STUDENT REGISTRSTION FORM

<!doctype html> <html lang="en"> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1"> <title>STUDENT REGISTRSTION FORM</title> <link rel="shortcut icon" href="logo.ico" type="image/x-icon">  <link href="css/bootstrap.min.css" rel="stylesheet">  <style> .wrapper { padding: 1em; } .bd-placeholder-img { font-size: 1.125rem; text-anchor: middle; -webkit-user-select: none; -moz-user-select: none; -ms-user-select: none; user-select: none; } @media (min-width: 768px) { .bd-placeholder-img-lg { font-size: 3.5rem; } } @media print { .no-print, .no-print * { display: none !important; } } #container { margin: 2rem; } #progressView { visibility: hidden } body { background-color: #f1f1f1; font-size: 1.075rem; } label { padding: 0 !important; } select.form-control { -webkit-appearance: menulist !important; -moz-appearance: menulist !important; -ms-appearance: menulist !important; -o-appearance: menulist !important; appearance: menulist !important; } fieldset { margin-bottom: 1em !important; border: 1px solid lightgray !important; padding: 4px !important; } legend { padding: 1px 10px !important; float: none; width: auto; } </style>  </head>  <datalist id="positions"> <option>Speaker</option> <option>Deputy Speaker</option> <option>Majority Leader</option> <option>Minority Leader</option> <option>Clerk</option> <option>Marshall</option> <option>Whip</option> </datalist> <datalist id="universities"> <option value="University of Ghana"></option> <option value="Kwame Nkrumah University of Science and Technology"></option> <option value="University of Cape Coast"></option> <option value="CK Tedam University for Technology and Applied Sciences"></option> <option value="University of Education, Winneba"></option> <option value="Simon Diedong Dombo University for Business and Integrated Development Studies"></option> <option value="Akenten Appiah Menkah University of Skills Training and Entrepreneurial Development, Kumasi"></option> <option value="University for Development Studies"></option> <option value="University of Professional Studies"></option> <option value="University of Mines and Technology"></option> <option value="University of Health and Allied Sciences"></option> <option value="University of Energy and Natural Resources"></option> <option value="University of Environment and Sustainable Development"></option> <option value="Ghana Institute of Management and Public Administration"></option> <option value="Ghana Communication Technology University"></option> <option value="Accra Technical University"></option> <option value="Bolgatanga Technical University"></option> <option value="Cape Coast Technical University"></option> <option value="Kumasi Technical University"></option> <option value="Koforidua Technical University"></option> <option value="Tamale Technical University"></option> <option value="Ho Technical University"></option> <option value="Takoradi Technical University"></option> <option value="Sunyani Technical University"></option> <option value="Wa Technical University"></option> <option value="Ghana Armed Forces Command and Staff College"></option> <option value="UNIMAC"></option> <option value="Ghana Institute of Surveying and Mapping"></option> <option value="Institution of Local Government Studies"></option> <option value="University of Professional Studies, Accra"></option> <option value="Kofi Annan International Peacekeeping Training Centre"></option> <option value="National Film and Television Institute"></option> <option value="Regional university"></option> <option value="Regional Maritime University"></option> <option value="Consular & Diplomatic Service University (CDSU)"></option> <option value="Valley View University"></option> <option value="Trinity Theological Seminary, Legon"></option> <option value="Akrofi-Christaller Institute of Theology, Mission and Culture"></option> <option value="Central University"></option> <option value="Pentecost University"></option> <option value="All Nations University"></option> <option value="Ashesi University"></option> <option value="Accra Institute of Technology"></option> <option value="African University College of Communications"></option> <option value="Anglican University College of Technology"></option> <option value="Catholic University College of Ghana"></option> <option