<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<!------ Include the above in your HEAD tag ---------->
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<!-- This file has been downloaded from Bootsnipp.com. Enjoy! -->
<title>MA Registration form - Bootsnipp.com</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link href="http://maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet">
<style type="text/css">
/*!Don't remove this!
* jQuery DCalendar and DCalendar Picker plugin styles
*
* Author: Dionlee Uy
* Email: dionleeuy@gmail.com
*
* Date: Mon Mar 2 2013
*/
.calendar {
position: relative;
font-family: 'Century Gothic','Segoe UI', Calibri, Arial;
font-size: 12px;
border-collapse: collapse;
margin: 0; padding: 0;
z-index: 4;
border:1px solid rgba(0,0,0,0.08);
width: 250px;
color: #000;
text-align: center;
background-color: #FFF;
}
.calendar th,
.calendar td {
text-align: center;
-webki-ttransition: all 0.3s ease;
-moz-transition: all 0.3s ease;
transition: all 0.3s ease;
}
.calendar th:first-child,
.calendar td:first-child {
margin-left: 5px;
}
.calendar span {
padding: 6px 4px;
display: block;
}
.calendar .month {
padding: 15px;
}
.calendar .pMDate, .calendar .nMDate { color: #AAA; }
.calendar .date, .calendar .pMDate, .calendar .nMDate, .calendar .month { cursor: pointer; }
.calendar .date:hover, .calendar .pMDate:hover, .calendar .nMDate:hover, .calendar .month:hover { background-color: #E2E2E2; }
.calendar .date:active, .calendar .pMDate:active, .calendar .nMDate:active, .calendar .month:active { background-color: #22A7F0; color: #FFF; }
.calendar .selected {
background-color: #22A7F0 !important;
color: #FFF !important;
}
.calendar tr:first-child th {
background-color: #FFF;
padding: 4px;
padding-top: 8px;
font-size: 14px;
}
.calendar tr:first-child th { cursor: pointer; color:#000; }
.calendar tr:first-child th:hover { color:#22A7F0; }
.calendar tr:first-child th:active { color: #22A7F0; }
.calendar thead tr:nth-child(2) th { color: #555; padding: 8px 3px; }
.calendar #prev, .calendar #next {
font-family: 'Times New Roman';
font-size: 20px;
padding: 0;
}
.calendar #today {
text-align: center; cursor: pointer;
color: #22A7F0; padding: 10px 6px;
}
.calendar #today:hover { color: #80A7DD; }
.calendar #today:active { color: #000; }
.calendar #currDay { color:#22A7F0; }
.datepicker {
background: #ffffff url('https://cdn4.iconfinder.com/data/icons/small-n-flat/24/calendar-128.png') no-repeat right top;
background-size: 30px 30px;;
}
</style>
<script src="http://code.jquery.com/jquery-1.11.1.min.js"></script>
<script src="http://maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
</head>
<body>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1">
<!-- The above 3 meta tags *must* come first in the head; any other head content must come *after* these tags -->
<title>Registration Form</title>
<!-- Bootstrap -->
<link href="css/bootstrap.min.css" rel="stylesheet">
<link href="css/dcalendar.picker.css" rel="stylesheet">
<style type="text/css">
#deceased{
background-color:#FFF3F5;
padding-top:10px;
margin-bottom:10px;
}
.remove_field{
float:right;
cursor:pointer;
position : absolute;
}
.remove_field:hover{
text-decoration:none;
}
</style>
<!-- HTML5 shim and Respond.js for IE8 support of HTML5 elements and media queries -->
<!-- WARNING: Respond.js doesn't work if you view the page via file:// -->
<!--[if lt IE 9]>
<script src="https://oss.maxcdn.com/html5shiv/3.7.2/html5shiv.min.js"></script>
<script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script>
<![endif]-->
<!-- jQuery (necessary for Bootstrap's JavaScript plugins) -->
<script src="js/jquery-1.12.4.js"></script>
<script src="js/dcalendar.picker.js"></script>
<!-- Include all compiled plugins (below), or include individual files as needed -->
<script src="js/bootstrap.min.js"></script>
<script type='text/javascript'>
$(function() {
//calendar call function
$('.datepicker').dcalendar();
$('.datepicker').dcalendarpicker();
var max_fields = 10; //maximum input boxes allowed
