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✏️ Editing: newrecruitdbp.php

<?php
ob_start();
session_start();
include("includes/inall.php");
if(!isset($_SESSION['duplblock']) && $_SESSION['duplblock']=="") {
	$_SESSION['duplblock']=strtotime("now");
}
function SMS_Sender($mobile_number,$message_det) {
	$curl=curl_init();
	curl_setopt_array($curl,array(
		CURLOPT_URL=>"https://api.msg91.com/api/v2/sendsms",
		CURLOPT_RETURNTRANSFER=>true,
		CURLOPT_ENCODING=>"",
		CURLOPT_MAXREDIRS=>10,
		CURLOPT_TIMEOUT=>30,
		CURLOPT_HTTP_VERSION=>CURL_HTTP_VERSION_1_1,
		CURLOPT_CUSTOMREQUEST=>"POST",
		CURLOPT_POSTFIELDS=>"{ \"sender\": \"CCADMS\", \"route\": \"4\", \"country\": \"91\", \"sms\": [ { \"message\": \"".$message_det."\", \"to\": [ \"".$mobile_number."\" ] } ] }",
		CURLOPT_SSL_VERIFYHOST=>0,
		CURLOPT_SSL_VERIFYPEER=>0,
		CURLOPT_HTTPHEADER=>array(
		"authkey:261846ALkgB0xvZ5c5c4e87",
		"content-type:application/json"
	),
	));
	$response=curl_exec($curl);
	$err=curl_error($curl);
	curl_close($curl);
	if ($err) {
		echo "cURL Error #:" . $err;
	} else {
		echo $response;
	}
}
function makelevels($memb,$cusid,$level) {
	$d=date("Y-m-d");
	$res=mysqli_query($_SESSION['concton'],"select * from `registration` where `cusid`='".$memb."'");
	if(mysqli_num_rows($res)>=1) {
		$row=mysqli_fetch_array($res);
		if($row['imrid']!="") {
			$rowsc=mysqli_fetch_array(mysqli_query($_SESSION['concton'],"select `reg_id` from `registration` where `cusid`='".$row['imrid']."'"));
			$insert_sql_data=array('ddate'=>$d,
			'refid'=>$rowsc['reg_id'],
			'sponsor'=>$row['imrid'],
			'member'=>$cusid,
			'level'=>$level,
			'status'=>'0'
			);
			tep_db_perform("downline",$insert_sql_data,"insert");
			//$count++;
			//if($count<=20) {
				makelevels($row['imrid'],$cusid,$level);
			//}
		}	
	}	
}
function findid() {
	//$newid="CCAD".rand(100002,999999);
	$newid=rand(100002,999999);
	$resa=mysqli_query($_SESSION['concton'],"select * from `registration` where `cusid`='".$newid."'");
	if(mysqli_num_rows($resa)<1) {
		$cusid=$newid;
	} else {
		$cusid=findid();
	}
	return $cusid;
}
function findpid() {
	$newid="CJN".rand(111111,999999);
	$resa=mysqli_query($_SESSION['concton'],"select * from `orderp` where `or_id`='".$newid."'");
	if(mysqli_num_rows($resa)<1) {
		$pid=$newid;
	} else {
		$pid=findpid();
	}
	return $pid;
}
if(isset($_POST['submitin']) && $_POST['submitin']=="Register") {
	$d=date("Y-m-d");
	$sponsor=isset($_POST['sponsor'])?addslashes(trim($_POST['sponsor'])):'';
	$resa=mysqli_query($con,"select * from `registration` where `cusid`='".$sponsor."'");
	if(mysqli_num_rows($resa)<1) {
		$_SESSION['msgerr']="Invalid Sponsor ID!";
		header("location:newrecruitdbp.php");
		exit();
	} 
	$rowspon=mysqli_fetch_array($resa);
	$sdistrict=isset($_POST['sdistrict'])?addslashes(trim($_POST['sdistrict'])):'';
	$sblkmn=isset($_POST['sblkmn'])?addslashes(trim($_POST['sblkmn'])):'';
	$spnward=isset($_POST['spnward'])?addslashes(trim($_POST['spnward'])):'';
	$level=isset($_POST['level'])?addslashes(trim($_POST['level'])):'';
	$location=isset($_POST['location'])?addslashes(strtoupper(trim($_POST['location']))):'';
	$cname=isset($_POST['cname'])?addslashes(strtoupper(trim($_POST['cname']))):'';
	$ccontact=isset($_POST['ccontact'])?addslashes(strtoupper(trim($_POST['ccontact']))):'';
	$gstin=isset($_POST['gstin'])?addslashes(strtoupper(trim($_POST['gstin']))):'';
	$caddress=isset($_POST['caddress'])?addslashes(strtoupper(trim($_POST['caddress']))):'';
	$title=isset($_POST['title'])?addslashes(strtoupper(trim($_POST['title']))):'';
	$fname=isset($_POST['fname'])?addslashes(strtoupper(trim($_POST['fname']))):'';
	$mname=isset($_POST['mname'])?addslashes(strtoupper(trim($_POST['mname']))):'';
	$lname=isset($_POST['lname'])?addslashes(strtoupper(trim($_POST['lname']))):'';
	$dob=isset($_POST['dob'])?addslashes(trim($_POST['dob'])):'';
	$ptitle=isset($_POST['ptitle'])?addslashes(strtoupper(trim($_POST['ptitle']))):'';
	$pname=isset($_POST['pname'])?addslashes(strtoupper(trim($_POST['pname']))):'';
	$prelation=isset($_POST['prelation'])?addslashes(strtoupper(trim($_POST['prelation']))):'';
	$pothname=isset($_POST['pothname'])?addslashes(strtoupper(trim($_POST['pothname']))):'';
	$gender=isset($_POST['gender'])?addslashes(strtoupper(trim($_POST['gender']))):'';
	$mstatus=isset($_POST['mstatus'])?addslashes(strtoupper(trim($_POST['mstatus']))):'';
	$education=isset($_POST['education'])?addslashes(strtoupper(trim($_POST['education']))):'';
	$mobile=isset($_POST['mobile'])?addslashes(trim($_POST['mobile'])):'';
	$amobile=isset($_POST['amobile'])?addslashes(trim($_POST['amobile'])):'';