value="Christian Service University College"></option> <option value="Family Health Medical School"></option> <option value="Good News Theological Seminary"></option> <option value="Islamic University College"></option> <option value="Knutsford University College"></option> <option value="Lancaster University"></option> <option value="Methodist University College Ghana"></option> <option value="Presbyterian University College"></option> <option value="Wisconsin International University College"></option> <option value="Central University College"></option> <option value="Catholic Institute of Business and Technology"></option> <option value="National Film and Television Institute"></option> <option value="Institute Of Accountancy Training"></option> <option value="Narh-Bita School of Nursing"></option> <option value="Ghana Institute of Languages"></option> <option value="St. Victor's Seminary"></option> <option value="St. Peters Seminary"></option> <option value="St. Paul Seminary"></option> <option value="Ghana Armed Forces Command and Staff College "></option> <option value="Regional Maritime University"></option> <option value="BlueCrest College"></option> <option value="Ensign Global College"></option> <option value="College of Science, Arts and Education"></option> <option value="Accra Institute of Technology"></option> <option value="Osei Tutu II Institute for Advanced ICT Studies"></option> <option value="KAAF University College"></option> <option value="Radford University College"></option> <option value="Garden City University College"></option> <option value="Regent University College of Science and Technology"></option> <option value="Technical University College"></option> <option value="Spiritan University College"></option> <option value="Data Link University College"></option> <option value="Mountcrest University College"></option> <option value="University College of Agriculture and Environmental Studies"></option> <option value="Entrepreneurship Training Institute"></option> <option value="Deltas University College"></option> <option value="Evangelical Presbyterian University College"></option> <option value="Ghana Baptist University College"></option> <option value="Kings University College"></option> <option value="Maranatha University College"></option> <option value="Meridian (Insaaniyya) University College"></option> <option value="Pan African Christian University College"></option> <option value="Wisconsin International University College"></option> <option value="Advanced Business University College"></option> <option value="BlueCrest University College"></option> <option value="Jayee University College"></option> <option value="University College of Management Studies"></option> <option value="Webster University Ghana Campus"></option> <option value="Sikkim Manipal University Ghana LC"></option> <option value="Ghana Christian University College"></option> <option value="Zenith University College"></option> <option value="China Europe International Business School"></option> <option value="Ghana Christian University College"></option> <option value="The Bible University College of Ghana"></option> <option value="Catholic Institute of Business and Technology"></option> <option value="North American Center for Professional Studies"></option> <option value="Premier Institute of Law Enforcement Management and Administration"></option> <option value="Kessben College"></option> </datalist> <br><br> <div class="row d-flex justify-content-center" id=""> <img src="img/logo.png" style="width: 8rem;" /> </div><br><br> <div class="row d-flex justify-content-center" id=""> <form action="index.php" method="POST" class="col-10 col-md-5 card needs-validation" novalidate style="padding:1rem" enctype="multipart/form-data"> <h2 class="row d-flex justify-content-center"> <center> STUDENT PARLIAMENT</center> </h2> <h5 class="text-muted d-flex justify-content-center">STUDENT REGISTRATION FORM<br></h5> <div class="alert alert-primary"> <h5 class=" form-text text-muted d-flex justify-content-center"> <h5></h5>The Department of Public Engagement is compiling data on all Student Parliaments nationwide. Kindly provide your background information if you are a Student Parliamentarian in a Tertiary Institution affiliated with the Parliament of Ghana. <br><br> <h5 