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<td>8. Passport No.:(if available)
<span class="mandatory" style="color:red;font-size:70%"><br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<table>
<input type="text" id="passportno" maxlength="50" name="passportno" value="<?=$passportno?>">
<br><!-- <img src="" width="150" height="70" id="passportpic" name="passportpic" class="">-->
<?php
if(!empty($passportpic))
{
echo $passportpic."
<input type='hidden' name='passportpic' id='passportpic' value='".$passportpic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='passportpic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnpassport" id="btnpassport1" size="10" >';
}
?>
</td>
<td>
</td>
</tr>
</table>
</td>
</tr>
<script>
$(document).ready(function() {
$("#btnpaddress1").change(function () {
var fileInput = document.getElementById('btnpaddress1');
var filePath = fileInput.value;
var file_size = $("#btnpaddress1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnaddress1").change(function () {
var fileInput = document.getElementById('btnaddress1');
var filePath = fileInput.value;
var file_size = $("#btnaddress1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnprof_address1").change(function () {
var fileInput = document.getElementById('btnprof_address1');
var filePath = fileInput.value;
var file_size = $("#btnprof_address1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr style="display:<?php echo $display;?>">
<td colspan="2">
9. Address for Correspondence:
<h5 style="color:blue">(Note: This shall be recorded as the registered
address)
</h5>
<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span>
</td>
<td colspan="2">
<table cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td colspan="2">
<table>
<tbody>
<tr>
<td>Address:</td>
<td><input type="text" id="address_of_correspondence" maxlength="255" name="address_of_correspondence" value="<?=$address_of_correspondence?>" style="width:99%;" ></td>
</tr>
<tr>
<td>State:</td>
<td>
<select name="state" id="state" >
<?php
$sql="select * from state_master order by statename ";
$result = mysqli_query($GLOBALS["link"], $sql);
while($row = mysqli_fetch_assoc($result)){
if($corresspondence_state==$row['statename'])
echo "<option value='".$row['statename']."' selected>".$row['statename']."</option>";
else
echo "<option value='".$row['statename']."'>".$row['statename']."</option>";
}
?>
</select>
<!--<input type="text" id="state" maxlength="255" name="state" value="=$corresspondence_state" class="pt" > -->
City: <input type="text" id="city" maxlength="255" name="city" value="<?=$corresspondence_city?>" class="pt2" >
Pin: <input type="number" id="pin" name="pin" maxlength="6" value="<?=$corresspondence_pincode?>" class="pt2" onKeyPress="if(this.value.length==6) return false;" />
</td>
</tr>
<tr>
<td></td>
<td><?php
if(!empty($addresspic))
{
echo $addresspic."
<input type='hidden' name='addresspic' id='addresspic' value='".$addresspic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='addresspic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnaddress" id="btnaddress1" size="10" >';
}
?></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">10. Permanent Address:<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td colspan="2">
<table cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td colspan="2">
<table>
<tbody>
<tr>
<td colspan="2"><input type="checkbox" id="chkobox" name="chkobox"><span style="">Same as Correspondence Address</span></td>
</tr>
<tr>
<td>Address:</td>
<td><input type="text" id="permanent_address" maxlength="255" name="permanent_address" value="<?=$permanent_address?>" style="width:99%;" ></td>
</tr>
<tr>
<td>State:</td>
<td>
<select name="pstate" id="pstate" >
<?php
$sql="select * from state_master order by statename ";
$result = mysqli_query($GLOBALS["link"], $sql);
while($row = mysqli_fetch_assoc($result)){
if($permanent_state==$row['statename'])
echo "<option value='".$row['statename']."' selected>".$row['statename']."</option>";
else
echo "<option value='".$row['statename']."'>".$row['statename']."</option>";
}
?>
</select>
<!--<input type="text" id="pstate" name="pstate" value="$permanent_state" class="pt">-->
City: <input type="text" id="pcity" name="pcity" value="<?=$permanent_city?>" class="pt2" >
Pin: <input type="number" pattern="[0-9]{6}" id="ppin" name="ppin" value="<?=$permanent_pincode?>" class="pt2" onKeyPress="if(this.value.length==6) return false;" />
</td>
</tr>
<tr>
<td></td>
<td><?php
if(!empty($paddresspic))
{
echo $paddresspic."
<input type='hidden' name='paddresspic' id='paddresspic' value='".$paddresspic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='paddresspic' class='remove'>Remove</button>
</form>";
}
else
{
echo ' <input type="file" name="btnpaddress" id="btnpaddress1" size="10" >';
}
?></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>
11. E-Mail Address:
<h5 style="color:blue">(Note: This shall be recorded as the registered e-mail address) </h5>
<span class="mandatory">*<span>
</td>
<td><input type="text" id="emailid" maxlength="255" name="emailid" value="<?=$emailid?>" class="email " readonly></td>
<td>
12. Mobile No.:
<h5 style="color:blue">(Note:This shall be recorded as the registered mobile number)</h5>
<span class="mandatory">*<span>
</td>
<td><input type="text" id="mobileno" minlength="10" maxlength="15" name="mobileno" value="<?=$mobileno?>" minlength="10" maxlength="10" readonly></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td>13. Landline No.: </td>
<td><input type="text" maxlength="255" id="landline" name="landline" value="<?=$landline?>" class=""></td>
<td>14. GST No.(Individual):</td>
<td>
<select name="gstinstatus" id="gstinstatus" class="valid" aria-invalid="false">
<option value="0">Not Applicable</option>
<option value="1">Yes</option>
</select>
<input type="text" id="gst_no" name="gst_no" value="<?=$gst_no?>" class="">
</td>
</tr>
<!--<tr style="display:<?php echo $display;?>">
<td>14. DIN(if available): <span class="mandatory">*<span></td>
<td>
<table>
<input type="text" id="dinvalue" maxlength="255" name="din" value="<?=$din?>">
<br><!-- <img src="" width="150" height="70" id="passportpic" name="passportpic" class="">
<?php
/*if(!empty($din_pic))
{
echo $din_pic."