	$email=isset($_POST['email'])?addslashes(trim($_POST['email'])):'';
	$pidentity=isset($_POST['pidentity'])?addslashes(strtoupper(trim($_POST['pidentity']))):'';
	$pidentityno=isset($_POST['pidentityno'])?addslashes(strtoupper(trim($_POST['pidentityno']))):'';
	$holdingno=isset($_POST['holdingno'])?addslashes(strtoupper(trim($_POST['holdingno']))):'';
	$streetname=isset($_POST['streetname'])?addslashes(strtoupper(trim($_POST['streetname']))):'';
	$addresslinea=isset($_POST['addresslinea'])?addslashes(strtoupper(trim($_POST['addresslinea']))):'';
	$addresslineb=isset($_POST['addresslineb'])?addslashes(strtoupper(trim($_POST['addresslineb']))):'';
	$state=isset($_POST['state'])?addslashes(strtoupper(trim($_POST['state']))):'';
	$district=isset($_POST['district'])?addslashes(strtoupper(trim($_POST['district']))):'';
	$pin=isset($_POST['pin'])?addslashes(trim($_POST['pin'])):'';
	$pholdingno=isset($_POST['pholdingno'])?addslashes(strtoupper(trim($_POST['pholdingno']))):'';
	$pstreetname=isset($_POST['pstreetname'])?addslashes(strtoupper(trim($_POST['pstreetname']))):'';
	$paddresslinea=isset($_POST['paddresslinea'])?addslashes(strtoupper(trim($_POST['paddresslinea']))):'';
	$paddresslineb=isset($_POST['paddresslineb'])?addslashes(strtoupper(trim($_POST['paddresslineb']))):'';
	$pstate=isset($_POST['pstate'])?addslashes(strtoupper(trim($_POST['pstate']))):'';
	$pdistrict=isset($_POST['pdistrict'])?addslashes(strtoupper(trim($_POST['pdistrict']))):'';
	$ppin=isset($_POST['ppin'])?addslashes(trim($_POST['ppin'])):'';
	$paddress=isset($_POST['paddress'])?addslashes(strtoupper(trim($_POST['paddress']))):'';
	$pdistrict=isset($_POST['pdistrict'])?addslashes(strtoupper(trim($_POST['pdistrict']))):'';
	$pstate=isset($_POST['pstate'])?addslashes(strtoupper(trim($_POST['pstate']))):'';
	$ppin=isset($_POST['ppin'])?addslashes(strtoupper(trim($_POST['ppin']))):'';
	$panno=isset($_POST['panno'])?addslashes(strtoupper(trim($_POST['panno']))):'';
	$adprooftype=isset($_POST['adprooftype'])?addslashes(strtoupper(trim($_POST['adprooftype']))):'';
	$adproofoth=isset($_POST['adproofoth'])?addslashes(strtoupper(trim($_POST['adproofoth']))):'';
	$adproofno=isset($_POST['adproofno'])?addslashes(strtoupper(trim($_POST['adproofno']))):'';
	$pidprooftype=isset($_POST['pidprooftype'])?addslashes(strtoupper(trim($_POST['pidprooftype']))):'';
	$pidproofoth=isset($_POST['pidproofoth'])?addslashes(strtoupper(trim($_POST['pidproofoth']))):'';
	$pidproofno=isset($_POST['pidproofno'])?addslashes(strtoupper(trim($_POST['pidproofno']))):'';
	$ntitle=isset($_POST['ntitle'])?addslashes(strtoupper(trim($_POST['ntitle']))):'';
	$nname=isset($_POST['nname'])?addslashes(strtoupper(trim($_POST['nname']))):'';
	$ndob=isset($_POST['ndob'])?addslashes(trim($_POST['ndob'])):'';
	$nrelation=isset($_POST['nrelation'])?addslashes(strtoupper(trim($_POST['nrelation']))):'';
	$nfname=isset($_POST['nfname'])?addslashes(strtoupper(trim($_POST['nfname']))):'';
	$apname=isset($_POST['apname'])?addslashes(strtoupper(trim($_POST['apname']))):'';
	$apdob=isset($_POST['apdob'])?addslashes(trim($_POST['apdob'])):'';
	$aprelation=isset($_POST['aprelation'])?addslashes(strtoupper(trim($_POST['aprelation']))):'';
	$aponame=isset($_POST['aponame'])?addslashes(strtoupper(trim($_POST['aponame']))):'';
	$accname=isset($_POST['accname'])?addslashes(strtoupper(trim($_POST['accname']))):'';
	$acctype=isset($_POST['acctype'])?addslashes(strtoupper(trim($_POST['acctype']))):'';
	$accno=isset($_POST['accno'])?addslashes(strtoupper(trim($_POST['accno']))):'';
	$bank=isset($_POST['bank'])?addslashes(strtoupper(trim($_POST['bank']))):'';
	$branch=isset($_POST['branch'])?addslashes(strtoupper(trim($_POST['branch']))):'';
	$ifsc=isset($_POST['ifsc'])?addslashes(strtoupper(trim($_POST['ifsc']))):'';
	$rank=isset($_POST['rank'])?addslashes(strtoupper(trim($_POST['rank']))):'';
	$newid=findid();
	$pid=findpid();
	$resa=mysqli_query($con,"select * from `registration` where `cusid`='".$newid."'");
	if(mysqli_num_rows($resa)<1) {
		$insert_sql_data=array('date'=>$d,
		'cusid'=>$newid,
		'sdistrict'=>$sdistrict,
		'sblkmn'=>$sblkmn,
		'spnward'=>$spnward,
		'cname'=>$cname,
		'ccontact'=>$ccontact,
		'gstin'=>$gstin,
		'caddress'=>$caddress,
		'title'=>$title,
		'fname'=>$fname,
		'mname'=>$mname,
		'lname'=>$lname,
		'dob'=>$dob,
		'ptitle'=>$ptitle,
		'pname'=>$pname,
		'prelation'=>$prelation,
		'pothname'=>$pothname,
		'gender'=>$gender,
		'mstatus'=>$mstatus,
		'education'=>$education,
		'mobile'=>$mobile,
		'amobile'=>$amobile,
		'email'=>$email,
		'pidentity'=>$pidentity,
		'pidentityno'=>$pidentityno,
		'holdingno'=>$holdingno,
		'streetname'=>$streetname,