id="priv">Privacy Statement:</h5> Information gathered shall be kept confidential and strictly used for this purpose. </h5> </div> <span id="sTxt" style="color:green;font-size:2rem"></span> <span id="sTxt2" style="color:red;font-size:2rem"></span> <input type="hidden" name="update" value="1"> <fieldset class="p-4 "> <legend>Biodata</legend> <div class="row"> <label>Surname</label> <input type="text" class="form-control" name="surname" id="surname" required> <div class="invalid-feedback"> Provide your surname </div> </div> <br> <div class="row"> <label>Other Names</label> <input type="text" name="othername" class="form-control"> <div class="invalid-feedback"> Provide your other names </div> </div> <br> <div class="row"> <label>First name</label> <input type="text" name="firstname" class="form-control" required> <div class="invalid-feedback"> Provide your first name </div> </div> <br> <div class="row"> <div class="col-6"> <label>Sex</label> <div class="row"> <div class="col-4 form-check-inline"> <input type="radio" class="form-check-input" name="sex" value="Male" checked> <label class="form-check-label" for="sex">Male</label> </div> <div class="col-4 form-check-inline"> <input type="radio" class="form-check-input" name="sex" value="Female"> <label class="form-check-label" for="sex">Female</label> </div> </div> </div> <div class="col-6"> <label>Date of Birth</label> <input type="date" class="form-control" name="age" id="age" required> <div class="invalid-feedback"> Provide your date of birth </div> </div> </div> <br> <div class="row"> <label>Nationality</label> <select name="nationality" class="form-select" required> <option value="">-- select one --</option> <option value="afghan">Afghan</option> <option value="albanian">Albanian</option> <option value="algerian">Algerian</option> <option value="american">American</option> <option value="andorran">Andorran</option> <option value="angolan">Angolan</option> <option value="antiguans">Antiguans</option> <option value="argentinean">Argentinean</option> <option value="armenian">Armenian</option> <option value="australian">Australian</option> <option value="austrian">Austrian</option> <option value="azerbaijani">Azerbaijani</option> <option value="bahamian">Bahamian</option> <option value="bahraini">Bahraini</option> <option value="bangladeshi">Bangladeshi</option> <option value="barbadian">Barbadian</option> <option value="barbudans">Barbudans</option> <option value="batswana">Batswana</option> <option value="belarusian">Belarusian</option> <option value="belgian">Belgian</option> <option value="belizean">Belizean</option> <option value="beninese">Beninese</option> <option value="bhutanese">Bhutanese</option> <option value="bolivian">Bolivian</option> <option value="bosnian">Bosnian</option> <option value="brazilian">Brazilian</option> <option value="british">British</option> <option value="bruneian">Bruneian</option> <option value="bulgarian">Bulgarian</option> <option value="burkinabe">Burkinabe</option> <option value="burmese">Burmese</option> <option value="burundian">Burundian</option> <option value="cambodian">Cambodian</option> <option value="cameroonian">Cameroonian</option> <option value="canadian">Canadian</option> <option value="cape verdean">Cape Verdean</option> <option value="central african">Central African</option> <option value="chadian">Chadian</option> <option value="chilean">Chilean</option> <option value="chinese">Chinese</option> <option value="colombian">Colombian</option> <option value="comoran">Comoran</option> <option value="congolese">Congolese</option> <option value="costa rican">Costa Rican</option> <option value="croatian">Croatian</option> <option value="cuban">Cuban</option> <option value="cypriot">Cypriot</option> <option value="czech">Czech</option> <option value="danish">Danish</option> <option value="djibouti">Djibouti</option> <option value="dominican">Dominican</option> <option value="dutch">Dutch</option> <option value="east timorese">East Timorese</option> <option value="ecuadorean">Ecuadorean</option> <option value="egyptian">Egyptian</option> <option value="emirian">Emirian</option> <option value="equatorial guinean">Equatorial Guinean</option> <option value="eritrean">Eritrean</option> <option value="estonian">Estonian</option> <option value="ethiopian">Ethiopian</option> <option