<input type='hidden' name='din_pic' id='din_pic' value='".$din_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='din_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="din_pic" id="din_pic" size="10" class="">';
} */
?>
</td>
<td>
</td>
</tr>
</table>
</td>-->
<script>
$(document).ready(function() {
$("#din_pic1").change(function () {
var fileInput = document.getElementById('din_pic1');
var filePath = fileInput.value;
var file_size = $("#din_pic1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnscore1").change(function () {
var fileInput = document.getElementById('btnscore1');
var filePath = fileInput.value;
var file_size = $("#btnscore1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr style="display:<?php echo $display;?>">
<td>15. DIN(if available):
<h5 style="color:blue"> (Note: If No-Kindly attach the self-declaration that you are not holding any DIN)</h5>
<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></td>
<td>
<?php
if($din_yes_no=="")
{
echo '<span><input type="radio" name="din_yes_no" id="dinRadio" value="Yes" >Yes</input>
<input type="text" id="din" maxlength="255" name="din" value="'.$din.'">
<input type="radio" name="din_yes_no" id="dinRadioNo" value="No" >No</input></span>
';
}
else
{
if($din_yes_no=="Yes")
{
echo '<span><input type="radio" name="din_yes_no" id="dinRadio" value="Yes" checked>Yes</input>
<input type="text" id="din" maxlength="255" name="din" value="'.$din.'">
<input type="radio" name="din_yes_no" id="dinRadioNo" value="No">No</input></span>
';
}
else
{
echo '<span><input type="radio" name="din_yes_no" id="dinRadio" value="Yes">Yes</input>
<input type="text" id="din" maxlength="255" name="din" value="'.$din.'">
<input type="radio" name="din_yes_no" id="dinRadioNo" value="No" checked>No</input></span>
<br>
';
}
}
?>
<?php
// echo"I hereby confirm that I do not have DIN/DPIN";
if(!empty($din_pic))
{
echo $din_pic."
<input type='hidden' name='din_pic' id='din_pic' value='".$din_pic."' readonly >
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='din_pic' class='remove'>Remove</button>
</form> ";
}
else
{
echo '<span class="fileuploaddin"><input type="file" name="din_pic" id="din_pic1" size="10" ></span>';
}
?>
</td>
<td>
16. CIBIL SCORE:(Mandatory )<br/>
<h5 style="color:blue">(Note: score report downloaded from any RBI registered Credit Information)</h5>
<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span>
</td>
<td>
<table class="table" width="50%">
<tr>
<td>
<input type="text" maxlength="255" id="score" name="score" value="<?=$score?>" ><br>
<!-- <img src="" width="150" height="70" id="scorepic" name="scorepic" class="">-->
<?php
if(!empty($scorepic))
{
echo $scorepic."
<input type='hidden' name='scorepic' id='scorepic' value='".$scorepic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='scorepic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnscore" id="btnscore1" size="10" > <span class="mandatory">*<span>';
}
?>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>B. EDUCATIONAL, PROFESSIONAL AND VALUATION EXAMINATION QUALIFICATIONS</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>1. Educational Qualifications </h4>
<span>[Please provide educational qualifications from Bachelor's degree onwards]</span>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table class="table" width="100%">
<thead>
<tr>
<th width="5%">Sl.No.</th>
<th width="25%">Educational Qualification</th>
<th width="10%">Year of Passing</th>
<th width="30%">University/College</th>
<th width="10%">Remarks, if any</th>
<th width="20%">Attachment
<span style="color:red;font-size:70%">[Max upload JPG/JPEG/PNG/PDF size 2MB]</span></th>
</tr>
</thead>
<tbody class="eduBody">
</tbody>
<tfoot>
<tr>
<td colspan="4"></td>
<td colspan="2" align="right">
<input type="hidden" name="eduBodyRowCount" id="eduBodyRowCount" value="">
<button type="button" class="removeRow" datafld="eduBody">Remove last row</button>
<button type="button" class="addRow" datafld="eduBody">Add Row</button>
</td>
</tr>
</tfoot>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<h4>2. Professional Qualifications:</h4><br/>
<h5 style="color:blue">(Note: ACA/ACS/ACMA / Bar Council Membership certificate -attachment required, For Lawyers- Degree of Graduation /<br/>
Final year passing Mark sheet-attachment required)
</h5>
<span class="mandatory">*<span>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table class="table" width="100%">
<thead>
<tr>
<th width="5%">Sl.No.</th>
<th>Professional Qualifications</th>
<th>Year of Passing</th>
<th>University/Institute</th>
<th>Membership No. (if applicable)</th>
<th>Date of enrolment</th>
<th>Date of Certificate of Practice</th>
<th>Remarks, if any</th>
<th>Attachment
<span style="color:red;font-size:70%">[Max upload JPG/JPEG/PNG/PDF size 2MB]</span></th>
</tr>
</thead>
<tbody class="profBody">
</tbody>
<tfoot>
<tr>
<td colspan="8"></td>
<td colspan="2" align="right">