		'addresslinea'=>$addresslinea,
		'addresslineb'=>$addresslineb,
		'state'=>$state,
		'district'=>$district,
		'pin'=>$pin,
		'pholdingno'=>$pholdingno,
		'pstreetname'=>$pstreetname,
		'paddresslinea'=>$paddresslinea,
		'paddresslineb'=>$paddresslineb,
		'pstate'=>$pstate,
		'pdistrict'=>$pdistrict,
		'ppin'=>$ppin,
		'panno'=>$panno,
		'adprooftype'=>$adprooftype,
		'adproofoth'=>$adproofoth,
		'adproofno'=>$adproofno,
		'pidprooftype'=>$pidprooftype,
		'pidproofoth'=>$pidproofoth,
		'pidproofno'=>$pidproofno,
		'ntitle'=>$ntitle,
		'nname'=>$nname,
		'ndob'=>$ndob,
		'nrelation'=>$nrelation,
		'nfname'=>$nfname,
		'apname'=>$apname,
		'apdob'=>$apdob,
		'aprelation'=>$aprelation,
		'aponame'=>$aponame,
		'password'=>$mobile,
		'accname'=>$accname,
		'acctype'=>$acctype,
		'bank'=>$bank,
		'accno'=>$accno,
		'branch'=>$branch,
		'ifsc'=>$ifsc,
		'rid'=>$sponsor,
		'imrid'=>$sponsor,
		'addedby'=>$_SESSION['rcusid'],
		'rank'=>$rank,
		'location'=>$location,
		'status'=>'5',
		'duplblock'=>$_SESSION['duplblock'],
		'paymentid'=>$pid,
		'bap'=>'Yes'
		);
		$ins_query=tep_db_perform("registration",$insert_sql_data,"insert");
        $id=mysqli_insert_id($con);
        $nid=base64_encode($id);
		if(isset($_FILES['photo']['name']) && $_FILES['photo']['name']!="") {
			$userfile_name=$_FILES['photo']['name'];
			$userfile_tmp=$_FILES['photo']['tmp_name'];
			$img=$_FILES['photo']['tmp_name'];
			$userfile_size=$_FILES['photo']['size'];
			$userfile_type=$_FILES['photo']['type'];
			$t=explode(".",$userfile_name);
			if($t[1]=="pdf" || $t[1]=="PDF") {
				$path=time().$userfile_name; //original path
				$uppath="kyc/".$path;
				move_uploaded_file($_FILES['photo']['tmp_name'],$uppath);
			}
			$insert_sql_data=array('photo'=>$path);
			tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");	
		}
		if(isset($_FILES['pan']['name']) && $_FILES['pan']['name']!="") {
			$userfile_name=$_FILES['pan']['name'];
			$userfile_tmp=$_FILES['pan']['tmp_name'];
			$img=$_FILES['pan']['tmp_name'];
			$userfile_size=$_FILES['pan']['size'];
			$userfile_type=$_FILES['pan']['type'];
			$t=explode(".",$userfile_name);
			if($t[1]=="pdf" || $t[1]=="PDF") {
				$path=time().$userfile_name; //original path
				$uppath="kyc/".$path;
				move_uploaded_file($_FILES['pan']['tmp_name'],$uppath);
			}
			$insert_sql_data=array('pan'=>$path);
			tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");
		}
		$pidproof="";
		$total=count($_FILES['pidproof']['name']);
		for($i=0;$i<$total;$i++) {
			if(isset($_FILES['pidproof']['name'][$i]) && $_FILES['pidproof']['name'][$i]!="") {
				$userfile_name=$_FILES['pidproof']['name'][$i];
				$userfile_tmp=$_FILES['pidproof']['tmp_name'][$i];
				$img=$_FILES['pidproof']['tmp_name'][$i];
				$userfile_size=$_FILES['pidproof']['size'][$i];
				$userfile_type=$_FILES['pidproof']['type'][$i];
				$$t=explode(".",$userfile_name);
				if($t[1]=="pdf" || $t[1]=="PDF") {
					$path=time().$userfile_name; //original path
					$uppath="kyc/".$path;
					move_uploaded_file($_FILES['pidproof']['tmp_name'][$i],$uppath);
				}
				$pidproof.=$path."/";		
			}
		}
		$insert_sql_data=array('pidproof'=>$pidproof);
		tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");	
		$adproof="";
		$total=count($_FILES['adproof']['name']);
		for($i=0;$i<$total;$i++) {
			if(isset($_FILES['adproof']['name'][$i]) && $_FILES['adproof']['name'][$i]!="") {
				$userfile_name=$_FILES['adproof']['name'][$i];
				$userfile_tmp=$_FILES['adproof']['tmp_name'][$i];
				$img=$_FILES['adproof']['tmp_name'][$i];
				$userfile_size=$_FILES['adproof']['size'][$i];
				$userfile_type=$_FILES['adproof']['type'][$i];
				$t=explode(".",$userfile_name);
				if($t[1]=="pdf" || $t[1]=="PDF") {
					$path=time().$userfile_name; //original path
					$uppath="kyc/".$path;
					move_uploaded_file($_FILES['adproof']['tmp_name'][$i],$uppath);
				}
				$adproof.=$path."/";		
			}
		}
		$insert_sql_data=array('adproof'=>$adproof);
		tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");	
		if(isset($_FILES['cheque']['name']) && $_FILES['cheque']['name']!="") {
			$userfile_name=$_FILES['cheque']['name'];
			$userfile_tmp=$_FILES['cheque']['tmp_name'];
			$img=$_FILES['cheque']['tmp_name'];
			$userfile_size=$_FILES['cheque']['size'];
			$userfile_type=$_FILES['cheque']['type'];
			$t=explode(".",$userfile_name);
			if($t[1]=="pdf" || $t[1]=="PDF") {
				$path=time().$userfile_name; //original path
				$uppath="kyc/".$path;
				move_uploaded_file($_FILES['cheque']['tmp_name'],$uppath);
			}
			$insert_sql_data=array('cheque'=>$path);
			tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");		
		}