value="fijian">Fijian</option> <option value="filipino">Filipino</option> <option value="finnish">Finnish</option> <option value="french">French</option> <option value="gabonese">Gabonese</option> <option value="gambian">Gambian</option> <option value="georgian">Georgian</option> <option value="german">German</option> <option value="ghanaian">Ghanaian</option> <option value="greek">Greek</option> <option value="grenadian">Grenadian</option> <option value="guatemalan">Guatemalan</option> <option value="guinea-bissauan">Guinea-Bissauan</option> <option value="guinean">Guinean</option> <option value="guyanese">Guyanese</option> <option value="haitian">Haitian</option> <option value="herzegovinian">Herzegovinian</option> <option value="honduran">Honduran</option> <option value="hungarian">Hungarian</option> <option value="icelander">Icelander</option> <option value="indian">Indian</option> <option value="indonesian">Indonesian</option> <option value="iranian">Iranian</option> <option value="iraqi">Iraqi</option> <option value="irish">Irish</option> <option value="israeli">Israeli</option> <option value="italian">Italian</option> <option value="ivorian">Ivorian</option> <option value="jamaican">Jamaican</option> <option value="japanese">Japanese</option> <option value="jordanian">Jordanian</option> <option value="kazakhstani">Kazakhstani</option> <option value="kenyan">Kenyan</option> <option value="kittian and nevisian">Kittian and Nevisian</option> <option value="kuwaiti">Kuwaiti</option> <option value="kyrgyz">Kyrgyz</option> <option value="laotian">Laotian</option> <option value="latvian">Latvian</option> <option value="lebanese">Lebanese</option> <option value="liberian">Liberian</option> <option value="libyan">Libyan</option> <option value="liechtensteiner">Liechtensteiner</option> <option value="lithuanian">Lithuanian</option> <option value="luxembourger">Luxembourger</option> <option value="macedonian">Macedonian</option> <option value="malagasy">Malagasy</option> <option value="malawian">Malawian</option> <option value="malaysian">Malaysian</option> <option value="maldivan">Maldivan</option> <option value="malian">Malian</option> <option value="maltese">Maltese</option> <option value="marshallese">Marshallese</option> <option value="mauritanian">Mauritanian</option> <option value="mauritian">Mauritian</option> <option value="mexican">Mexican</option> <option value="micronesian">Micronesian</option> <option value="moldovan">Moldovan</option> <option value="monacan">Monacan</option> <option value="mongolian">Mongolian</option> <option value="moroccan">Moroccan</option> <option value="mosotho">Mosotho</option> <option value="motswana">Motswana</option> <option value="mozambican">Mozambican</option> <option value="namibian">Namibian</option> <option value="nauruan">Nauruan</option> <option value="nepalese">Nepalese</option> <option value="new zealander">New Zealander</option> <option value="ni-vanuatu">Ni-Vanuatu</option> <option value="nicaraguan">Nicaraguan</option> <option value="nigerien">Nigerien</option> <option value="north korean">North Korean</option> <option value="northern irish">Northern Irish</option> <option value="norwegian">Norwegian</option> <option value="omani">Omani</option> <option value="pakistani">Pakistani</option> <option value="palauan">Palauan</option> <option value="panamanian">Panamanian</option> <option value="papua new guinean">Papua New Guinean</option> <option value="paraguayan">Paraguayan</option> <option value="peruvian">Peruvian</option> <option value="polish">Polish</option> <option value="portuguese">Portuguese</option> <option value="qatari">Qatari</option> <option value="romanian">Romanian</option> <option value="russian">Russian</option> <option value="rwandan">Rwandan</option> <option value="saint lucian">Saint Lucian</option> <option value="salvadoran">Salvadoran</option> <option value="samoan">Samoan</option> <option value="san marinese">San Marinese</option> <option value="sao tomean">Sao Tomean</option> <option value="saudi">Saudi</option> <option value="scottish">Scottish</option> <option value="senegalese">Senegalese</option> <option value="serbian">Serbian</option> <option value="seychellois">Seychellois</option> <option value="sierra leonean">Sierra Leonean</option> <option value="singaporean">Singaporean</option> <option