<input type="hidden" name="profBodyRowCount" id="profBodyRowCount" value="">
<button type="button" class="removeRow" datafld="profBody">Remove last row</button>
<button type="button" class="addRow" datafld="profBody">Add Row</button>
</td>
</tr>
</tfoot>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<h4>3. Insolvency Qualifications <span class="mandatory">*<span></h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="6">
<?php
$sql="select * from pre_reg_form where emailid='{$_SESSION['email']}' and mobileno='{$_SESSION['mobile']}' ";
$result = mysqli_query($GLOBALS["link"], $sql);
if(mysqli_num_rows($result)>0){
$sql="select * from iiici_editing_entry where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
}
else{
$sql="select * from iiici_editing_entry_temp where batchid='$batchid'";
$result4 = mysqli_query($GLOBALS["link"], $sql);
}
if($row4 = mysqli_fetch_assoc($result4)){
// foreach ($row4 as $key => $value) {
// ${$key} = $value;
// $k='_'.$s;
// echo "
// prefilldata[\"$key$k\"] = \"".str_replace("\r\n","",nl2br($row4[$key]))."\";
// ";
// }
// $s++;
//@extract($row4);
/*$set_isIcaiCouncilorRVO=$row4['isIcaiCouncilorRVO'];
$set_isIcaiCouncilorRVOdetails = $row4['isundischaredbankruptdetails'];
$set_InsolvencyProfessional= $row4['InsolvencyProfessional'];
$set_DateofApplication = $row4['dateofapplication'];
$set_NameoftheIPA = $row4['nameofipa'];
$set_ReasonofRejection = $row4['reasonofrejection'];
$set_DateofRejection = $row4['dateofrejection'];*/
$set_limitedWhetherPassed = $row4['limitedWhetherPassed'];
$set_limitedInstitute = $row4['limitedInstitute'];
$set_limitedMarks = $row4['limitedMarks'];
$set_limitedDateOfPassing = $row4['limitedDateOfPassing'];
$set_limitedRemarks = $row4['limitedRemarks'];
$set_limited_pic=$row4['btnlimited_pic'];
$set_graduateWhetherPassed = $row4['graduateWhetherPassed'];
$set_graduateInstitute = $row4['graduateInstitute'];
$set_graduateMarks = $row4['graduateMarks'];
$set_graduateDateOfPassing = $row4['graduateDateOfPassing'];
$set_graduateRemarks = $row4['graduateRemarks'];
$set_graduate_pic=$row4['btngraduate_pic'];
}
?>
<table class="table" width="100%">
<tr>
<th width="2%">Sl.No.</th>
<th>Name of the examination/programme</th>
<th>Whether passed
(Yes / No)
</th>
<th>Name of the institute/organisation</th>
<th>Marks (%) /Grade/Class</th>
<th>Date of passing</th>
<th>Remarks, if any</th>
<th>Attachment
<span style="color:red;font-size:70%">[Max upload JPG/JPEG/PNG/PDF size 2MB]</span></th>
</tr>
<!-- <script>
function newFu() {
document.getElementById("Limited Insolvency Examination").disabled = true;
document.getElementById("Limited Insolvency Examination1").disabled = true;
document.getElementById("insolvency_exam_date").disabled = true;
document.getElementById("Limited Insolvency Examination3").disabled = true;
}
function dnewFu() {
document.getElementById("Limited Insolvency Examination").disabled = false;
document.getElementById("Limited Insolvency Examination1").disabled = false;
document.getElementById("insolvency_exam_date").disabled = false;
document.getElementById("Limited Insolvency Examination3").disabled = false;
}
</script>
<script src="https://code.jquery.com/ui/1.10.4/jquery-ui.js">
</script>
<!--<script>
$(document).ready(function() {
$("#ofrejection").datepicker({
changeYear:true,
yearRange: "2020:"
});
});
</script>-->
<script>
$(document).ready(function() {
$("#btnlimited_pic1").change(function () {
var fileInput = document.getElementById('btnlimited_pic1');
var filePath = fileInput.value;
var file_size = $("#btnlimited_pic1")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr >
<td >1</td>
<td>Limited Insolvency Examination</td>
<!--<td><span>
<input type="radio" name="Whetherpassed" id="whether" value="Yes" onclick="dnewFu()" <?php if($set_limitedWhetherPassed == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="Whetherpassed" id="whether" onclick="newFu()" value="No" <?php if($set_limitedWhetherPassed == 'No'){?> checked <?php } ?>> No</span>
</td>-->
<td></td>
<td> <input type="varchar" name="institute/organisation" maxlength="255" id="Limited_Insolvency_Examination" value="<?=$set_limitedInstitute?>" size="25" ></td>
<td><input type="varchar" name="Grade/Class" maxlength="2" id="Limited_Insolvency_Examination1" value="<?=$set_limitedMarks?>" size="17" ></td>
<td><!--<input type="text" name="dateof" id="ofrejection" value="<?=$set_limitedDateOfPassing?>" class="form-control datetime dp" readonly >-->
<input type="text" name="dateof" id="insolvency_exam_date" value="<?=$set_limitedDateOfPassing?>" class="form-control datetime dp" readonly ></td>
<td><input type="varchar" name="Remarksif" maxlength="255" id="Limited_Insolvency_Examination3" value="<?=$set_limitedRemarks?>" size="12" ></td>
<td colspan="2">
<!-- <img src="" width="100" height="100" id="insolvency_exam_pic" name="insolvency_exam_pic">-->
<?php
if(!empty($limited_pic))
{
echo $limited_pic."
