Course applied for

<%if(request.getParameter("reg_position")!=null){%> <%=reg_position%> <%}else{%> ..........Select........... MBBS MD BDS MDS BE Aerospace BE Agricultural BE Bioengineering BE Chemical BE Civil BE Computer Science BE Information Technology BE Electrical BE Environmental BE Fire Engineering BE Industrial BE Material BE Mechanical BE Software Engineering BE Electronics B.Tech Electronics B.Tech Aerospace B.Tech Agricultural B.Tech Bioengineering B.Tech Chemical B.Tech Civil B.Tech Computer Science B.Tech Information Technology B.Tech Electrical B.Tech Environmental B.Tech Fire Engineering B.Tech Industrial B.Tech Material B.Tech Mechanical B.Tech Software Engineering BSc Nursing Gen.Nursing Post BSc Nursing MSc Nursing MBA MCA Hotel Management BPT BPharm MFT MSW B.Ed Physical Science B.Ed Malayalam B.Ed Hindi B.Ed Social Science B.Ed English B.Ed Computer science MSc Bio-Technology MSc Information Technology MSc Interior Designing MSc Fashion Technology MSc Bio chemistry MSc Micro Biology MSc Physics MSc Chemistry MSc Zoology MSc Biology MSc Bio-Informatics MSc Electronics Polytechnic Electronics Polytechnic Civil Polytechnic Mechanical Polytechnic Electrical LLB LLM Gemmology Other <%}%> *

Country applied for

<%if(request.getParameter("reg_country")!=null){%> <%=reg_country%> <%}else{%> ...................Select..................... <%}%> <% /* *Retrieving values from country_list table */ String country_code=""; Statement stcountry=con.createStatement(); ResultSet rscountry=stcountry.executeQuery("select country_name from country_list"); while(rscountry.next()) { %> <%=rscountry.getString(1)%> <% } stcountry.close(); rscountry.close(); %> *

State applied for

<%if(request.getParameter("reg_state")!=null){%> <%=reg_country%> <%}else{%> ......Select........ AP-Anantapur AP-Guntakal AP-Guntur AP-Hyderabad AP-Kurnool AP-Nellore AP-Nizamabad AP-Rajahmundry AP-Secunderabad AP-Tirupati AP-Vijaywada AP-Visakhapatnam AP-Warangal AP-Other Arunachal P'desh-Itanagar Assam-Guwahati Assam-Silchar Bihar-Bahgalpur Bihar-Dhanbad Bihar-Jamshedpur Bihar-Patna Chandigarh Chhattisgarh-Bhillai Chhattisgarh-Raipur Dadra&Nagar Haveli Daman&Dui Delhi Goa Goa-Panaji Goa-Panjim Goa-Vasco Da Gama Guj-Ahmedabad Guj-Anand Guj-Baroda Guj-Bharuch Guj-Bhavnagar Guj-Bhuj Guj-Gandhinagar Guj-Gir Guj-Jamnagar Guj-Kandla Guj-Porbandar Guj-Rajkot Guj-Surat Guj-Vadodara Haryana-Ambala Haryana-Faridabad Haryana-Gurgaon Haryana-Karnal Haryana-Kurukshetra Haryana-Panipat Haryana-Rohtak HP-Dalhousie HP-Dharmsala HP-Kulu/Manali HP-Shimla J&K-Jammu J&K-Srinagar Jharkhand-Bokaro Jharkhand-Ranchi Karnataka-Bangalore Karnataka-Belgaum Karnataka-Bellary Karnataka-Bidar Karnataka-Dharwad Karnataka-Gulbarga Karnataka-Hubli Karnataka-Kolar Karnataka-Mangalore Karnataka-Mysore Kerala-Calicut Kerala-Cochin Kerala-Ernakulam Kerala-Kochi Kerala-Kollam Kerala-Kottayam Kerala-Kozhikode Kerala-Palakkad Kerala-Thrissur Kerala-Trivandrum MP-Bhopal MP-Gwalior MP-Indore MP-Jabalpur MP-Ujjain Maharashtra-Ahmednagar Maharashtra-Aurangabad Maharashtra-Jalgaon Maharashtra-Kolhapur Maharashtra-Mumbai Maharashtra-Nagpur Maharashtra-Nasik Maharashtra-Pune Maharashtra-Sholapur Manipur-Imphal Meghalaya-Shillong Miz.-Aizawal Nagaland-Dimapur Orissa-Bhubaneshwar Orissa-Cuttack Orissa-Paradeep Orissa-Puri Orissa-Rourkela Pondicherry Punjab-Amritsar Punjab-Jalandhar Punjab-Ludhiana Punjab-Mohali Punjab-Pathankot Punjab-Patiala Rajasthan-Ajmer Rajasthan-Jaipur Rajasthan-Jaisalmer Rajasthan-Jodhpur Rajasthan-Kota Rajasthan-Udaipur Sikkim-Gangtok TN-Chennai TN-Coimbatore TN-Erode TN-Hosur TN-Madurai TN-Ooty TN- Salem TN-Tirunelveli TN-Trichy TN-Vellore Tripura-Agartala UP-Agra UP-Aligarh UP-Allahabad UP-Bareilly UP-Faizabad UP-Ghaziabad UP-Gorakhpur UP-Kanpur UP-Lucknow UP-Mathura UP-Meerut UP-Noida UP-Varanasi Uttaranchal-Dehradun WB-Durgapur WB-Kharagpur WB-Kolkata Other <%}%>