var x = 1; //initlal text box count
$('#add').click(function () {
if(x < max_fields){ //max input box allowed
x++; //text box increment
$("#addblock").before('<div class="col-md-12 col-sm-12" id="deceased"> <a href="#" class="remove_field" title="Remove">X</a> <div class="form-group col-md-3 col-sm-3"> <label for="name">Name*</label> <input type="text" class="form-control input-sm" id="name" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="gender">Gender*</label> <input type="text" class="form-control input-sm" id="gender" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="age">Age*</label> <input type="text" class="form-control input-sm" id="age" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="DOB">Date of Birth or Exact Birth Year*</label> <input type="text" class="form-control input-sm datepicker" id="DOB'+x+'" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="DOD">Date of Death or Exact Death Year*</label> <input type="text" class="form-control input-sm datepicker" id="DOD'+x+'" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="mother">Deceased Person\'s Mother Name*</label> <input type="text" class="form-control input-sm" id="mother" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="father">Deceased Person\'s Father Name*</label> <input type="text" class="form-control input-sm" id="father" placeholder=""> </div> <div class="form-group col-md-3 col-sm-3"> <label for="photo">Upload Photo*</label> <input type="file" id="photo"> <p class="help-block">Please upload individual photo. Group photo is not acceptable.</p> </div></div>');
$('.datepicker').dcalendarpicker();
} else{
alert("Only 10 Names Allowed");
}
});
$(document).on('click', '.remove_field', function(e){
e.preventDefault();
$(this).parent('div').remove();
x--;
});
});
</script>
</head>
<body>
<div class="panel panel-primary" style="margin:20px;">
<div class="panel-heading">
<h3 class="panel-title">Registration Form</h3>
</div>
<div class="panel-body">
<form>
<div class="col-md-12 col-sm-12">
<div class="form-group col-md-6 col-sm-6">
<label for="name">Name* </label>
<input type="text" class="form-control input-sm" id="name" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="email">Email*</label>
<input type="email" class="form-control input-sm" id="email" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="mobile">Mobile*</label>
<input type="text" class="form-control input-sm" id="mobile" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="address">Address*</label>
<textarea class="form-control input-sm" id="address" rows="3"></textarea>
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="city">City*</label>
<input type="text" class="form-control input-sm" id="city" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="state">State*</label>
<input type="text" class="form-control input-sm" id="state" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="country">Country*</label>
<input type="text" class="form-control input-sm" id="country" placeholder="">
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="pincode">Pincode</label>
<input type="text" class="form-control input-sm" id="pincode" placeholder="">
</div>
<div class = "form-group col-md-6 col-sm-6">
<label for="years">You could register for up to 10 years for Kalabhairava Shanthi - M.A *</label>
<span class="help-block">Please choose the no. of months for which you would like to register</span>
<select class="form-control input-sm" id="years">
<option>-- Select No of Year --</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
</select>
</div>
<div class = "form-group col-md-6 col-sm-6">
<label for="months">You could register for up to 10 months for Kalabhairava Shanthi. *</label>
<span class="help-block">Please choose the no. of months for which you would like to register</span>
<select class="form-control input-sm" id="months">
<option>-- Select No of Month --</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
</select>
</div>
<div class="form-group col-md-6 col-sm-6" >