<input type='hidden' name='limited_pic' id='limited_pic' value='".$limited_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='limited_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnlimited_pic" id="btnlimited_pic1" class="form-control "> <span class="mandatory">*<span>';
}
?>
</td>
</tr>
<script>
function newF() {
document.getElementById("Graduate Insolvency Programme").disabled = true;
document.getElementById("Graduate Insolvency Programme1").disabled = true;
document.getElementById("Graduate").disabled = true;
document.getElementById("Graduate Insolvency Programme3").disabled = true;
document.getElementById("btngraduate_pic").disabled = true;
}
function dnewF() {
document.getElementById("Graduate Insolvency Programme").disabled = false;
document.getElementById("Graduate Insolvency Programme1").disabled = false;
document.getElementById("Graduate").disabled = false;
document.getElementById("Graduate Insolvency Programme3").disabled = false;
document.getElementById("btngraduate_pic").disabled = false;
}
</script>
<tr>
<td>2</td>
<td>Graduate Insolvency Programme</td>
<td><span>
<input type="radio" name="Whetherpassedor" id=" Insolvency Programme" value="Yes" onclick="dnewF()" <?php if($set_graduateWhetherPassed == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="Whetherpassedor" id="Insolvency Programme" onclick="newF()" value="No" <?php if($set_graduateWhetherPassed == 'No'){?> checked <?php } ?>> No</span>
</td>
<td> <input type="varchar" name="institute/organisations" maxlength="255" " <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate Insolvency Programme" value="<?=$set_graduateInstitute?>" size="25"></td>
<td><input type="varchar" name="Grade/Classp" maxlength="2" <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate Insolvency Programme1" value="<?=$set_graduateMarks?>" size="17"></td>
<td><input type="text" name="dateofp" <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate" value="<?=$set_graduateDateOfPassing?>" class="form-control datetime dp" ></td>
<td> <input type="varchar" name="Remarksi" maxlength="255" <?php if($set_graduateWhetherPassed == 'No'){?> disabled <?php } ?> id="Graduate Insolvency Programme3" value="<?=$set_graduateRemarks?>" size="12"></td>
<td colspan="2">
<?php
if(!empty($graduate_pic))
{
echo $graduate_pic."
<input type='hidden' name='graduate_pic' id='graduate_pic' value='".$graduate_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='graduate_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btngraduate_pic" id="btngraduate_pic" class="form-control "> <span class=""><span>';
}
?>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>C. WORK EXPERIENCE</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">1. Are you presently in practice / employment? <span class="mandatory" >*<span></td>
<?php
if($ispracticeemployment=="")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice" > Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment"> Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others"> Others
<input type="text" name="oth" id="oth" value="'.$oth.'" >
<br>
<span class="emplomenttext">I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</span>
</td>';
}
else
{
if($ispracticeemployment=="Practice")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice" checked> Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment"> Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others"> Others
<input type="text" name="oth" id="oth" value="'.$oth.'"><br>
<span class="emplomenttext">I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</span>
</td>';
}
if($ispracticeemployment=="Employment")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice"> Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment" checked> Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others"> Others
<input type="text" name="oth" id="oth" value="'.$oth.'">
<br>
<span class="emplomenttext_new"><b>I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</b></span>
</td>';
}
if($ispracticeemployment=="Others")
{
echo '<td colspan="2"><input type="radio" name="ispracticeemployment" id="ispracticeemployment1" value="Practice"> Practice
<input type="radio" name="ispracticeemployment" id="ispracticeemployment2" value="Employment" > Employment
<input type="radio" name="ispracticeemployment" id="ispracticeemployment3" value="Others" checked> Others
<input type="text" name="oth" id="oth" value="'.$oth.'">
<br>
<span class="emplomenttext">I declare that I am not eligible for Authorisation for Assignment till the time I am in employment.</span>
</td>';
}
}
?>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">2. Number of years in employment (in years and months):<span class="mandatory">*<span></td>
<td colspan="2"><input type="text" id="years_in_employment" name="years_in_employment" value="<?=$years_in_employment?>" ></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">3. Number of years in practice (in years and months): <span class="mandatory">*<span> </td>
<td colspan="2"><input type="text" maxlength="255" id="years_in_practice" name="years_in_practice" value="<?=$years_in_practice?>" ></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="2">
<h4>4. Professional Correspondence Address: <span class="mandatory">*<span></h4>
</td>
<td colspan="2">
<table cellpadding="0" cellspacing="0" width="100%">
<tr>
<td ><input type="checkbox" id="pchkobox" name="pchkobox"> Same as Correspondence </td>
<td ><input type="checkbox" id="pchkobox1" name="pchkobox1">Same as Permanent Address</td>
</tr>
<tr>
<td colspan="2">
<table>
<tr>
<td>Address:</td>
<td><input type="text" maxlength="255" name="prof_address" id="prof_address" value="<?=$prof_address?>" style="width:99%;" ></td>
</tr>
<td>State:</td>
<td>
<select name="pcstate" id="pcstate" >
<?php
$sql="select * from state_master order by statename ";
$result = mysqli_query($GLOBALS["link"], $sql);
while($row = mysqli_fetch_assoc($result)){
if($professional_state==$row['statename'])
echo "<option value='".$row['statename']."' selected>".$row['statename']."</option>";
else
echo "<option value='".$row['statename']."'>".$row['statename']."</option>";
}
?>
</select>
<!--<input style="width:28%;" type="text" name="pcstate" id="pcstate" value=""> -->
City: <input type="text" name="pccity" id="pccity" value="<?=$professional_city?>" class="pt2" >
Pin: <input type="text" name="pcpin" id="pcpin" value="<?=$professional_pincode?>" class="pt2" maxlength="6" pattern="[0-9]{6}">
</td>
</tr>
<tr>
<td></td>
<td><?php
if(!empty($prof_address_pic))
{
echo $prof_address_pic."
