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<h4>Membership Application Form for Scientific Committees and Editorial Review Boards </h4> <p> <form id="member_form" name="member_form" method="post" action="member_process.php" enctype="multipart/form-data"> <input type="hidden" name="addm" id="addm" value="0" /> <table border="0" cellspacing="5" cellpadding="5" class="table"> <tr> <td width="19%"> </td> <td width="1%"> </td> <td width="33%"> </td> <td width="47%"> </td> </tr> <tr> <td class="blog_content">Membership Type </td> <td> </td> <td> <select name="membership_type" class="form-control" id="membership_type" onchange="get_member_type(this.value)"> <option value="0">Choose Membership Type</option> <option value="1"> Student and apprentice members </option> <option value="2"> Associate</option> <option value="3"> Fellow</option> <option value="4"> Honorary Fellow</option> <option value="5"> Institutional Membership</option> </select> </td> <td rowspan="6" valign="top"> <div id="m_t_det"></div> </td> </tr> <tr> <td class="blog_content"> Name</td> <td> </td> <td> <input name="name" type="text" class="form-control" id="name" /> </td> </tr> <tr> <td class="blog_content">Photo</td> <td> </td> <td> <div style="width:200px; overflow:hidden"> <input name="images" type="file" class="form_file" id="images" /><br /> <div class="in_error" id="response"></div> </div> <script language="javascript"> (function() { var input = document.getElementById("images"), formdata = false; if (window.FormData) { formdata = new FormData(); } input.addEventListener("change", function(evt) { document.getElementById("addm").value = 1; $('#response').html( '<img src="loader.gif" /> Uploading Please Wait...' ); if (!/(\.bmp|\.gif|\.jpg|\.jpeg|\.png)$/i.test( images.value)) { $('#response').html( 'Please Upload image file only'); alert("Invalid image file type."); fld.form.reset(); fld.focus(); return false; } file = this.files[0]; formdata.append("images", file); if (formdata) { $.ajax({ url: "mem_upload.php", type: "POST", data: formdata, processData: false, contentType: false, success: function(res) { document.getElementById( "response") .innerHTML = res; document.getElementById( "addm").value = 0; } }); } }, false); }()); </script> </td> </tr> <tr> <td class="blog_content">Affiliation</td> <td> </td> <td> <input name="affiliation" type="text" class="form-control" id="affiliation" /> </td> </tr> <tr> <td class="blog_content">Designation</td> <td> </td> <td> <input name="designation" type="text" class="form-control" id="designation" /> </td> </tr> <tr> <td class="blog_content">Department</td> <td> </td> <td> <input name="department" type="text" class="form-control" id="department" /> </td> </tr> <tr> <td class="blog_content">Gender</td> <td> </td> <td> <input name="gender" id="gender" type="radio" value="Male" /> Male     <input name="gender" id="gender" type="radio" value="Female" /> Female </td> <td> </td> </tr> <tr> <td class="blog_content">Age</td> <td> </td> <td> <input name="age" type="text" class="form-control" id="age" /> </td> <td> </td> </tr> <tr> <td class="blog_content">Country</td> <td> </td> <td> <select name="country" class="form-control" id="country"> <option value="0">Choose Country</option> <option value="1#Afghanistan"> Afghanistan</option> <option value="2#Albania"> Albania</option> <option value="3#Algeria"> Algeria</option> <option value="4#American Samoa"> American Samoa</option> <option value="5#Andorra"> Andorra</option> <option value="6#Angola"> Angola</option> <option value="7#Anguilla"> Anguilla</option> <option value="8#Antarctica"> Antarctica</option> <option value="9#Antigua and Barbuda"> Antigua and Barbuda</option> <option value="10#Argentina"> Argentina</option> <option value="238#Aringland Islands"> Aringland Islands</option> <option value="11#Armenia"> Armenia</option> <option value="12#Aruba"> Aruba</option> <option value="13#Australia"> Australia</option> <option value="14#Austria"> Austria</option> <option