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<title>Bhuvnesh Bal Vidyalayal - Kota</title>
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<body>
<div class="container">
  <div class="header">
    <table width="980" border="0" align="center" cellpadding="0" cellspacing="0">
      <tr>
        <td width="7%" align="right" style="color:#4e250a; padding:4px 0 0 0 ;">Date Time :</td>
        <td width="24%"><div class="left" style="width:200px; color:#4e250a">
            <script language="JavaScript" type="text/javascript">
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            <div id="time" style="font-size:11px; font-family:Arial, Helvetica, sans-serif; color:#4e250a; padding:5px 0 0 10px;">&nbsp;</div>
          </div></td>
        <td width="69%" align="right"><div style="float:right"> <a href="founder.html">Founder</a> <a href="">|</a><a href="management.html">Management</a> <a href="">|</a> <a href="school-song.html">School Song</a><a href="">|</a> <a href="publication.html">Publication</a><a href="">|</a> <a href="alumni.php">Alumni</a></div></td>
      </tr>
    </table>
  </div>
  <!-----------------logo------------------>
  <div align="center" class="bl-tpr">
    <div class="wrap">
      <div class="logo"><a href="index_1.php"><img src="images/balvidyalaya-logo.png"  alt="." /></a></div>
    </div>
  </div>
  <!----------------------logo end---------->
  <div class="clr"></div>
  <!----------------------------Menu----------------------->
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    <div class="nav">
      <ul id="menu" class="clear">
        <li class=""><a href="index_1.php">Home</a></li>
        <li class="has_child"><a href="#">About Us</a>
          <ul>
            <li><a href="school-info.html">School Information</a></li>
            <li><a href="school-history.html">School History</a></li>
            <li><a href="founder.html">Founder</a></li>
            <li><a href="director.html">Director</a></li>
            <li><a href="principal.html">Principal</a></li>
            <li><a href="our-aim.html">Our Aim</a></li>
            <li><a href="van-shivir.html">Our Speciality (Van Shivir)</a></li>
          </ul>
        </li>
        <li class="has_child"><a href="#">Academics</a>
          <ul>
            <li><a href="curriculum.html">Curriculum</a></li>
            <li><a href="it.html">Information Technology</a></li>
            <li><a href="calendra.php">Calendar</a></li>
            <li><a href="examination.html">Examination</a></li>
          </ul>
        </li>
        <li class="has_child"><a href="#">Admission</a>
          <ul>
            <li><a href="admission.html">Admission Process & Fee info</a></li>
            <li><a href="rules.html">School Rules</a></li>
            <li><a href="syllabus.php">Syllabus</a></li>
            <li><a href="uniform.html">Uniform</a></li>
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        <li class="has_child"><a href="#">Facility</a>
          <ul>
            <li class="has_child"><a href="#">Infrastructure</a>
              <ul>
                <li><a href="hostels.html">Hostels</a></li>
                <li><a href="classroom.html">Classroom</a></li>
                <li><a href="medical-nutrition.html">Medical & Nutrition</a></li>
                <li><a href="library.html">Library</a></li>
                <li><a href="computer-lab.html">Computer Center</a></li>
                <li><a href="science-lab.html">Science Lab</a></li>
                <li class="has_child"><a href="#">Museum</a>
                  <ul>
                    <li><a href="science-museum.html">Science Museum</a></li>
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                </li>
                <li><a href="music-dance.html">Music & Dance Room</a></li>
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            <li class="has_child"><a href="#">Games & Sports</a>
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                <li><a href="tennice.html">Tennice Court </a></li>
                <li><a href="volleyball-court.html">Volley Ball Courts </a></li>
                <li><a href="badminton-hall.html">Badminton Hall </a></li>
                <li><a href="gymnasium.html">Gymnasium</a></li>
                <li><a href="swimming-pool.html">Swimming Pool</a></li>
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        <li class="has_child"><a href="#">Activities</a>
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                <li><a href="cultural-activities.html">Cultural Activities</a></li>
                <li><a href="van-shivir.html">Van Shivir</a></li>
                <li><a href="edu-tour.html">Education Tour</a></li>
                <li><a href="ncc.html">N.C.C</a></li>
                <li><a href="nss.html">N.S.S</a></li>
                <li><a href="scout.html">Scout & Guide </a></li>
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        <li><a href="achievements.html">Achievements</a></li>
        <li class="has_child"><a href="#">Gallery</a>
          <ul>
            <li><a href="days.html">National Celebration</a></li>
            <li><a href="van-shivir-photo.html">Van Shivir </a></li>
            <li><a href="sports.html">Sports</a></li>
            <li><a href="news.html">News</a></li>
            <li><a href="celebrations.html">School Celebrations</a></li>
            <li><a href="campus.html">Campus</a></li>
            <li><a href="60-foundatio-day.html">60th Foundation Day</a></li>
            <li><a href="bharat-smirit-cup.html">Bharat Smirit Cup</a></li>  
			<li><a href="statue-unveiled-programme.html">Statue Unveiled Programme</a></li>          
          </ul>
        </li>
        <li><a href="prize.html">Prize Distribution</a></li>
        <li><a href="visitor.html">Visitor's</a></li>
        <li><a href="scholarship.html">Scholarship</a></li>
        <li><a href="#">Contact</a>
         <ul>
            <li><a href="tc_download.php">TC Download</a></li>
            <li><a href="Mandatory_Disclosure.html">Mandatory Disclosures</a></li>
            <li><a href="contact-us.php">Contact Us</a></li>
          </ul>
        </li>
      </ul>
    </div>
  </div>
  <!---------------------------End-------------------------->
  <div class="clr"></div>
  <!----------------------Slider------------------------------->
  <div> 
  <table width="1020px" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td style="background-color: rgba(255, 255, 255, 0.55);">
<div id="sld">
    <table width="1000" border="0" cellspacing="0" cellpadding="0">
      <tr>
        <td width="220" height="10"></td>
        <td width="10" height="10"></td>
        <td width="540" height="10"></td>
        <td width="10" height="10"></td>
        <td width="220" height="10"></td>
      </tr>
      <tr>
        <td colspan="5" valign="top"><img src="images/school-building.jpg" width="1000" height="279" alt="Bhuvnesh Bal Vidyalaya kota" /></td>
      </tr>
      <tr>
        <td colspan="5" valign="top"><img src="images/image-shadow.png" width="1000" height="15" alt="Bhuvnesh Bal Vidyalaya kota" /></td>
      </tr>
    </table>
  </div>
  <!--------------------------Slider End------------------------>
  <div class="clr"></div>
  <div id="ash-cnt_1">
  <p style="font-size:22px">Admission Enquiry Form</p>
  