<input type='hidden' name='prof_address_pic' id='prof_address_pic' value='".$prof_address_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='prof_address_pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnprof_address" id="btnprof_address1" class="form-control" >';
}
?> </td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<h4>5. Experience Details:<span class="mandatory">*<span></h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table class="table" width="100%">
<thead>
<tr>
<th >S.No.</th>
<th >From Date</th>
<th >To Date</th>
<th >Employment / Practice</th>
<th >If employed, Name of Employer and Designation</th>
<th >If in practice, practice as Advocate/Chartered Accountant/Company Secretary/Cost Accountant</th>
<th >Area of work</th>
<th >Attachment
<span style="color:red;font-size:70%">(Max upload JPG/JPEG/PNG/PDF size 2MB)</span></th>
</tr>
</thead>
<tbody class="experienceBody expd">
</tbody>
<tfoot>
<tr>
<td colspan="6"></td>
<td colspan="2" align="right">
<input type="hidden" name="experienceBodyRowCount" id="experienceBodyRowCount" value="">
<button type="button" class="removeRow" datafld="experienceBody">Remove last row</button>
<button type="button" class="addRow" datafld="experienceBody">Add Row</button>
</td>
</tr>
</tfoot>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>D. ADDITIONAL INFORMATION</h4>
</td>
</tr>
<script>
function disab()
{
document.getElementById("isconvictdetails").disabled = true;
}
function enab()
{
document.getElementById("isconvictdetails").disabled = false;
}
</script>
<tr style="display:<?php echo $display;?>">
<td><span class="mandatory">*</span> 1. Have you ever been convicted for an offence? </td>
<td>
<input type="radio" name="isconvict" id="isconvict" value="Yes" onclick="enab()" <?php if($isconvict == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="isconvict" id="isconvict" value="No" onclick="disab()" <?php if($isconvict == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($isconvict == 'No'){?> disabled <?php } ?> name="isconvictdetails" id="isconvictdetails" value="<?=$isconvictdetails?>" size="10"></span>
<?php
/*if($isconvict=="")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" onclick="disab()" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" onclick="enab()"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="" size="10"></span>';
}
else
{
if($isconvict=="Yes")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" checked> Yes
<input type="radio" name="isconvict" id="isconvict" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="'.$isconvictdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" checked> No</span><br>';
}
}*/
?>
</td>
<?php
/* if($isconvict=="")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" onclick="Function()"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="" size="10"></span>';
}
else
{
if($isconvict=="Yes")
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" checked> Yes
<input type="radio" name="isconvict" id="isconvict" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isconvictdetails" id="isconvictdetails" value="'.$isconvictdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="isconvict" id="isconvict" value="Yes" > Yes
<input type="radio" name="isconvict" id="isconvict" value="No" > No</span><br>';
}
}*/
?>
</td>
<script>
function enable()
{
document.getElementById("iscriminalproceedingsdetails").disabled = true;
}
function disable()
{
document.getElementById("iscriminalproceedingsdetails").disabled = false;
}
</script>
<td><span class="mandatory">*</span> 2. Are any criminal proceedings pending against you? </td>
<td>
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="Yes" onclick="disable()" <?php if($iscriminalproceedings == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="No" onclick="enable()" <?php if($iscriminalproceedings == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($iscriminalproceedings == 'No'){?> disabled <?php } ?> name="iscriminalproceedingsdetails" id="iscriminalproceedingsdetails" value="<?=$iscriminalproceedingsdetails?>" size="10"></span>
<?php
/*if($iscriminalproceedings=="")
{
echo '<span><input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" onclick="disable()" value="Yes" > Yes
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" onclick="enable()" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="iscriminalproceedingsdetails" maxlength="255" id="iscriminalproceedingsdetails" value="" size="10"></span>';
}
else
{
if($iscriminalproceedings=="Yes")
{
echo '<span><input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="Yes" checked> Yes <input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="iscriminalproceedingsdetails" maxlength="255" id="iscriminalproceedingsdetails" value="'.$iscriminalproceedingsdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="Yes"> Yes
<input type="radio" name="iscriminalproceedings" id="iscriminalproceedings" value="No" checked> No</span><br>';
}
}*/
?>
</td>
</tr>
<script>
function fun()
{
document.getElementById("isundischaredbankruptdetails").disabled = true;
}
function dfun()
{
document.getElementById("isundischaredbankruptdetails").disabled = false;
}
</script>
<tr style="display:<?php echo $display;?>">
<td><span class="mandatory">*</span> 3. Have you ever been declared as an insolvent/bankrupt, or applied to be declared so? </td>
<td>
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="Yes" onclick="dfun()" <?php if($isundischaredbankrupt == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="No" onclick="fun()" <?php if($isundischaredbankrupt == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($isundischaredbankrupt == 'No'){?> disabled <?php } ?> name="isundischaredbankruptdetails" id="isundischaredbankruptdetails" value="<?=$isundischaredbankruptdetails?>" size="10"></span>
<?php
/*if($isundischaredbankrupt=="")
{
echo '<span><input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" onclick="dfun()" value="Yes" > Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" onclick="fun()" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isundischaredbankruptdetails" id="type" maxlength="255" value="" size="10"></span>';
}
else
{
if($isundischaredbankrupt=="Yes")
{
echo '<span><input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="Yes" checked> Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isundischaredbankruptdetails" id="isundischaredbankruptdetails" maxlength="255" value="'.$isundischaredbankruptdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="Yes"> Yes
<input type="radio" name="isundischaredbankrupt" id="isundischaredbankrupt" value="No" checked> No</span><br>';
}
}*/
?>
</td>
<script>
function enabl()
{
document.getElementById("types").disabled = true;
//document.getElementById("types").setAttribute('disabled') = 'disabled';
}
function disabl()
{
document.getElementById("types").disabled = false;
}
</script>
<td><span class="mandatory">*</span>4. Is there any disciplinary proceeding pending against you or has been taken against you at any time
in the preceding three years by the ICAI, ICSI, ICAI (Cost), Bar Council or RVO?