if(isset($_FILES['video']['name']) && $_FILES['video']['name']!="") {
			$userfile_name=$_FILES['video']['name'];
			$userfile_tmp=$_FILES['video']['tmp_name'];
			$img=$_FILES['video']['tmp_name'];
			$userfile_size=$_FILES['video']['size'];
			$userfile_type=$_FILES['video']['type'];
			$t=explode(".",$userfile_name);
			$ttype=explode("/",$userfile_type);
			if($ttype[0]=="Video" || $ttype[0]=="Audio" || $ttype[0]=="video"|| $ttype[0]=="audio") {
				$path=time().$userfile_name; //original path
				$uppath="kyc/".$path;
				move_uploaded_file($_FILES['video']['tmp_name'],$uppath);
			}
			$insert_sql_data=array('video'=>$path);
			tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");		
		}
		if(isset($_FILES['questionnaire']['name']) && $_FILES['questionnaire']['name']!="") {
			$userfile_name=$_FILES['questionnaire']['name'];
			$userfile_tmp=$_FILES['questionnaire']['tmp_name'];
			$img=$_FILES['questionnaire']['tmp_name'];
			$userfile_size=$_FILES['questionnaire']['size'];
			$userfile_type=$_FILES['questionnaire']['type'];
			$t=explode(".",$userfile_name);
			if($t[1]=="pdf" || $t[1]=="PDF" || $t[1]=="DOC" || $t[1]=="doc" || $t[1]=="docx" || $t[1]=="DOCX") {
				$path=time().$userfile_name; //original path
				$uppath="kyc/".$path;
				move_uploaded_file($_FILES['questionnaire']['tmp_name'],$uppath);
			}
			$insert_sql_data=array('questionnaire'=>$path);
			tep_db_perform("registration",$insert_sql_data,'update',"reg_id='".(int)$id."'");		
		}
		makelevels($newid,$newid,$level);
	}	
	unset($_SESSION['duplblock']);
	if($ins_query) {	
		/*if($stkpoint=="") {	
			$t=date("h:i:s A");
			$disam=0;
			$ttax=0;
			$ship=0;	
			$insert_sql_data=array('or_gstname'=>$_SESSION['gstname'],
			'or_gstaddress'=>$_SESSION['gstaddress'],
			'or_gstcity'=>$_SESSION['gstcity'],
			'or_gstpin'=>$_SESSION['gstpin'],
			'or_gstin'=>$_SESSION['gstin'],
			'or_id'=>$pid,
			'or_inv_id'=>$pid,
			'or_category'=>'Cash',
			'or_value'=>1500,
			'or_discount'=>$disam,
			'or_gst'=>$ttax,
			'or_shipval'=>$ship,
			'or_net'=>1500,
			'or_delmode'=>'Prepaid',
			'or_promo'=>'',
			'or_date'=>$d,
			'or_time'=>$t,
			'orderstatus'=>'Order Work In Progress',
			'paymentstatus'=>'Not Done',
			'cusid'=>$id
			);
			$ins_query=tep_db_perform("orderp",$insert_sql_data,"insert");
			$id=mysqli_insert_id($con);
			$insert_sql_data=array('orderpro_ref'=>$id,
			'orderpro_pro'=>'214',
			'orderpro_qty'=>'1',
			'orderpro_mrp'=>'1500',
			'orderpro_val'=>'1500',
			'status'=>'Order Work In Progress'
			);
			$ins_query=tep_db_perform("orderpro",$insert_sql_data,"insert");
		}*/	
		$message="Dear ".$fname.", welcome to CCAD family. User ID: ".$newid.", Password: ".$mobile.", thank you for your registration. Please click https://ccadmultiservices.com to login.";
		//SMS_Sender($mobile,$message);
		//SMS_Sender($rowspon['mobile'],$message);
		//$to="avikbanerjee0461@gmail.com";
		$toa="bobds69@gmail.com";
		//$tob="avik_bandyopadhyay@rediffmail.com";
		$subject="Notification Regarding Joining";
		$headers='MIME-Version: 1.0' . "\r\n";
		$headers.='Content-type: text/html; charset=iso-8859-1' . "\r\n";
		// Additional headers
		$headers.='To: '.$to. "\r\n";
		$headers.='From: No-Reply <>' . "\r\n";
		//$headers.='Cc: info@ccadmultiservices.com' . "\r\n";
		//$headers.='Bcc: '.$bcc. "\r\n";
		mail($to,$subject,$message,$headers);
		mail($toa,$subject,$message,$headers);
		mail($tob,$subject,$message,$headers);
		mail($email,$subject,$message,$headers);
		$_SESSION['msg']="Registration is successful. Thank you.";
		header("location:newrecruitpay.php?nid=".$nid);
		exit();
	} else {
		$_SESSION['msgerr']="Some error occured.";
		header("location:newrecruitdbp.php");
		exit();
	}
}
include("includes/headermain.php"); 
?>
<?php if($_SESSION['msg']!="" || $_SESSION['msgerr']!="") { ?>
	<script src="//ajax.googleapis.com/ajax/libs/jquery/1.11.1/jquery.js"></script>
	<script>
	$(document).ready(function() {	
		var id = '#dialog';
			