<label for="pincode">Would you be visiting ashram to participate in Kalabhairava Shanthi - M.A ? *
<input type="checkbox" checked data-toggle="toggle"></label>
<span class="help-block">if you need a cottage to stay, you could book in advance through email to ishastay@ishafoundation.org</span>
</div>
<div class="form-group col-md-6 col-sm-6">
<label for="arrival">Arrival Date</label>
<input type="text" class="form-control input-sm datepicker" id="arrival" placeholder="">
</div>
</div>
<div class="col-md-12 col-sm-12" id="deceased">
<div class="form-group col-md-3 col-sm-3">
<label for="name">Name*</label>
<input type="text" class="form-control input-sm" id="name" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="gender">Gender*</label>
<input type="text" class="form-control input-sm" id="gender" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="age">Age*</label>
<input type="text" class="form-control input-sm" id="age" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="DOB">Date of Birth or Exact Birth Year*</label>
<input type="text" class="form-control input-sm datepicker" id="DOB" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="DOD">Date of Death or Exact Death Year*</label>
<input type="text" class="form-control input-sm datepicker" id=" DOD" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="mother">Deceased Person's Mother Name*</label>
<input type="text" class="form-control input-sm" id="mother" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="father">Deceased Person's Father Name*</label>
<input type="text" class="form-control input-sm" id="father" placeholder="">
</div>
<div class="form-group col-md-3 col-sm-3">
<label for="photo">Photo*</label>
<input type="file" id="photo">
<p class="help-block">Please upload individual photo. Group photo is not acceptable.</p>
</div>
</div>
<div class="col-md-12 col-sm-12" id="addblock">
<div class="form-group col-md-3 col-sm-3">
<input type='button' class="btn btn-primary" value="Add" id="add"/>
</div>
</div>
<div class="col-md-12 col-sm-12" >
<div class="form-group col-md-3 col-sm-3 pull-right">
<input type='text' class="form-control input-sm" id="amount" readonly placeholder="Total Amount"/>
</div>
</div>
<div class="col-md-12 col-sm-12">
<div class="form-group col-md-3 col-sm-3 pull-right" >
<input type="submit" class="btn btn-primary" value="Submit"/>
</div>
</div>
</form>
</div>
</body>
</html>
<script type="text/javascript">
/* -- DO NOT REMOVE --
* jQuery DCalendar 1.1 and DCalendar Picker 1.1 plugin
*
* Author: Dionlee Uy
* Email: dionleeuy@gmail.com
*
* Date: Sat Mar 2 2013
*
* @requires jQuery
* -- DO NOT REMOVE --
*/
if (typeof jQuery === 'undefined') { throw new Error('DCalendar.Picker: This plugin requires jQuery'); }
+function ($) {
Date.prototype.getDays = function() { return new Date(this.getFullYear(), this.getMonth() + 1, 0).getDate(); };
var months = ['January','February','March','April','May','June','July','August','September','October','November','December'],
short_months = ['Jan','Feb','Mar','Apr','May','Jun','Jul','Aug','Sep','Oct','Nov','Dec'],
daysofweek = ['Sunday','Monday','Tuesday','Wednesday','Thursday','Friday','Saturday'],
DCalendar = function(elem, options) {
this.calendar = $(elem);
this.today = new Date(); //system date
this.date = this.today; //current selected date, default is today
this.viewMode = 'days';
this.options = options;
this.selected = (this.date.getMonth() + 1) + "/" + this.date.getDate() + "/" + this.date.getFullYear();
if(options.mode === 'calendar')
this.tHead = $('<thead><tr><th id="prev">‹</th><th colspan="5" id="currM"></th><th id="next">›</th></tr><tr><th>Su</th><th>Mo</th><th>Tu</th><th>We</th><th>Th</th><th>Fr</th><th>Sa</th></tr></thead>');
else if (options.mode === 'datepicker')
this.tHead = $('<thead><tr><th id="prev">‹</th><th colspan="5" id="currM"></th><th id="next">›</th></tr><tr><th>S</th><th>M</th><th>T</th><th>W</th><th>T</th><th>F</th><th>S</th></tr></thead>');