</td>
<td>
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes" onclick="disabl()" <?php if($isIcaiCouncilorRVO == 'Yes'){?> checked <?php } ?>> Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No" onclick="enabl()" <?php if($isIcaiCouncilorRVO == 'No'){?> checked <?php } ?>> No</span><br>
<span>If Yes, please give details: <input type="text" <?php if($isIcaiCouncilorRVO == 'No'){?> disabled <?php } ?> name="isIcaiCouncilorRVOdetails" id="types" value="<?=$isIcaiCouncilorRVOdetails?>" size="10"></span>
<?php
/*if($isIcaiCouncilorRVO=="")
{
echo '<span><input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes" onclick="disabl()" > Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No" onclick="enabl()"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isIcaiCouncilorRVOdetails" id="ICAI" maxlength="255" value="" size="10"></span>';
}
else
{
if($isIcaiCouncilorRVO=="Yes")
{
echo '<span><input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes" checked> Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No"> No</span><br>
<span>If Yes, please give details: <input type="text" name="isIcaiCouncilorRVOdetails" id="isIcaiCouncilorRVOdetails" maxlength="255" value="'.$isIcaiCouncilorRVOdetails.'" size="10"></span>';
}
else
{
echo '<span><input type="radio" name="jay" id="isIcaiCouncilorRVO" value="Yes"> Yes
<input type="radio" name="jay" id="isIcaiCouncilorRVO" value="No" checked> No</span><br>';
}
}*/
?>
</td>
</tr>
</tr>
<tr style="display:<?php echo $display;?>">
<td><span class="mandatory">*</span>5.Have your ever applied for Enrollment with any Insolvency Professional Agency? </td>
<td>
<script>
function newFuncti() {
document.getElementById("Professional").disabled = true;
document.getElementById("Professional1").disabled = true;
document.getElementById("Professional2").disabled = true;
document.getElementById("Professional3").disabled = true;
}
function dnewFuncti() {
document.getElementById("Professional").disabled = false;
document.getElementById("Professional1").disabled = false;
document.getElementById("Professional2").disabled = false;
document.getElementById("Professional3").disabled = false;
}
</script>
<span><input type="radio" name="professional_agency" id="Professional" onclick="dnewFuncti()" value="Yes" <?php if($InsolvencyProfessional == 'Yes'){?> checked <?php } ?> > Yes
<input type="radio" name="professional_agency" id="Professional" value="No" onclick="newFuncti(this)" <?php if($InsolvencyProfessional == 'No'){?> checked <?php } ?> > No</span><br>
<span>If Yes, please give details: </br>
<table class="table" border="1px">
<tr>
<th align="left">Date of application:</th>
<!--<th> <input type="longtext" name="dateofapplication" id="Professional" value="<?=$DateofApplication?>" class="form-control datetime dp" ></th>
<th > <input type="longtext" name="dateofapplication" id="Professional" value="<?=$DateofApplication?>" class="form-control datetime dp" ></th>-->
<th > <input type="longtext" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="dateofapplication" id="Professional" value="<?=$DateofApplication?>" class="form-control datetime dp" readonly ></th>
</tr>
<tr>
<th align="left"> Name of the IPA:</th>
<th><input type="text" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="nameofipa" id="Professional1" value="<?=$NameoftheIPA?>" ></th>
</tr>
<tr>
<th align="left">Reason of Rejection:</th>
<th><input type="text" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="reasonofrejection" id="Professional2" value="<?=$ReasonofRejection?>" ></th>
</tr>
<tr>
<th align="left"> Date of rejection:</th>
<!--<th><input type="longtext" name="dateofrejection" id="Professional3" value="<?=$DateofRejection?>" class="form-control datetime dp" ></th>-->
<th><input type="longtext" <?php if($InsolvencyProfessional == 'No'){?> disabled <?php } ?> name="dateofrejection" id="Professional3" value="<?=$DateofRejection?>" class="form-control datetime dp" readonly ></th>
</tr>
</table>
</span>
<?php
/* if($InsolvencyProfessional=="")
{
echo '<span><input type="radio" name="professional_agency" id="Professional " onclick="dnewFuncti()" value="Yes" > Yes
<input type="radio" name="professional_agency" id="Professional " value="No" onclick="newFuncti()" > No</span><br>
<span>If Yes, please give details: </br>
<table class="table" border="2px">
<tr>
<th align="left">Date of application:</th>
<th> <input type="longtext" name="dateofapplication" id="Professional" value="'.$DateofApplication.'" class="form-control datetime dp" readonly ></th>
</tr>
<tr>
<th align="left"> Name of the IPA:</th>
<th><input type="text" name="nameofipa" id="Professional1" value="'.$NameoftheIPA.'" ></th>
</tr>
<tr>
<th align="left">Reason of Rejection:</th>
<th><input type="text" name="reasonofrejection" id="Professional2" value="'.$ReasonofRejection.'" ></th>
</tr>
<tr>
<th align="left"> Date of rejection:</th>
<th><input type="longtext" name="dateofrejection" id="Professional3" value="'.$DateofRejection.'" class="form-control datetime dp" readonly ></th>
</tr>
</table>
</span>';
}
else
{
if($InsolvencyProfessional=="Yes")
{
echo '<span><input type="radio" name="professional_agency" id="Professional Agency" value="Yes" checked> Yes
<input type="radio" name="professional_agency" id="Professional Agency" value="No" > No</span><br>
<span>If Yes, please give details:</br>
<table border="2px">
<tr>
<th align="left">Date of application:</th>
<th><input type="longtext" name="dateofapplication" id="insolvency_exam_date" value="'.$DateofApplication.'" class="form-control datetime dp" readonly ></th></tr>
<tr>
<th align="left"> Name of the IPA:</th>
<th><input type="text" name="nameofipa" id="isundischaredbankruptdetails" value="'. $NameoftheIPA.'" ></th></tr>
<tr>
<th align="left">Reason of Rejection:</th>
<th><input type="text" name="reasonofrejection" id="isundischaredbankruptdetails" value="'.$ReasonofRejection.'" ></th></tr>
<tr>
<th align="left"> Date of rejection:</th>
<th><input type="longtext" name="dateofrejection" id="dateofrejection" value="'. $DateofRejection.'" class="form-control datetime dp" readonly ></th>
</tr>
</table>
</span>';
}
else
{
echo '<span><input type="radio" name="professional_agency" id="Professional Agency" value="Yes"> Yes