		//Get the screen height and width
		var maskHeight = $(document).height();
		var maskWidth = $(window).width();
			
		//Set heigth and width to mask to fill up the whole screen
		$('#mask').css({'width':maskWidth,'height':maskHeight});
	
		//transition effect
		$('#mask').fadeIn(500);	
		$('#mask').fadeTo("slow",0.9);	
			
		//Get the window height and width
		var winH = $(window).height();
		var winW = $(window).width();
					  
		//Set the popup window to center
		$(id).css('top',  winH/2-$(id).height()/2);
		$(id).css('left', winW/2-$(id).width()/2);
		
		//transition effect
		$(id).fadeIn(2000); 	
		
		//if close button is clicked
		$('.window .close').click(function (e) {
			//Cancel the link behavior
			e.preventDefault();
		
			$('#mask').hide();
			$('.window').hide();
		});
	
		//if mask is clicked
		$('#mask').click(function () {
			$(this).hide();
			$('.window').hide();
		});
	});
	</script>
	<style>
	#mask {
		position: absolute;
		left: 0;
		top: 0;
		z-index: 9000;
		display: none;
	}
	#boxes .window {
		position: absolute;
		left: 0;
		top: 0;
		width: 300px;
		height: 200px;
		display: none;
		z-index: 9999;
		padding: 20px;
		border-radius: 5px;
		text-align: center;
	}
	#boxes #dialog {
		width: 300px;
		height: 200px;
		padding: 10px;
		background: #F9F9F9;
		font-size: 16px;
		font-weight: bold;
		webkit-box-shadow: 0 0 10px #999999;
  		box-shadow: 0 0 10px #999999;
	}
	#popupfoot {
		position: absolute;
		margin: auto;
		bottom: 20px;
		color: #005CB9;
	}
	.close {
		font-size: 12px !important;
	}
	</style>
	<div id="boxes">
		<div id="dialog" class="window">
			<?php if($_SESSION['msg']) { ?><span><?php print $_SESSION['msg']; $_SESSION['msg']=""; ?></span><?php } ?>
			<?php if($_SESSION['msgerr']) { ?><span class="redtxt"><?php print $_SESSION['msgerr']; $_SESSION['msgerr']=""; ?></span><?php } ?>
			<div id="popupfoot"><a href="#" class="close">Close</a></div>
		</div>
		<div id="mask"></div>
	</div>
<?php } ?>
<body class="body-bg">


<div id="preloader">
	<div class="loader"></div>
</div>


<div class="horizontal-main-wrapper">
	<?php include("includes/header.php"); ?>
	
	<div class="main-content">
	 	<div class="main-content-inner">
			
			<div> 
				<div class="col-lg-12 mt-5">
					<div class="card">
						<div class="card-body">
							<h4 class="header-title titlebg">New Recruit (BAP)</h4>
							<form action="#" method="post" name="rform" enctype="multipart/form-data" onSubmit="return validatert();">
								<input type="hidden" name="submitin" value="Register">
								<?php /*?><?php if($_SESSION['msgerr']) { ?><span class="redtxt"><?php print $_SESSION['msgerr']; $_SESSION['msgerr']=""; ?></span><div class="cleaner h10"></div><?php } ?>
								<?php if($_SESSION['msg']) { ?><span class="grtxt"><?php print $_SESSION['msg']; $_SESSION['msg']=""; ?></span><div class="cleaner h10"></div><?php } ?><?php */?>
								<?php /*?><div class="form-group">
									<label for="example-text-input" class="col-form-label">SPONSOR</label> <strong><?php print $_SESSION['rcusid']; ?></strong>
								</div><?php */?>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">*District</label>
									<select class="form-control" id="sdistrict" name="sdistrict" required onChange="fetchblkmn(this.value)">
										<option value="">Select District*
										<?php 
										$sql="select distinct `district` from `disblkwrds` order by `district`";
										$res=mysqli_query($con,$sql);
										while($row=mysqli_fetch_assoc($res)) {
										?>
											<option value="<?php print ucwords(strtolower($row['district'])); ?>"><?php print ucwords(strtolower($row['district'])); ?>
										<?php } ?>
									</select>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">*Block/Municipality</label>
									<select class="form-control" id="sblkmn" name="sblkmn" required onChange="fetchpward(this.value)">
										<option value="">Select Block/Municipality*
										<?php 
										$sql="select distinct `block` from `disblkwrds` order by `block`";
										$res=mysqli_query($con,$sql);
										while($row=mysqli_fetch_assoc($res)) {
										?>
											<option value="<?php print ucwords(strtolower($row['block'])); ?>"><?php print ucwords(strtolower($row['block'])); ?>
										<?php } ?>
									</select>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">*Panchayat/Ward</label>
									<select class="form-control" id="spnward" name="spnward" required>
										<option value="">Select Panchayat/Ward*
										<?php 
										$sql="select distinct `pancha` from `disblkwrds` order by `pancha`";
										$res=mysqli_query($con,$sql);
										while($row=mysqli_fetch_assoc($res)) {
										?>
											<option value="<?php print ucwords(strtolower($row['pancha'])); ?>"><?php print ucwords(strtolower($row['pancha'])); ?>
										<?php } ?>
									</select>
								</div>