this.tHead.find('#currM').text(months[this.today.getMonth()] +" " + this.today.getFullYear());
this.calendar.prepend(this.tHead);
var that = this;
this.calendar.on('click', '#next', function() { initCreate('next'); })
.on('click', '#prev', function() { initCreate('prev'); })
.on('click', '#today', function() {
that.viewMode = 'days';
var curr = new Date(that.date),
sys = new Date(that.today);
if(curr.toString() != sys.toString()) { that.date = sys; }
that.create('days');
}).on('click', '.date, .pMDate, .nMDate', function() {
var tClass = $(this).attr('class'),
sdate = $(this).text(),
cmonth = that.date.getMonth(),
cyear = that.date.getFullYear();
/* Calculate year */
if(tClass === 'pMDate') { cyear = (cmonth === 0 ? cyear - 1 : cyear); }
else if(tClass === 'nMDate') { cyear = (cmonth + 2 === 13 ? cyear + 1 : cyear); }
/* Calculate month */
if(tClass === 'pMDate'){ cmonth = (cmonth === 0 ? '12' : cmonth); }
else if (tClass === 'nMDate') { cmonth = (cmonth + 2 === 13 ? '1' : cmonth + 2); }
else { cmonth = cmonth + 1; }
// Selected date
that.selected = cmonth + '/' + sdate + '/' + cyear;
if(that.options.mode === 'datepicker') {
that.calendar.find('td').removeClass('selected');
$(this).addClass('selected');
}
selectDate();
return true;
}).on('click', '#currM', function(){
that.viewMode = 'months';
that.create(that.viewMode);
}).on('click', '.month', function(e){
that.viewMode = 'days';
var curr = new Date(that.date), y = that.calendar.find('#currM').text();
curr.setMonth($(e.currentTarget).attr('num'));
that.date = curr;
that.create(that.viewMode);
});
function selectDate () {
var newDate = formatDate(that.options.format);
var e = $.Event('selectdate', {date: newDate});
that.calendar.trigger(e);
}
function formatDate (format) {
var d = new Date(that.selected), day = d.getDate(), m = d.getMonth(), y = d.getFullYear();
return format.replace(/(yyyy|yy|mmmm|mmm|mm|m|dd|d)/gi, function (e) {
switch(e.toLowerCase()){
case 'd': return day;
case 'dd': return (day < 10 ? "0"+day: day);
case 'm': return m+1;
case 'mm': return (m+1 < 10 ? "0"+(m+1): (m+1));
case 'mmm': return short_months[m];
case 'mmmm': return months[m];
case 'yy': return y.toString().substr(2,2);
case 'yyyy': return y;
}
});
}
function initCreate(o){
var curr = new Date(that.date),
currMonth = curr.getMonth(),
currYear = curr.getFullYear();
curr.setDate(1);
if(that.viewMode === 'days') {
curr.setMonth(currMonth + (o === 'next' ? 1 : -1));
} else {
curr.setFullYear(currYear + (o === 'next' ? 1 : - 1));
}
that.date = curr;
that.create(that.viewMode);
}
this.create(this.viewMode);
}
DCalendar.prototype = {
constructor : DCalendar,
//setDate : function(){},
create : function(mode){
var that = this, cal = [], tBody = $('<tbody></tbody>'), d = new Date(that.date), days = that.date.getDays(), day = 1, nStartDate = 1, selDate = that.selected.split('/');
that.calendar.empty();
if(mode === "days") {
if(that.options.mode === 'calendar') {
that.tHead = $('<thead><tr><th id="prev">‹</th><th colspan="5" id="currM"></th><th id="next">›</th></tr><tr><th>Su</th><th>Mo</th><th>Tu</th><th>We</th><th>Th</th><th>Fr</th><th>Sa</th></tr></thead>');
} else if (that.options.mode === 'datepicker') {
that.tHead = $('<thead><tr><th id="prev">‹</th><th colspan="5" id="currM"></th><th id="next">›</th></tr><tr><th>S</th><th>M</th><th>T</th><th>W</th><th>T</th><th>F</th><th>S</th></tr></thead>');
}
that.tHead.find('#currM').text(months[that.date.getMonth()] +" " + that.date.getFullYear());
that.calendar.append(that.tHead);
for(var i = 1; i <= 6; i++){
var temp = [$('<td></td>'),$('<td></td>'),$('<td></td>'),$('<td></td>'),$('<td></td>'),$('<td></td>'),$('<td></td>')];
while(day <= days){
d.setDate(day);
var dayOfWeek = d.getDay();
if(day === that.today.getDate()
&& d.getMonth() === that.today.getMonth()
&& d.getFullYear() === that.today.getFullYear()) {
temp[dayOfWeek].attr('id', 'currDay');
}
if(that.options.mode === 'datepicker'
&& (((d.getMonth() + 1) + "/" + day + "/" + d.getFullYear()) === (selDate[0] + "/" + selDate[1] + "/" + selDate[2]))) {