value="slovakian">Slovakian</option> <option value="slovenian">Slovenian</option> <option value="solomon islander">Solomon Islander</option> <option value="somali">Somali</option> <option value="south african">South African</option> <option value="south korean">South Korean</option> <option value="spanish">Spanish</option> <option value="sri lankan">Sri Lankan</option> <option value="sudanese">Sudanese</option> <option value="surinamer">Surinamer</option> <option value="swazi">Swazi</option> <option value="swedish">Swedish</option> <option value="swiss">Swiss</option> <option value="syrian">Syrian</option> <option value="taiwanese">Taiwanese</option> <option value="tajik">Tajik</option> <option value="tanzanian">Tanzanian</option> <option value="thai">Thai</option> <option value="togolese">Togolese</option> <option value="tongan">Tongan</option> <option value="trinidadian or tobagonian">Trinidadian or Tobagonian</option> <option value="tunisian">Tunisian</option> <option value="turkish">Turkish</option> <option value="tuvaluan">Tuvaluan</option> <option value="ugandan">Ugandan</option> <option value="ukrainian">Ukrainian</option> <option value="uruguayan">Uruguayan</option> <option value="uzbekistani">Uzbekistani</option> <option value="venezuelan">Venezuelan</option> <option value="vietnamese">Vietnamese</option> <option value="welsh">Welsh</option> <option value="yemenite">Yemenite</option> <option value="zambian">Zambian</option> <option value="zimbabwean">Zimbabwean</option> </select> <div class="invalid-feedback"> Select your nationality </div> </div> </fieldset> <br> <fieldset class="p-4 m-0"> <legend>Education</legend> <div class="row"> <label>Name of University</label> <input type="text" class="form-control" name="inst" list="universities" required> <div class="invalid-feedback"> Provide the name of your university </div> </div> <br> <div class="row"> <div class="col-6"> <label>Type of University</label> <div class="row"> <div class="col-4 form-check-inline"> <input type="radio" class="form-check-input" name="type" value="Public" checked> <label class="form-check-label" for="type">Public</label> </div> <div class="col-4 form-check-inline"> <input type="radio" class="form-check-input" name="type" value="Private"> <label class="form-check-label" for="type">Private</label> </div> </div> </div> <div class="col-6"> <label>Level</label> <input type="number" class="form-control" name="level" id="age" step="100" min=100 max=900 required> <div class="invalid-feedback"> Provide current level </div> </div> </div> <br> <div class="row"> <div class="col-6"> <label>Year of Entry</label> <input type="number" class="form-control" name="entry" min=2016 max=2024 required> <div class="invalid-feedback"> Provide Year of Entry </div> </div> <div class="col-6"> <label>Year of Completion </label> <input type="number" class="form-control" name="exit" min=2024 max=2034 required> <div class="invalid-feedback"> Provide Year of Completion </div> </div> </div> <br> <div class="row"> <label>Programme Offered</label> <input type="text" class="form-control" name="programme" id="programme" required> <div class="invalid-feedback"> Provide the name of the programme you are currently offering </div> </div> <br> </fieldset> <br> <fieldset class="p-4 m-0"> <legend>Student Parliament Model</legend> <div class="row"> <label>Are you a member of the Parliament of Ghana鈥檚 Student Parliament?</label> <div class="col-4 form-check-inline"> <input type="radio" class="form-check-input" name="member" value="Yes" checked> <label class="form-check-label" for="type">Yes</label> </div> <div class="col-4 form-check-inline"> <input type="radio" class="form-check-input" name="member" value="No"> <label class="form-check-label" for="type">No</label> </div> </div> <br> <div class="row"> <label>Indicate position, if any</label> <input type="text" name="position" list="positions" class="form-control"> </div> <br> <div class="row"> <label>What is your motivation for joining the Student Parliament?