<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">Sponsor</label>
									<input class="form-control" type="text" name="sponsor" id="sponsor" value="<?php print $_SESSION['rcusid']; ?>" onBlur="checkrefid();" autocomplete="off">
									<div id="ridtxt"></div>
								</div>
								<?php if($_SESSION['rank']=="Block Adhikarta" || $_SESSION['rcusid']=="100001") { ?>
									<div class="form-group col-md-4 floatleft">
										<label for="example-text-input" class="col-form-label">Rank</label>
										<?php //$levellimit=$_SESSION['level']-1; ?>
										<select class="form-control spslc" name="rank" id="rank" required>
											<option value="">Select
											<option value="Ayush Bandhu">Ayush Bandhu
											<?php if($_SESSION['rank']=="District Manager" || $_SESSION['rcusid']=="100001") { ?>
												<option value="Block Adhikarta">Block Adhikarta
											<?php } if($_SESSION['rcusid']=="100001") { ?>	
												<option value="District Manager">District Manager
											<?php } ?>
										</select>
									</div>
								<?php } ?>	
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">Location</label>
									<input class="form-control" type="text" name="location" id="location" autocomplete="off">
								</div>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Company Details</h4>
								<div class="form-group col-md-6 floatleft">
									<label for="example-text-input" class="col-form-label">Company Name</label>
									<input class="form-control" type="text" name="cname" id="cname" autocomplete="off">
								</div>
								<div class="form-group col-md-6 floatleft">
									<label for="example-text-input" class="col-form-label">Contact No.</label>
									<input class="form-control" type="text" name="ccontact" id="ccontact" autocomplete="off">
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-12 floatleft">
									<label for="example-text-input" class="col-form-label">Address</label>
									<input class="form-control" type="text" name="caddress" id="caddress" autocomplete="off">
								</div>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Personal Details</h4>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Title</label>
									<select class="form-control spslc" name="title" id="title">
										<option value="">Select
										<option value="Mr.">Mr.
										<option value="Mrs.">Mrs.
										<option value="Miss">Miss
										<option value="Dr.">Dr.
										<option value="Prof.">Prof.
									</select>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>First Name</label>
									<input class="form-control" type="text" name="fname" id="fname" autocomplete="off" onBlur="copyname();" required>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Middle Name</label>
									<input class="form-control" type="text" name="mname" id="mname" autocomplete="off" onBlur="copyname();">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Last Name</label>
									<input class="form-control" type="text" name="lname" id="lname" autocomplete="off" onBlur="copyname();" required>
								</div>
								<?php /* ?><div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Gurdian's Title</label>
									<select class="form-control spslc" name="ptitle" id="ptitle">
										<option value="">Select
										<option value="Mr.">Mr.
										<option value="Mrs.">Mrs.
										<option value="Miss">Miss
										<option value="Dr.">Dr.
										<option value="Prof.">Prof.
									</select>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Gurdian's Name</label>
									<input class="form-control" type="text" name="pname" id="pname" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Relation</label>
									<select class="form-control spslc" name="prelation" id="prelation">
										<option value="">Select
										<option value="Father">Father
										<option value="Mother">Mother
										<option value="Spouse">Spouse
										<option value="Others">Others
									</select>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">If Relation Others</label>
									<input class="form-control" type="text" name="pothname" id="pothname" autocomplete="off">
								</div><?php */ ?>
								<div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">DOB</label>
									<input class="form-control" type="date" name="dob" id="dob" autocomplete="off" pattern="dd-mm-yyyy">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Gender</label>
									<select class="form-control spslc" name="gender" id="gender" autocomplete="off">
										<option value="">Select
										<option value="Male">Male
										<option value="Female">Female
										<option value="Transgender">Transgender
									</select>
								</div>
								<?php /* ?><div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Marital Status</label>
									<select class="form-control spslc" name="mstatus" id="mstatus">
										<option value="">Select
										<option value="Married">Married
										<option value="Unmarried">Unmarried
										<option value="Widow">Widow
										<option value="Divorced">Divorced
									</select>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Highest Education</label>
									<select class="form-control spslc" name="education" id="education">
										<option value="">Select
										<option value="Below 10th">Below 10th
										<option value="10th Standard">10th Standard
										<option value="12th Standard">12th Standard
										<option value="Diploma">Diploma
										<option value="Graduate">Graduate
										<option value="Post Graduate">Post Graduate
										<option value="PHD">PHD
									</select>
								</div><?php */ ?>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Contact Details</h4>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Mobile No.</label>
									<input class="form-control" type="number" name="mobile" id="mobile" onBlur="checkmobile('mobile',this.value);checkunique('mobile',this.value,'mbtxt');" autocomplete="off" required>
									<div id="mbtxt"></div>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">*Alternative No.</label>
									<input class="form-control" type="number" name="amobile" id="amobile" onBlur="checkmobile('amobile',this.value);" autocomplete="off" required>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">Email ID</label>
									<input class="form-control" type="email" name="email" id="email" autocomplete="off">
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-6 floatleft">
									<label for="example-text-input" class="col-form-label">*Personal Identification Type</label>
									<select class="form-control spslc" name="pidentity" id="pidentity" onChange="copykycno();" required>
										<option value="">Select
										<option value="Aadhaar">Aadhaar
										<option value="PAN">PAN
										<option value="Voter ID">Voter ID
										<option value="Driving License">Driving License
									</select>
								</div>
								<div class="form-group col-md-6 floatleft">
									<label for="example-text-input" class="col-form-label">*Personal Identification No.</label>
									<input class="form-control" type="text" name="pidentityno" id="pidentityno" onBlur="checkunique('pidentityno',this.value,'pitxt');copykycno();" autocomplete="off" required>
									<div id="pitxt"></div>
								</div>
								