<input type="radio" name="professional_agency" id="Professional Agency" value="No" checked> No</span><br>';
}
}*/
?>
</td>
<td ><b class="mandatory">*</b> 6. Please provide any additional information that may be relevant for your application. </td>
<td> <textarea id="additionalInfo" name="additionalInfo" ><?=$additionalInfo?></textarea></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>E. ATTACHMENTS <span class="mandatory">*<span></h4>
</td>
</tr>
<script>
$(document).ready(function() {
$("#btnyear4").change(function () {
var fileInput = document.getElementById('btnyear4');
var filePath = fileInput.value;
var file_size = $("#btnyear4")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnyear5").change(function () {
var fileInput = document.getElementById('btnyear5');
var filePath = fileInput.value;
var file_size = $("#btnyear5")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
$(document).ready(function() {
$("#btnyear6").change(function () {
var fileInput = document.getElementById('btnyear6');
var filePath = fileInput.value;
var file_size = $("#btnyear6")[0].files[0].size;
// Allowing file type
var allowedExtensions =
/(\.jpg|\.jpeg|\.png|\.pdf)$/i;
if (!allowedExtensions.exec(filePath)) {
alert('Invalid file type');
fileInput.value = '';
return false;
}else if(file_size > 2097152){
alert('File size must be less than 2MB.');
fileInput.value = '';
return false;
}
});
});
</script>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
1. Financial statement/ Income-tax-Returns for the last three years(Copy of Acknowledgement).
<table class="table" width="50%">
<tr>
<thead>
<th>Sl.No.</th>
<th>Year</th>
<th>Attach Proof<span class="mandatory" style="color:red;font-size:70%">*<br/>
[Max upload JPG/JPEG/PNG/PDF size 2MB]<span></th>
</thead>
</tr>
<tbody >
<tr>
<td align="center">1.</td>
<td align="center">
<?php
echo '<select name="year1" id="year1">';
$from=date("Y");
while($from!=2014)
{
$tmp=$from.'-'.($from+1);
if($year1==$tmp)
{
echo "<option value='".$from.'-'.($from+1)."' selected>".$from.'-'.($from+1)."</option>";
}
else
{
echo "<option value='".$from.'-'.($from+1)."'>".$from.'-'.($from+1)."</option>";
}
$from=$from-1;
}
echo '</select>';
?>
</td>
<td align="center">
<?php
if(!empty($year1pic))
{
echo $year1pic."
<input type='hidden' name='year1pic' id='year1pic' value='".$year1pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='year1pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnyear1" id="btnyear4" class="form-control" >';
}
?>
<!-- <img src="" width="70" height="90" id="year1pic" name="year1pic"><br>-->
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td align="center">2.</td>
<td align="center">
<?php
echo '<select name="year2" id="year2">';
$from=date("Y");
while($from!=2014)
{
$tmp=$from.'-'.($from+1);
if($year2==$tmp)
{
echo "<option value='".$from.'-'.($from+1)."' selected>".$from.'-'.($from+1)."</option>";
}
else
{
echo "<option value='".$from.'-'.($from+1)."'>".$from.'-'.($from+1)."</option>";
}
$from=$from-1;
}
echo '</select>';
?>
</td>
<td align="center">
<!-- <img src="" width="70" height="90" id="year2pic" name="year2pic"><br>-->
<?php
if(!empty($year2pic))
{
echo $year2pic."
<input type='hidden' name='year2pic' id='year2pic' value='".$year2pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='year2pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnyear2" id="btnyear5" class="form-control" >';
}
?>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td align="center">3.</td>
<td align="center">
<?php
echo '<select name="year3" id="year3">';
$from=date("Y");
while($from!=2014)
{
$tmp=$from.'-'.($from+1);
if($year3==$tmp)
{
echo "<option value='".$from.'-'.($from+1)."' selected>".$from.'-'.($from+1)."</option>";
}
else
{
echo "<option value='".$from.'-'.($from+1)."'>".$from.'-'.($from+1)."</option>";
}
$from=$from-1;
}
echo '</select>';
?>
</td>
<td align="center">
<!--<img src="" width="70" height="90" id="year3pic" name="year3pic"><br>-->
<?php
if(!empty($year3pic))
{
echo $year3pic."
<input type='hidden' name='year3pic' id='year3pic' value='".$year3pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
<button type='submit' name='removeimg' id='removeimg' value='year3pic' class='remove'>Remove</button>
</form>";
}
else
{
echo '<input type="file" name="btnyear3" id="btnyear6" class="form-control" >';
}
?>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">2. Enrolment Fees: <span class="mandatory">*</span></td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">
<table width="100%">
<tr>
<td style="width:20%;">a). Payment of Fees: </td>
<td >Transaction ID:
<input type="text" name="payment_recd" id="payment_recd" readonly>
<input type="hidden" name="paymentfees" id="paymentfees" value="<?=$paymentfees?>">
</td>
<td id="pstatus">
Payment From: <span class="mandatory">*<span>
<select name="paymentfrom" id="paymentfrom" >
<option value="0">--Select--</option>
<?php
if($paymentfrom=='CA')
{
echo "<option value='CA' selected>Chartered Accountant</option>";
}
else{
echo "<option value='CA'>Chartered Accountant</option>";
}
if($paymentfrom=='Ot')
{
echo "<option value='Others' selected>Others</option>";
}
else{
echo "<option value='Others'>Others</option>";
}
?>
</select>
<button type="button" id="pymnt">Payment</button>
</td>
<td></td>
<td></td>
</tr>
</table>
</td>
<!-- <img src="" width="70" height="90" id="evidence_pic" name="evidence_pic"><br>-->
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>F. UNDERSTANDING</h4>
<p>I understand and agree that my enrolment with IIIPI and attending of Pre-registration course does not entitle me to the registration, which is subject to my complying with various requirements of IBBI and satisfactory completion of Pre-Registration Course.</p>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4" class="">
<h4>G. AFFIRMATIONS</h4>
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">1. <span class="mandatory">*</span>
<input class="form-check-input " type="checkbox" id="affirm1" name="affirm1" value="1" <?php echo ($affirm1)?'checked':''; ?> > Copies of documents, required as of this application form have been attached/uploaded.<br> I undertake to furnish any additional information/documents as and when called for.
