<div class="col-lg-12 col-md-12 col-sm-12 ">
<h5 class="page-title mb-3"><?=strtoupper($page_title)?></h5>
<div class="card rounded-0 border border-secondary mb-3">
<div class="card-body">
<form>
<div class="form-group row mb-2">
<label for="full_name" class="col-sm-3 control-label">Nama Lengkap <span style="color: red">*</span></label>
<div class="col-sm-9">
<input type="text" class="form-control form-control-sm rounded-0 border border-secondary" id="full_name" name="full_name">
</div>
</div>
<div class="form-group row mb-2">
<label for="gender" class="col-sm-3 control-label">Jenis Kelamin <span style="color: red">*</span></label>
<div class="col-sm-9">
<?=form_dropdown('gender', ['' => 'Pilih :', 'M' => 'Laki-laki', 'F' => 'Perempuan'], '', 'class="custom-select custom-select-sm rounded-0 border border-secondary" id="gender"')?>
</div>
</div>
<div class="form-group row mb-2">
<label for="birth_date" class="col-sm-3 control-label">Tanggal Lahir <span style="color: red">*</span></label>
<div class="col-sm-9">
<div class="input-group">
<input type="text" readonly class="form-control form-control-sm rounded-0 border border-secondary date" id="birth_date" name="birth_date">
<div class="input-group-append">
<span class="btn btn-sm btn-outline-secondary rounded-0"><i class="fa fa-calendar text-dark"></i></span>
</div>
</div>
</div>
</div>
<div class="form-group row mb-2">
<label for="end_date" class="col-sm-3 control-label">Tahun Lulus <span style="color: red">*</span></label>
<div class="col-sm-9">
<input type="text" class="form-control form-control-sm rounded-0 border border-secondary" id="end_date" name="end_date">
</div>
</div>
<div class="form-group row mb-2">
<label for="identity_number" class="col-sm-3 control-label"><?=__session('_identity_number')?></label>
<div class="col-sm-9">
<input type="text" class="form-control form-control-sm rounded-0 border border-secondary" id="identity_number" name="identity_number">
</div>
</div>
<div class="form-group row mb-2">
<label for="street_address" class="col-sm-3 control-label">Alamat <span style="color: red">*</span></label>
<div class="col-sm-9">
<textarea rows="5" class="form-control form-control-sm rounded-0 border border-secondary" id="street_address" name="street_address"></textarea>
</div>
</div>
<div class="form-group row mb-2">
<label for="email" class="col-sm-3 control-label">Email <span style="color: red">*</span></label>
<div class="col-sm-9">
<input type="text" class="form-control form-control-sm rounded-0 border border-secondary" id="email" name="email">
</div>
</div>
<div class="form-group row mb-2">
<label for="phone" class="col-sm-3 control-label">Telepon</label>
<div class="col-sm-9">
<input type="text" class="form-control form-control-sm rounded-0 border border-secondary" id="phone" name="phone">
</div>
</div>
<div class="form-group row mb-2">
<label for="mobile_phone" class="col-sm-3 control-label">Handphone</label>
<div class="col-sm-9">
<input type="text" class="form-control form-control-sm rounded-0 border border-secondary" id="mobile_phone" name="mobile_phone">
</div>
</div>
<div class="form-group row mb-2">
<label for="file" class="col-sm-3 control-label">Foto</label>
<div class="col-sm-9">
<input type="file" id="photo" name="photo">
<small class="form-text text-muted">Foto harus JPG dan ukuran file maksimal 1 Mb</small>
</div>
</div>
<?php if (NULL !== __session('recaptcha_status') && __session('recaptcha_status') == 'enable') { ?>
<input type="hidden" class="g-recaptcha-response" name="g-recaptcha-response">
<?php } ?>
</form>
</div>
<div class="card-footer">
<div class="form-group row mb-0">
<div class="offset-sm-3 col-sm-9">
<button type="button" onclick="alumni_registration(); return false;" class="btn action-button rounded-0"><i class="fa fa-send"></i> Submit</button>
</div>
</div>
</div>
</div>
</div>