temp[dayOfWeek].addClass('selected');
}
if(i === 1 && dayOfWeek === 0){
break;
} else if(dayOfWeek < 6){
temp[dayOfWeek].html('<span>'+(day++)+'</span>').addClass('date');
} else {
temp[dayOfWeek].html('<span>'+(day++)+'</span>').addClass('date');
break;
}
}
/* For days of previous and next month */
if (i === 1 || i > 4) {
var p = new Date(that.date);
// First week
if (i === 1) {
var pMonth = p.getMonth(), pDays = 0;
p.setDate(1);
p.setMonth(pMonth - 1);
pDays = p.getDays();
for (var a = 6; a >= 0; a--) {
if (temp[a].text() === ''){
temp[a].html('<span>' + (pDays--) + '</span>').addClass('pMDate');
if (that.options.mode === 'datepicker'
&& (((d.getMonth()) + "/" + (pDays + 1) + "/" + d.getFullYear()) === (selDate[0] + "/" + selDate[1] + "/" + selDate[2]))) {
temp[a].addClass('selected');
}
}
}
}
// Last week
else if (i > 4) {
for (var a = 0; a <= 6; a++) {
if (temp[a].text() === ''){
temp[a].html('<span>' + (nStartDate++) + '</span>').addClass('nMDate');
if (that.options.mode === 'datepicker'
&& (((d.getMonth()+2) + "/" + (nStartDate - 1) + "/" + d.getFullYear()) === (selDate[0] + "/" + selDate[1] + "/" + selDate[2]))) {
temp[a].addClass('selected');
}
}
}
}
}
cal.push(temp);
}
$.each(cal, function(i, v){
var row = $('<tr></tr>'), l = v.length;
for(var i = 0; i < l; i++) { row.append(v[i]); }
tBody.append(row);
});
var sysDate = "Today: " + daysofweek[that.today.getDay()] + ", " + months[that.today.getMonth()] + " " + that.today.getDate() + ", " + that.today.getFullYear();
tBody.append('<tr><td colspan="7" id="today">' + sysDate + '</td></tr>').appendTo(that.calendar);
} else {
this.tHead = $('<thead><tr><th id="prev">‹</th><th colspan="2" id="currM"></th><th id="next">›</th></tr>');
that.tHead.find('#currM').text(that.date.getFullYear());
that.tHead.appendTo(that.calendar);
var currI = 0;
for (var i = 0; i < 3; i++) {
var row = $('<tr></tr>');
for (var x = 0; x < 4; x++) {
var col = $('<td align="center"></td>');
var m = $('<span class="month" num="' + currI + '">' + short_months[currI] + '</span>');
col.append(m).appendTo(row);
currI++;
}
tBody.append(row);
}
var sysDate = "Today: " + daysofweek[that.today.getDay()] + ", "+ months[that.today.getMonth()] + " " + that.today.getDate() + ", " + that.today.getFullYear();
tBody.append('<tr><td colspan="4" id="today">' + sysDate + '</td></tr>').appendTo(that.calendar);
}
}
}
/* DEFINITION FOR DCALENDAR */
$.fn.dcalendar = function(opts){
return $(this).each(function(index, elem){
var that = this;
var $this = $(that),
data = $(that).data('dcalendar'),
options = $.extend({}, $.fn.dcalendar.defaults, $this.data(), typeof opts === 'object' && opts);
if(!data){
$this.data('dcalendar', (data = new DCalendar(this, options)));
}
if(typeof opts === 'string') data[opts]();
});
}
$.fn.dcalendar.defaults = {
mode : 'calendar',
format: 'dd/mm/yyyy',
};
$.fn.dcalendar.Constructor = DCalendar;
/* DEFINITION FOR DCALENDAR PICKER */
$.fn.dcalendarpicker = function(opts){
return $(this).each(function(){
var that = $(this);
var cal = $('<table class="calendar"></table>'), hovered = false, selectedDate = false;
that.wrap($('<div class="datepicker" style="position:relative;"></div>'));
cal.css({
position:'absolute',
left:0, display:'none',
'box-shadow':'0 4px 6px 1px rgba(0, 0, 0, 0.14)',
width:'230px',
}).appendTo(that.parent());
if(opts){
opts.mode = 'datepicker';
cal.dcalendar(opts);
} else{
cal.dcalendar({mode: 'datepicker'});
}
cal.hover(function(){
hovered = true;
}, function(){
hovered = false;
}).on('click', function(){
if(!selectedDate)
that.focus();
else {
selectedDate = false;
$(this).hide();
}
}).on('selectdate', function(e){
that.val(e.date).trigger('onchange');
that.trigger($.Event('dateselected', {date: e.date, elem: that}));
selectedDate = true;
});
that.on('keydown', function(e){ if(e.which) return false; })
.on('focus', function(){
$('.datepicker').find('.calendar').not(cal).hide();
cal.show();
})
.on('blur', function(){ if(!hovered) cal.hide(); });
});
}
}(jQuery);
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