First Name

<%if(request.getParameter("reg_fname")!=null){%> <%}else{%> <%}%> *

Middle Name

<%if(request.getParameter("reg_midname")!=null){%> <%}else{%> <%}%>

Last Name

<%if(request.getParameter("reg_lname")!=null){%> <%}else{%> <%}%> *

E-mail id

<% //if Special characters are present after submitting to Reg2.jsp //if javascript is disabled for the browser if(request.getParameter("reg_eid")!=null) { %> "> <% } else { %> <% } %> * <% //if userid exists this message will display if(request.getParameter("uid_exists")!=null) { %> User id exist. Please enter another id <% } %>

Desired Password

*

Confirm Password

*

Phone with STD/ISD code (Present)

<%if(request.getParameter("reg_phpresent")!=null){%> <%}else{%> <%}%> *

Phone with STD/ISD code (Permanent)

<%if(request.getParameter("reg_phpermanent")!=null){%> <%}else{%> <%}%>

Sex

<%if(request.getParameter("reg_sex")!=null){%> <%=reg_sex%> <%}else{%> ...................Select..................... <%}%> Male Female *

Date of Birth

<%if(request.getParameter("reg_day")!=null){%> <%=reg_day%> <%}else{%> Day <%}%> 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 <%if(request.getParameter("reg_month")!=null){%> <%=reg_month%> <%}else{%> Month <%}%> Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec <%if(request.getParameter("reg_year")!=null){%> <%=reg_year%> <%}else{%> Year <%}%> 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 *

Age

<%if(request.getParameter("reg_age")!=null){%> <%}else{%> <%}%> *

Marital Status

<%if(request.getParameter("reg_mar_status")!=null){%> <%=reg_mar_status%> <%}else{%> ...................Select..................... <%}%> Single Married Divorced Married and seperated *

Religion

<%if(request.getParameter("reg_religion")!=null){%> <%}else{%> <%}%>

Height (eg. 5 feet 4 inches)

<%if(request.getParameter("reg_height")!=null){%> <%}else{%> <%}%>

Weight

<%if(request.getParameter("reg_weight")!=null){%> <%}else{%> <%}%> in Kg and <%if(request.getParameter("reg_weightlbs")!=null){%> <%}else{%> <%}%> in Lbs

Country of Origin

<%if(request.getParameter("reg_country_origin")!=null){%> <%=reg_country_origin%> <%}else{%> ...................Select..................... <%}%> <% /* *Retrieving values from country_list table */ Statement stcountry_origin=con.createStatement(); ResultSet rscountry_origin=stcountry_origin.executeQuery("select country_name from country_list"); while(rscountry_origin.next()) { %> <%=rscountry_origin.getString(1)%> <% } stcountry_origin.close(); rscountry_origin.close(); %> *

Languages known

<%if(request.getParameter("reg_language_known")!=null){%> <%}else{%> <%}%>

Permanent Address (with pincode)

<%if(request.getParameter("reg_per_address")!=null){%> <%=reg_per_address%> <%}else{%> <%}%> *

Address for Correspondence
(Resent Address with pincode)

<%if(request.getParameter("reg_cor_address")!=null){%> <%=reg_cor_address%> <%}else{%> <%}%> *

Hobbies/Leisure Interests

<%if(request.getParameter("reg_hobby")!=null){%> <%}else{%> <%}%>