  <br />
   
 <div style="border: 2px solid #C19770; border-radius: 5px;">



<div class="kk" style="padding:20px; background-color:#fff; box-shadow: 0px 8px 15px rgba(0, 0, 0, 0.1);">         
          <form id="frmlogin" action="online_reg_mail.php" method="post" name="frmlogin" onSubmit="return checkFields();" >
<table width="950" align="center" class="text3">
<tr>
	<td>Student First Name<br />
<input class="form-control" name="std_f_name" id="std_f_name" type="text" placeholder="Student First Name..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
	<td>Student Last Name<br />
<input class="form-control" name="std_l_name" id="std_l_name" type="text" placeholder="Student Last Name..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
	<td>Aadhaar Card No<br />
<input class="form-control" name="uid_num" id="uid_num" type="text" placeholder="Aadhaar Card No..."  required="required"/></td>
	<td>Date of Birth<br />
<input type="text" size="30" name="d_o_b" id="d_o_b"  placeholder=" DD / MM / YYYY" required /></td>
</tr>
<tr>
  <td colspan="4" height="8"></td>
</tr>

<tr>
	<td>Age (Year)<br />
<input type="text" size="30" name="age_yr" id="age_yr"  placeholder=" YY" required /></td>
  	<td>Age (Month)<br />
<input type="text" size="30" name="age_mon" id="age_mon"  placeholder=" mm" required /></td>
  	
  	<td>Class<br />
    <select class="form-control" id="class" name="class">
<option value="">-- Class --</option>
<option value="LKG">LKG</option>
<option value="HKG">HKG</option>
<option value="I">I</option>
<option value="II">II</option>
<option value="III">III</option>
<option value="IV">IV</option>
<option value="V">V</option>
<option value="VI">VI</option>
<option value="VII">VII</option>
<option value="VIII">VIII</option>
<option value="IX">IX</option>
<option value="X">X</option>
<option value="XI Science Maths">XI Science Maths</option>
<option value="XI Science Biology">XI Science Biology</option>
<option value="XI Commerce">XI Commerce</option>
<option value="XII Science Maths">XII Science Maths</option>
<option value="XII Science Biology">XII Science Biology</option>
<option value="XII Commerce">XII Commerce</option>
</select></td> 
<td>Gender<br />
<select class="form-control" id="gender" name="gender">
<option value="">-- Gender  --</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
</select></td> 
</tr>