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Address Details</h4>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Holding No.</label>
									<input class="form-control" type="text" name="holdingno" id="holdingno" autocomplete="off">
								</div>
								<div class="form-group col-md-9 floatleft">
									<label for="example-text-input" class="col-form-label">Street Name</label>
									<input class="form-control" type="text" name="streetname" id="streetname" autocomplete="off">
								</div>
								<div class="form-group col-md-12 floatleft">
									<label for="example-text-input" class="col-form-label">Address Line 1</label>
									<input class="form-control" type="text" name="addresslinea" id="addresslinea" autocomplete="off">
								</div>
								<div class="form-group col-md-12 floatleft">
									<label for="example-text-input" class="col-form-label">Address Line 2</label>
									<input class="form-control" type="text" name="addresslineb" id="addresslineb" autocomplete="off">
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">State</label>
									<?php /*?><input class="form-control" type="text" name="state" id="state" autocomplete="off"><?php */?>
									<select class="form-control spslc" name="state" id="state" onChange="fetchdistrict('disblock','district',this.value);">
										<option value="">Select
										<?php
										$resst=mysqli_query($con,"select distinct `state` from `statedis` where 1");
										while($rowst=mysqli_fetch_array($resst)) {
										?>
											<option value="<?php print $rowst['state']; ?>"><?php print $rowst['state']; ?>
										<?php } ?>	
									</select>
								</div>
								<div class="form-group col-md-4 floatleft" id="disblock">
									<label for="example-text-input" class="col-form-label"><span>*</span>District</label>
									<?php /*?><input class="form-control" type="text" name="district" id="district" autocomplete="off"><?php */?>
									<select class="form-control spslc" name="district" id="district" required>
										<option value="">Select
									</select>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">PIN</label>
									<input class="form-control" type="number" name="pin" id="pin" onBlur="checkpin('pin',this.value);" autocomplete="off">
									<div id="pintxt"></div>
								</div>
								<div class="cleaner h20"></div>
								<div class="form-group col-md-12">
									<input type="checkbox" name="sameas" id="sameas" onClick="pastepaddress();">&nbsp;&nbsp;<label><strong>Permanent Address is same.</strong></label>
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Holding No. (Permanent Address)</label>
									<input class="form-control" type="text" name="pholdingno" id="pholdingno" autocomplete="off">
								</div>
								<div class="form-group col-md-9 floatleft">
									<label for="example-text-input" class="col-form-label">Street Name (Permanent Address)</label>
									<input class="form-control" type="text" name="pstreetname" id="pstreetname" autocomplete="off">
								</div>
								<div class="form-group col-md-12 floatleft">
									<label for="example-text-input" class="col-form-label">Permanent Address Line 1</label>
									<input class="form-control" type="text" name="paddresslinea" id="paddresslinea" autocomplete="off">
								</div>
								<div class="form-group col-md-12 floatleft">
									<label for="example-text-input" class="col-form-label">Permanent Address Line 2</label>
									<input class="form-control" type="text" name="paddresslineb" id="paddresslineb" autocomplete="off">
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">State</label>
									<?php /*?><input class="form-control" type="text" name="pstate" id="pstate" autocomplete="off"><?php */?>
									<select class="form-control spslc" name="pstate" id="pstate" onChange="fetchdistrict('disblockp','pdistrict',this.value);">
										<option value="">Select
										<?php
										$resst=mysqli_query($con,"select distinct `state` from `statedis` where 1");
										while($rowst=mysqli_fetch_array($resst)) {
										?>
											<option value="<?php print $rowst['state']; ?>"><?php print $rowst['state']; ?>
										<?php } ?>	
									</select>
								</div>
								<div class="form-group col-md-4 floatleft" id="disblockp">
									<label for="example-text-input" class="col-form-label">District</label>
									<?php /*?><input class="form-control" type="text" name="pdistrict" id="pdistrict" autocomplete="off"><?php */?>
									<select class="form-control spslc" name="pdistrict" id="pdistrict">
										<option value="">Select
										<?php
										$resst=mysqli_query($con,"select distinct `district` from `statedis` where 1");
										while($rowst=mysqli_fetch_array($resst)) {
										?>
											<option value="<?php print $rowst['district']; ?>"><?php print $rowst['district']; ?>
										<?php } ?>	
									</select>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">PIN</label>
									<input class="form-control" type="number" name="ppin" id="ppin" onBlur="checkpin('ppin',this.value);" autocomplete="off">
									<div id="ppintxt"></div>
								</div>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">KYC Details</h4>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">Upload Photo</label>
									<input class="form-control" type="file" name="photo" id="photo">
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">PAN No.</label>
									<input class="form-control" type="text" name="panno" id="panno" autocomplete="off" onBlur="copykycno();">
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">Upload PAN (PDF only)</label>
									<input class="form-control" type="file" name="pan" id="pan">
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Photo ID Proof Type</label>
									<select class="form-control spslc" name="pidprooftype" id="pidprooftype" onChange="copykycno();">
										<option value="">Select
										<option value="Aadhaar">Aadhaar
										<option value="Voter ID">Voter ID
										<option value="Driving License">Driving License
										<option value="Passport">Passport
										<option value="Others">Others
									</select>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">If Photo ID Proof Others</label>
									<input class="form-control" type="text" name="pidproofoth" id="pidproofoth" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Photo ID Proof No.</label>
									<input class="form-control" type="text" name="pidproofno" id="pidproofno" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Upload Photo ID Proof (PDF only)</label>
									<input class="form-control" type="file" name="pidproof[]" id="pidproof[]" multiple>
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Address Proof Type</label>
									<select class="form-control spslc" name="adprooftype" id="adprooftype" onChange="copykycno();">
										<option value="">Select
