campusAmbassadorForm.html 9.39 KB
<div class="header">
    <div>
      <!-- <img src="images/LOGO.png" class="logojalsa"><span class="jalsaheadr" style="">2018</span> -->
      <!-- <img src="images/SartupJalsa_Logo.png" style="width:200px;position:relative;"> -->
    </div>      
  <div class="clearfix"></div>
  <div class="myLoaderWrap" ng-show="loading">       
     <img  class="ajax-loader" src="images/loader.gif">
  </div>
  </div>
  <!-- CLOSE HEADER -->
  <form name="applicantForm">  
     <div class="col-xs-12 col-md-8 col-md-offset-2">
        <div class="form-all">
            <div class="col-xs-12 col-md-8 col-md-offset-2 input-wrapper">
                <h4 class="title">CAMPUS AMBASSADOR FORM</h4>
                <div style="color: #FF6600;margin-bottom: 15px;">GENERAL DETAILS</div>
                <div>
                    <div class="form-group">
                        <label>Name:</label>
                        <input type="name" class="form-control" ng-model="data.name" required>
                    </div>
                    <div class="form-group">
                        <label>Contact Details:</label>
                        <input type="text" class="form-control" ng-model="data.number" required>
                        <!-- <label class="error-message f-family" id="invalidNumber">Please enter only numeric value.</label> -->
                    </div>
                    <div class="form-group">
                        <label>Email ID:</label>
                        <input type="email" class="form-control" ng-model="data.email" required>
                    </div>
                    <div class="form-group">
                        <label>College Name:</label>
                        <input type="collegeName" class="form-control" ng-model="data.collegeName" required>
                    </div>
                    <div class="form-group">
                        <label>State of your College:</label>
                        <select class="form-control" ng-model="data.collegeState" required>
                            <option name="business" selected disabled value="">Choose State</option>
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
                            <option value="Assam">Assam</option>
                            <option value="Bihar">Bihar</option>
                            <option value="Chhattisgarh">Chhattisgarh</option>
                            <option value="Goa">Goa</option>
                            <option value="Gujarat">Gujarat</option>
                            <option value="Haryana">Haryana</option>
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
                            <option value="Jharkhand">Jharkhand</option>
                            <option value="Karnataka">Karnataka</option>
                            <option value="Kerala">Kerala</option>
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
                            <option value="Maharashtra">Maharashtra</option>
                            <option value="Manipur">Manipur</option>
                            <option value="Meghalaya">Meghalaya</option>
                            <option value="Mizoram">Mizoram</option>
                            <option value="Nagaland">Nagaland</option>
                            <option value="Odisha">Odisha</option>
                            <option value="Punjab">Punjab</option>
                            <option value="Sikkim">Sikkim</option>
                            <option value="Tamil Nadu">Tamil Nadu</option>
                            <option value="Telangana">Telangana</option>
                            <option value="Rajasthan">Rajasthan</option>
                            <option value="Tripura">Tripura</option>
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
                            <option value="Uttarakhand">Uttarakhand</option>
                            <option value="West Bengal">West Bengal</option>
                            <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
                            <option value="Chandigarh">Chandigarh</option>
                            <option value="Dadar and Nagar Haveli">Dadar and Nagar Haveli</option>
                            <option value="Daman and Diu">Daman and Diu</option>
                            <option value="Delhi">Delhi</option>
                            <option value="Lakshadweep">Lakshadweep</option>
                            <option value="Puducherry">Puducherry</option>
                        </select>
                    </div>
                </div>
                <div style="color: #FF6600;">Workshops</div>
                <div style="margin-bottom: 15px;">In this section, let us know about the workshop you plan to organize under Startup Jalsa Ideate Edition. We understand that some of the information you enter here could be tentative. </div>
                <div>
                    <div class="form-group">
                        <label>Workshop Name:</label>
                        <input type="workshopName" class="form-control" ng-model="data.workshopName" placeholder="University events must be named after the institution (e.g., Ideate IIT Delhi)" required>
                    </div>
                    <div class="form-group">
                        <label>Workshop Type:</label>
                        <select class="form-control" ng-model="data.workshopType" required>
                            <option name="workshopType" selected disabled value="">Choose Type</option>
                            <option value="How to find startup ideas">How to find startup ideas</option>
                            <option value="How to build a MVP">How to build a MVP</option>
                            <option value="How to Start a startup">How to Start a startup</option>
                            <option value="How to create pitch deck">How to create pitch deck</option>
                            <option value="How to Pitch to investors">How to Pitch to investors</option>
                        </select>
                    </div>
                    <div class="form-group">
                        <label>Tell us about the local community you will serve with this workshop.</label>
                        <input type="community" class="form-control" ng-model="data.community" placeholder="Who will be in your intended audience?" required>
                    </div>
                    <div class="form-group">
                        <label>Describe the venue</label>
                        <input type="venue" class="form-control" ng-model="data.venue" placeholder="Tell us about the place in which you plan to host your workshop. If you are not sure where it will be, tell us the venues you are considering." required>
                    </div>
                    <div class="form-group">
                        <label>How many people will attend your workshop?</label>
                        <input type="people" class="form-control" ng-model="data.people" placeholder=" If you are not sure, give us your best guess. " required>
                    </div>
                </div>
                <div style="color: #FF6600;margin-bottom: 15px;">ABOUT YOU</div>
                <div>
                    <div class="form-group">
                        <label> What are you passionate about in your own life?</label>
                        <input type="life" class="form-control" ng-model="data.life" placeholder="E.g., your work, your community, your creative projects ..." required>
                    </div>
                    <div class="form-group">
                        <label>List the events which you have organised before</label>
                        <input type="events" class="form-control" ng-model="data.events" placeholder=" Provide website/facebook/Instagram link  of the event, if available" required>
                    </div>
                    <div class="form-group">
                        <label>What made you decide you wanted to become the Campus Ambassador of Startup Jalsa? What inspired you?</label>
                        <input type="inspired" class="form-control" ng-model="data.inspired" required>
                    </div>
                    <div class="form-group">
                        <label>What do we need to know about you that we didn't ask?</label>
                        <input type="task" class="form-control" ng-model="data.task" required>
                    </div>
                </div>
            </div>
            <div class="clearfix"></div>
            <div class="text-center">
                <input type="submit" class="btn submit-button-form" style="outline: none;" ng-disabled="applicantForm.$invalid" value="Submit" ng-click="formRegister()">
            </div>
        </div>
    </div>
  </form>
  <!-- CLOSE FORM -->
  <!-- </div> CLOSE CHECK VIEW -->
  <span ng-show="span == true">
     <span id="chennai"></span>
     <span id="mumbai"></span>
     <span id="hyderabad"></span>
     <span id="kolkata"></span>
     <span id="delhi"></span>
     <span id="ahmedabad"></span>
     <span id="bengaluru"></span>
     <span id="jaipur"></span>
     <span id="kanpur"></span>
     <span id="dharamsala"></span>
  </span>