value="15#Azerbaijan"> Azerbaijan</option> <option value="16#Bahamas"> Bahamas</option> <option value="17#Bahrain"> Bahrain</option> <option value="18#Bangladesh"> Bangladesh</option> <option value="19#Barbados"> Barbados</option> <option value="20#Belarus"> Belarus</option> <option value="21#Belgium"> Belgium</option> <option value="22#Belize"> Belize</option> <option value="23#Benin"> Benin</option> <option value="24#Bermuda"> Bermuda</option> <option value="25#Bhutan"> Bhutan</option> <option value="26#Bolivia"> Bolivia</option> <option value="27#Bosnia and Herzegovina"> Bosnia and Herzegovina</option> <option value="28#Botswana"> Botswana</option> <option value="29#Bouvet Island"> Bouvet Island</option> <option value="30#Brazil"> Brazil</option> <option value="31#British Indian Ocean territory"> British Indian Ocean territory</option> <option value="32#Brunei Darussalam"> Brunei Darussalam</option> <option value="33#Bulgaria"> Bulgaria</option> <option value="34#Burkina Faso"> Burkina Faso</option> <option value="35#Burundi"> Burundi</option> <option value="36#Cambodia"> Cambodia</option> <option value="37#Cameroon"> Cameroon</option> <option value="38#Canada"> Canada</option> <option value="39#Cape Verde"> Cape Verde</option> <option value="40#Cayman Islands"> Cayman Islands</option> <option value="41#Central African Republic"> Central African Republic</option> <option value="42#Chad"> Chad</option> <option value="43#Chile"> Chile</option> <option value="44#China"> China</option> <option value="45#Christmas Island"> Christmas Island</option> <option value="46#Cocos (Keeling) Islands"> Cocos (Keeling) Islands</option> <option value="47#Colombia"> Colombia</option> <option value="48#Comoros"> Comoros</option> <option value="49#Cook Islands"> Cook Islands</option> <option value="50#Costa Rica"> Costa Rica</option> <option value="51#Croatia (Hrvatska)"> Croatia (Hrvatska)</option> <option value="239#Cte dIvoire (Ivory Coast)"> Cte dIvoire (Ivory Coast)</option> <option value="52#Cuba"> Cuba</option> <option value="53#Cyprus"> Cyprus</option> <option value="54#Czech Republic"> Czech Republic</option> <option value="55#Democratic Republic of Congo"> Democratic Republic of Congo</option> <option value="56#Denmark"> Denmark</option> <option value="57#Djibouti"> Djibouti</option> <option value="58#Dominica"> Dominica</option> <option value="59#Dominican Republic"> Dominican Republic</option> <option value="60#East Timor"> East Timor</option> <option value="61#Ecuador"> Ecuador</option> <option value="62#Egypt"> Egypt</option> <option value="63#El Salvador"> El Salvador</option> <option value="64#Equatorial Guinea"> Equatorial Guinea</option> <option value="65#Eritrea"> Eritrea</option> <option value="66#Estonia"> Estonia</option> <option value="67#Ethiopia"> Ethiopia</option> <option value="68#Falkland Islands"> Falkland Islands</option> <option value="69#Faroe Islands"> Faroe Islands</option> <option value="70#Fiji"> Fiji</option> <option value="71#Finland"> Finland</option> <option value="72#France"> France</option> <option value="73#French Guiana"> French Guiana</option> <option value="74#French Polynesia"> French Polynesia</option> <option value="75#French Southern Territories"> French Southern Territories</option> <option value="76#Gabon"> Gabon</option> <option value="77#Gambia"> Gambia</option> <option value="78#Georgia"> Georgia</option> <option value="79#Germany"> Germany</option> <option value="80#Ghana"> Ghana</option> <option value="81#Gibraltar"> Gibraltar</option> <option value="82#Greece"> Greece</option> <option value="83#Greenland"> Greenland</option> <option value="84#Grenada"> Grenada</option> <option value="85#Guadeloupe"> Guadeloupe</option> <option value="86#Guam"> Guam</option> <option value="87#Guatemala"> Guatemala</option> <option value="88#Guinea"> Guinea</option> <option value="89#Guinea-Bissau"> Guinea-Bissau</option> <option value="90#Guyana"> Guyana</option> <option value="91#Haiti"> Haiti</option> <option