										<option value="Aadhaar">Aadhaar
										<option value="Voter ID">Voter ID
										<option value="Driving License">Driving License
										<option value="Ration Card">Ration Card
										<option value="Bank Statement">Bank Statement
										<option value="Passport">Passport
										<option value="Others">Others
									</select>
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">If Address Proof Others</label>
									<input class="form-control" type="text" name="adproofoth" id="adproofoth" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Address Proof ID No.</label>
									<input class="form-control" type="text" name="adproofno" id="adproofno" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Upload Address Proof (PDF only)</label>
									<input class="form-control" type="file" name="adproof[]" id="adproof[]" multiple>
								</div>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Nominee Details</h4>
								<div class="form-group col-md-2 floatleft">
									<label for="example-text-input" class="col-form-label">Nominee Title</label>
									<select class="form-control spslc" name="ntitle" id="ntitle">
										<option value="">Select
										<option value="Mr.">Mr.
										<option value="Mrs.">Mrs.
										<option value="Miss">Miss
										<option value="Dr.">Dr.
										<option value="Prof.">Prof.
									</select>
								</div>
								<div class="form-group col-md-4 floatleft">
									<label for="example-text-input" class="col-form-label">Nominee Name</label>
									<input class="form-control" type="text" name="nname" id="nname" autocomplete="off">
								</div>
								<div class="form-group col-md-2 floatleft">
									<label for="example-text-input" class="col-form-label">Nominee DOB</label>
									<input class="form-control" type="date" name="ndob" id="ndob">
								</div>
								<div class="form-group col-md-2 floatleft">
									<label for="example-text-input" class="col-form-label">Nominee Relation</label>
									<select class="form-control spslc" name="nrelation" id="nrelation" onChange="showappointee(this.value);">
										<option value="">Select
										<option value="Father">Father
										<option value="Mother">Mother
										<option value="Spouse">Spouse
										<option value="Children">Children
										<option value="Family">Family
									</select>
								</div>
								<div class="form-group col-md-2 floatleft">
									<label for="example-text-input" class="col-form-label">If Nominee Relation Family</label>
									<input class="form-control" type="text" name="nfname" id="nfname" autocomplete="off">
								</div>
								<div class="cleaner"></div>
								<div id="appointee">
									<div class="form-group col-md-3 floatleft">
										<label for="example-text-input" class="col-form-label">Appointee Name</label>
										<input class="form-control" type="text" name="apname" id="apname" autocomplete="off">
									</div>
									<div class="form-group col-md-3 floatleft">
										<label for="example-text-input" class="col-form-label">Appointee DOB</label>
										<input class="form-control" type="date" name="apdob" id="apdob">
									</div>
									<div class="form-group col-md-3 floatleft">
										<label for="example-text-input" class="col-form-label">Appointee Relation</label>
										<select class="form-control spslc" name="aprelation" id="aprelation">
											<option value="">Select
											<option value="Father">Father
											<option value="Mother">Mother
											<option value="Others">Others
										</select>
									</div>
									<div class="form-group col-md-3 floatleft">
										<label for="example-text-input" class="col-form-label">If Appointee Relation Others</label>
										<input class="form-control" type="text" name="aponame" id="aponame" autocomplete="off">
									</div>
								</div>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Account Details</h4>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Account Holder Name</label>
									<input class="form-control" type="text" name="accname" id="accname" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Account Type</label>
									<select class="form-control spslc" name="acctype" id="acctype">
										<option value="">Select
										<option value="Savings">Savings
										<option value="Current">Current
									</select>
								</div>	
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Account No.</label>
									<input class="form-control" type="password" name="accno" id="accno" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Confirm Account No.</label>
									<input class="form-control" type="text" name="conaccno" id="conaccno" autocomplete="off">
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Bank Name</label>
									<input class="form-control" type="text" name="bank" id="bank" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Branch Name</label>
									<input class="form-control" type="text" name="branch" id="branch">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">IFSC</label>
									<input class="form-control" type="text" name="ifsc" id="ifsc" autocomplete="off">
								</div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">Upload Cheque (PDF only)</label>
									<input class="form-control" type="file" name="cheque" id="cheque">
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-md-3 floatleft">
									<label for="example-text-input" class="col-form-label">GSTIN</label>
									<input class="form-control" type="text" name="gstin" id="gstin" autocomplete="off">
								</div>
								<div class="cleaner h20"></div>
								<h4 class="header-title titlebg">Upload Video & Questionnaire</h4>
								<div class="form-group col-md-6 floatleft">
									<label for="example-text-input" class="col-form-label">Upload Audio/Video</label>
									<input class="form-control" type="file" name="video" id="video">
								</div>
								<div class="form-group col-md-6 floatleft">
									<label for="example-text-input" class="col-form-label">Upload Questionnaire (DOC only)</label>
									<input class="form-control" type="file" name="questionnaire" id="questionnaire">
								</div>
								<div class="cleaner h20"></div>
								<div class="form-group col-md-12 floatleft">
									
									<a href="docs/Code of Ethics - CCAD Multiservices.pdf" target="_blank">Read Code of Ethics</a>
									<div class="cleaner"></div>
									<input type="checkbox" name="finalsubmit" id="finalsubmit" value="Yes" required>&nbsp;I agree with the Code of Ethics and ready to submit the form.
								</div>
								<button id="sbutton" type="submit" class="btn btn-primary mt-4 pr-4 pl-4">Submit</button>
							</form>	
						</div>
					</div>
				</div>
			</div>
			
		</div>
	</div>
	
	<?php include("includes/footer.php"); ?>
</div>


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