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">2. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm2" name="affirm2" value="1" <?php echo ($affirm2)?'checked':''; ?> > I am not disqualified from being enrolled as a professional member with any Insolvency<br> Professional Agency under the Insolvency and Bankruptcy Board of India (Insolvency <br> Professionals) Regulations,2016.</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">3. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm3" name="affirm3" value="1" <?php echo ($affirm3)?'checked':''; ?> > I hereby certify and declare that i am not an undischarged insolvent/bankrupt and have not made <br>any application to be adjudged so under the laws of any jurisdiction. </td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">4. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm4" name="affirm4" value="1" <?php echo ($affirm4)?'checked':''; ?> >This application and the information furnished by me along with this application is true and
complete. If found false or misleading at any stage, my enrolment shall be summarily
cancelled.
</td>
</tr>
<tr style="display:<?php echo $display;?>">
<td colspan="4">5. <span class="mandatory">*</span> <input class="form-check-input " type="checkbox" id="affirm5" name="affirm5" value="1" <?php echo ($affirm5)?'checked':''; ?> >I hereby undertake to comply with the requirements of the Insolvency and Bankruptcy Code,2016,the rules, regulations,guidlines and circulars issued thereunder, the bye-laws of the indian institute of Insolvency Professionals of ICAI (IIIPI) with which I am enrolled, and the resolutions passed, and directions given by the Board and the Governing Board of IIIPI. </td>
</tr>
<tr>
<td colspan="4" align="center">
<?php
if(empty($form_pic))
{
echo'<button type="submit" name="save_as_draft" id="save_as_draft" value="save_as_draft" style="display:'.$dis.'"><b>Save As Draft</b></button> ';
echo'<button type="button" name="bsave" id="bsave" value="bsave" onclick="return frm_validate();" style="display:'.$dis.'"><b>Submit</b></button>';
}
?>
<button type='submit' name="formcopy" id="formcopy" value="Formcopy" ><b>Download PDF Application</b></button>
<!--<button type='submit' name="formcopy" id="formcopy" value="Formcopy" ><b>Submit</b></button>-->
</td>
</tr>
<tr style="display:<?php echo $display.$footer;?>">
<td colspan="4">
<table width="100%">
<tr>
<td width="30%">Upload signed Copy of enrollment form:<span class="mandatory">*<span></td>
<td>
<?php
if(!empty($form_pic))
{
echo $form_pic."
<input type='hidden' name='form_pic' id='form_pic' value='".$form_pic."'>
<form action='{$_SERVER['PHP_SELF']}' method='post'>
</form>";
/* <button type='submit' name='removeimg' id='removeimg' value='form_pic' class='remove'>Remove</button> */
}
else
{
echo '<input type="file" name="btnform" id="btnform" class="form-control">';
}
?>
</td>
</tr>
<tr>
<td>Place:<span class="mandatory"><span></td>
<td><input type="text" maxlength="255" id="place" name="place" value="<?=$place?>" ></td>
</tr>
<tr>
<td>Date:</td>
<td><input type="text" maxlength="255" id="formdate" name="formdate" value="<?=date("d-m-Y")?>" readonly></td>
</tr>
</table>
</td>
</tr>
<!--
<tr>
<td colspan="4"><hr></td>
</tr>
<tr>
<td colspan="4">
<p align="center"><b>FOR OFFICE USE ONLY</b></p>
</td>
</tr>
<tr>
<td colspan="4">
<table width="100%">
<tr>
<td width="25%">1. Date of Receipt of Application:</td>
<td><input type="text" maxlength="255" name="date_of_receipt" id="date_of_receipt"></td>
</tr>
<tr>
<td>2. Receipt Number:</td>
<td><input type="text" maxlength="255" name="receiptno" id="receiptno"></td>
</tr>
<tr>
<td>3. Enrolment Number:</td>
<td><input type="text" maxlength="255" name="enrolmentno" id="enrolmentno"></td>
</tr>
<tr>
<td>4. Date of Issue:</td>
<td><input type="text" name="date_of_issue" id="date_of_issue" class="datetime"></td>
</tr>
</table>
</td>
</tr>
<tr>
<td colspan="4" align="right"><b>Signature</b></td>
</tr>
-->
<tr style="display:<?php echo $display.$footer;?>">
<td colspan="4" align="center">
<input type="hidden" name="relatefld" id="relatefld" value="<?=$rfld?>" class="">
<?php
if($form_pic!='')
{
/* echo '<button type="submit" class="btn btn-primary btn-lg" value="Submit" name="submit" id="submit" ><b>Final Upload</b></button>'; */
}
else
{
echo '<button type="submit" class="btn btn-primary btn-lg" value="Submit" name="submit" id="submit" disabled><b>Final Upload</b></button>';
}
?>
</td>
</tr>
</table>
</form>Function Calls
| uniqid | 1 |
Stats
| MD5 | 0da6cecb6dd2ee0d595f0847f0e910ed |
| Eval Count | 0 |
| Decode Time | 243 ms |