value="92#Heard and McDonald Islands"> Heard and McDonald Islands</option> <option value="93#Honduras"> Honduras</option> <option value="243#Hong Kong"> Hong Kong</option> <option value="94#Hungary"> Hungary</option> <option value="95#Iceland"> Iceland</option> <option value="96#India"> India</option> <option value="97#Indonesia"> Indonesia</option> <option value="98#Iran"> Iran</option> <option value="99#Iraq"> Iraq</option> <option value="100#Ireland"> Ireland</option> <option value="101#Israel"> Israel</option> <option value="102#Italy"> Italy</option> <option value="103#Jamaica"> Jamaica</option> <option value="104#Japan"> Japan</option> <option value="105#Jordan"> Jordan</option> <option value="106#Kazakhstan"> Kazakhstan</option> <option value="107#Kenya"> Kenya</option> <option value="108#Kiribati"> Kiribati</option> <option value="109#Korea (north)"> Korea (north)</option> <option value="110#Korea (south)"> Korea (south)</option> <option value="111#Kuwait"> Kuwait</option> <option value="112#Kyrgyzstan"> Kyrgyzstan</option> <option value="240#Lao Peoples Democratic Republic"> Lao Peoples Democratic Republic</option> <option value="113#Latvia"> Latvia</option> <option value="114#Lebanon"> Lebanon</option> <option value="115#Lesotho"> Lesotho</option> <option value="116#Liberia"> Liberia</option> <option value="117#Libyan Arab Jamahiriya"> Libyan Arab Jamahiriya</option> <option value="118#Liechtenstein"> Liechtenstein</option> <option value="119#Lithuania"> Lithuania</option> <option value="120#Luxembourg"> Luxembourg</option> <option value="121#Macau"> Macau</option> <option value="122#Macedonia"> Macedonia</option> <option value="123#Madagascar"> Madagascar</option> <option value="124#Malawi"> Malawi</option> <option value="125#Malaysia"> Malaysia</option> <option value="126#Maldives"> Maldives</option> <option value="127#Mali"> Mali</option> <option value="128#Malta"> Malta</option> <option value="129#Marshall Islands"> Marshall Islands</option> <option value="130#Martinique"> Martinique</option> <option value="131#Mauritania"> Mauritania</option> <option value="132#Mauritius"> Mauritius</option> <option value="133#Mayotte"> Mayotte</option> <option value="134#Mexico"> Mexico</option> <option value="135#Micronesia"> Micronesia</option> <option value="136#Moldova"> Moldova</option> <option value="137#Monaco"> Monaco</option> <option value="138#Mongolia"> Mongolia</option> <option value="139#Montserrat"> Montserrat</option> <option value="140#Morocco"> Morocco</option> <option value="141#Mozambique"> Mozambique</option> <option value="142#Myanmar"> Myanmar</option> <option value="143#Namibia"> Namibia</option> <option value="144#Nauru"> Nauru</option> <option value="145#Nepal"> Nepal</option> <option value="146#Netherlands"> Netherlands</option> <option value="147#New Caledonia"> New Caledonia</option> <option value="148#New Zealand"> New Zealand</option> <option value="149#Nicaragua"> Nicaragua</option> <option value="150#Niger"> Niger</option> <option value="151#Nigeria"> Nigeria</option> <option value="152#Niue"> Niue</option> <option value="153#Norfolk Island"> Norfolk Island</option> <option value="154#Northern Mariana Islands"> Northern Mariana Islands</option> <option value="155#Norway"> Norway</option> <option value="156#Oman"> Oman</option> <option value="157#Other"> Other</option> <option value="158#Pakistan"> Pakistan</option> <option value="159#Palau"> Palau</option> <option value="160#Palestinian Territories"> Palestinian Territories</option> <option value="161#Panama"> Panama</option> <option value="162#Papua New Guinea"> Papua New Guinea</option> <option value="163#Paraguay"> Paraguay</option> <option value="164#Peru"> Peru</option> <option value="165#Philippines"> Philippines</option> <option value="166#Pitcairn"> Pitcairn</option> <option value="167#Poland"> Poland</option> <option value="168#Portugal"> Portugal</option> <option value="169#Puerto Rico"> Puerto Rico</option> <option