</label> <textarea class="form-control" name="motivation" wordwrap style="min-height: 5rem;" required></textarea> <div class="invalid-feedback"> Please tell us the reason for which you joined the Student Parliament </div> </div> <br> <div class="row"> <label>Please provide Contact Information</label> <textarea class="form-control" name="contact" wordwrap style="min-height: 5rem;" required></textarea> <div class="invalid-feedback"> Please provide us your address and/or phone contacts </div> </div> <br> <div class="row"> <label>Email Address</label> <input type="email" class="form-control" name="email" id="email" required> <div class="invalid-feedback"> Provide your email address </div> </div> </fieldset> <br> <fieldset class="p-4 m-0"> <legend>Student ID</legend> <div class="alert alert-secondary" role="alert">To proceed, please either select your existing Student ID or capture a new image of your valid ID. Make sure your picture is clear and visible in the photo.</div> <div class="file-loading"> <input id="picture" name="picture" type="file" accept="image/jpeg" single><br><br> <button type="button" class="btn btn-secondary" id="capture">Use Camera</button><br><br> <img id="mypic" src="" alt="" style="width: 15rem;height:20rem;display:inline" /> <video id="video" width="300" height="380" autoplay style="display:none"></video> <canvas id="canvas" width="300" height="380" style="display: none;"></canvas> <button type="button" class="btn btn-primary" style="display: none;" id="snap">Capture</button> </div> <input type="hidden" name="capturedPic" id="capturedPic"> </fieldset><br><br> <div class="row ms-4"> <div class="col"> <input type="checkbox" class="form-check-input " required>   I accept the <a href="#priv" class="link-secondary">Privacy Statement</a> <div class=" row invalid-feedback"> You must accept the Privacy Statment as indicated at the top of the form </div> </div> </div><br> <div class="row d-flex justify-content-center"> <input type="submit" class="btn btn-success" id="send" value="Submit" style="width: 10rem;"> </div> <br> <span id="errorTxt" style="color:red"></span> <br> </form> </div> <br> <small class="d-flex justify-content-center">© 2024 Parliament of Ghana. All rights reserved.</small><br> <script src="js/jquery.min.js"></script> <script src="js/bootstrap.bundle.min.js"></script> <script> var image_data_url = null picture.onchange = evt => { const [file] = picture.files if (file) { mypic.style.display = "inline"; video.style.display = "none"; snap.style.display = "none"; canvas.style.display = "none"; image_data_url = null; mypic.src = URL.createObjectURL(file) } } capture.addEventListener('click', async function() { let stream = await navigator.mediaDevices.getUserMedia({ video: true, audio: false }); video.srcObject = stream; mypic.style.display = "none"; video.style.display = "inline"; snap.style.display = "inline"; canvas.style.display = "none"; }); snap.addEventListener('click', function() { canvas.style.display = "inline"; video.style.display = "none"; snap.style.display = "none"; canvas.getContext('2d').drawImage(video, 0, 0, canvas.width, canvas.height); image_data_url = canvas.toDataURL('image/jpeg'); $("#capturedPic").val(image_data_url); }); function updateForm() { $("#errorTxt").text(""); emailInput = email.value; //const allowedDomain = "@parliament.gh"; const emailRegex = /^[a-zA-Z0-9._-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,4}$/; var corrrect = emailRegex.test(emailInput); if ( !corrrect) { email.setCustomValidity('Enter a valid email address'); $("#errorTxt").text("Enter a valid email address"); return false } if (picture.files.length <= 0 && image_data_url == null) { $("#errorTxt").text("You must either select or capture your valid Student ID"); return false; } //form.submit(); return true; } (function() { 'use strict'; window.addEventListener('load', function() { // Fetch all the forms we want to apply custom Bootstrap validation styles to var forms = document.getElementsByClassName('needs-validation'); // Loop over them and prevent submission var validation = Array.prototype.filter.call(forms, function(form) { form.addEventListener('submit', function(event) { $("#send").val("Sending..."); $("#send").prop("disabled", true); email.setCustomValidity(''); // console.log("called " + form.checkValidity() + "; " + updateForm()); if (form.checkValidity() === false || updateForm() === false) { event.preventDefault(); event.stopPropagation(); $("#send").val("Submit"); $("#send").removeAttr("disabled"); } form.classList.add('was-validated'); }, false); }); }, false); })(); </script> </html>

CINXE.COM

STUDENT REGISTRSTION FORM