value="170#Qatar"> Qatar</option> <option value="172#Réunion"> Réunion</option> <option value="171#Republic of Congo"> Republic of Congo</option> <option value="173#Romania"> Romania</option> <option value="174#Russia"> Russia</option> <option value="175#Rwanda"> Rwanda</option> <option value="176#Saint Helena"> Saint Helena</option> <option value="177#Saint Kitts and Nevis"> Saint Kitts and Nevis</option> <option value="178#Saint Lucia"> Saint Lucia</option> <option value="179#Saint Pierre and Miquelon"> Saint Pierre and Miquelon</option> <option value="180#Saint Vincent and the Grenadines"> Saint Vincent and the Grenadines</option> <option value="181#Samoa"> Samoa</option> <option value="182#San Marino"> San Marino</option> <option value="183#Sao Tome and Principe"> Sao Tome and Principe</option> <option value="184#Saudi Arabia"> Saudi Arabia</option> <option value="185#Senegal"> Senegal</option> <option value="186#Serbia and Montenegro"> Serbia and Montenegro</option> <option value="187#Seychelles"> Seychelles</option> <option value="188#Sierra Leone"> Sierra Leone</option> <option value="189#Singapore"> Singapore</option> <option value="190#Slovakia"> Slovakia</option> <option value="191#Slovenia"> Slovenia</option> <option value="192#Solomon Islands"> Solomon Islands</option> <option value="193#Somalia"> Somalia</option> <option value="194#South Africa"> South Africa</option> <option value="195#South Georgia and the South Sandwich Islands"> South Georgia and the South Sandwich Islands</option> <option value="196#Spain"> Spain</option> <option value="197#Sri Lanka"> Sri Lanka</option> <option value="198#Sudan"> Sudan</option> <option value="199#Suriname"> Suriname</option> <option value="200#Svalbard and Jan Mayen Islands"> Svalbard and Jan Mayen Islands</option> <option value="201#Swaziland"> Swaziland</option> <option value="202#Sweden"> Sweden</option> <option value="203#Switzerland"> Switzerland</option> <option value="204#Syria"> Syria</option> <option value="205#Taiwan"> Taiwan</option> <option value="206#Tajikistan"> Tajikistan</option> <option value="207#Tanzania"> Tanzania</option> <option value="208#Thailand"> Thailand</option> <option value="209#Togo"> Togo</option> <option value="210#Tokelau"> Tokelau</option> <option value="211#Tonga"> Tonga</option> <option value="212#Trinidad and Tobago"> Trinidad and Tobago</option> <option value="213#Tunisia"> Tunisia</option> <option value="214#Turkey"> Turkey</option> <option value="215#Turkmenistan"> Turkmenistan</option> <option value="216#Turks and Caicos Islands"> Turks and Caicos Islands</option> <option value="217#Tuvalu"> Tuvalu</option> <option value="218#Uganda"> Uganda</option> <option value="219#Ukraine"> Ukraine</option> <option value="220#undefined"> undefined</option> <option value="241#United Arab Emirates"> United Arab Emirates</option> <option value="222#United Kingdom"> United Kingdom</option> <option value="223#United States of America"> United States of America</option> <option value="224#Uruguay"> Uruguay</option> <option value="225#Uzbekistan"> Uzbekistan</option> <option value="226#Vanuatu"> Vanuatu</option> <option value="227#Vatican City"> Vatican City</option> <option value="228#Venezuela"> Venezuela</option> <option value="229#Vietnam"> Vietnam</option> <option value="230#Virgin Islands (British)"> Virgin Islands (British)</option> <option value="231#Virgin Islands (US)"> Virgin Islands (US)</option> <option value="232#Wallis and Futuna Islands"> Wallis and Futuna Islands</option> <option value="233#Web"> Web</option> <option value="234#Western Sahara"> Western Sahara</option> <option value="235#Yemen"> Yemen</option> <option value="236#Zambia"> Zambia</option> <option value="237#Zimbabwe"> Zimbabwe</option> </select> </td> <td> </td> </tr> <tr> <td class="blog_content">State</td> <td> </td> <td> <input name="state" type="text" class="form-control" id="state" /> </td> <td> </td> </tr> <tr> <td 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