<tr>
  <td colspan="4" height="8"></td>
  </tr>
<tr>
  
  <td>Father's Name<br />
<input class="form-control" name="f_name" id="f_name" type="text" placeholder="Father's Name..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
  <td>Father's Qualification<br />
<input class="form-control" name="f_quli" id="f_quli" type="text" placeholder="Father's Qualification..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
  <td>Father's Occupation<br />
<input class="form-control" name="f_occu" id="f_occu" type="text" placeholder="Father's Occupation..." pattern="[A-Za-z\s]{4,}" required="required"/>	</td>
<td>Father's Mob. No<br />
<input class="form-control" name="f_mob_no" id="f_mob_no" type="text" placeholder="Father's Mob No..." oninput="this.value = this.value.replace(/[^0-9.+-]/g, '');" min="9" maxlength="15" pattern="[0-9]{10}" required="required"/>	</td>
</tr>


<tr>
  <td colspan="4" height="8"></td>
  </tr>
<tr>
  <td>Mother's Name<br />
<input class="form-control" name="m_name" id="m_name" type="text" placeholder="Mother's Name..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
  <td>Mother's Qualification<br />
<input class="form-control" name="m_quli" id="m_quli" type="text" placeholder="Mother's Qualification..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
  <td>Mother's Occupation<br />
<input class="form-control" name="m_occu" id="f_occu" type="text" placeholder="Mother's Occupation..." pattern="[A-Za-z\s]{4,}" required="required"/>	</td>
<td>Mother's Mob. No<br />
<input class="form-control" name="m_mob_no" id="m_mob_no" type="text" placeholder="Mother's Mob No..." oninput="this.value = this.value.replace(/[^0-9.+-]/g, '');" min="9" maxlength="15" pattern="[0-9]{10}" required="required"/>	</td>
</tr>



<tr>
  <td colspan="4" height="8"></td>
  </tr>
<tr>
<td>Hostel Accomodation<br />
<select class="form-control" id="hostel" name="hostel">
<option value="">-- Hostel Accomodation --</option>
<option value="YES">YES</option>
<option value="NO">NO</option>
</select></td>
  <td>E-mail<br />
<input class="form-control" placeholder="E-mail Address....." name="e_mail" id="e_mail" type="text"  pattern="([A-Za-z0-9_\-\.\'])+\@([A-Za-z0-9_\-\.])+\.([A-Za-z]{2,6})" required="required"/></td>
<!--  <td>Contact No.<br />
<input class="form-control"  name="phone_no" type="text"  oninput="this.value = this.value.replace(/[^0-9.+-]/g, '');" min="9" maxlength="15" pattern="[0-9]{10}" placeholder="Contact No..." required="required" /></td>-->
  <td>City Name<br />
<input class="form-control" name="city_name" id="city_name" type="text" placeholder="City Name..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
  <td>Address<br />
<input class="form-control" name="add_ress" id="add_ress" type="text" placeholder="Address..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
</tr>
<tr><td colspan="4" height="8"></td></tr>
<tr>
	<td>Pervious School Name<br />
<input class="form-control" name="pre_sch_nm" id="pre_sch_nm" type="text" placeholder="Pervious School Name..." pattern="[A-Za-z\s]{4,}" required="required"/></td>
    <td>Medium<br />
<select class="form-control" id="medium" name="medium">
<option value="">-- Medium --</option>
<option value="English">English</option>
<option value="Hindi">Hindi</option>
</select></td>
<td>Board<br />
<select class="form-control" id="board" name="board">
<option value="">-- Board --</option>
<option value="CBSE">CBSE</option>
<option value="ICSE">ICSE</option>
<option value="Raj.Board">Raj.Board</option>
<option value="Others">Others</option>
</select></td>
    <td>&nbsp;</td>
</tr>
<tr>
  <td colspan="4" height="8"></td>
  </tr>
<tr>
	<td colspan="3"><div class="g-recaptcha" data-sitekey="6Led0qsUAAAAAKtzltmYY1rSFSe_bh2SeMGt5zlh"></div>
    <div class="help-block with-errors"></div></td>
    <td><input class="submit" type="submit" name="submit" value="submit" onclick="return check_empty();"></td>
</tr>

</table> 
         
</form>          
</div>







 
 
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        <td height="25" colspan="3" align="center">Visitor's Number<br /></td>
      </tr>
      <tr>
        <td width="355" valign="top"><table width="340" border="0" cellspacing="0" cellpadding="0">
            <tr>
              <td height="20" class="svs3">Address : Bhuvnesh Bal Vidyalaya, NH - 27, Baran Road, Kota</td>
            </tr>
            <tr>
              <td height="20" class="svs3">Phone  &nbsp;&nbsp;: +91 - 744 - 2451047</td>
            </tr>
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              <td height="20" class="svs3">&nbsp;</td>
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              <td width="240" align="right"><img src="images/scl.png" width="58" height="15" alt="." />&nbsp;&nbsp;</td>
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              <td colspan="4" align="right" class="svs3">© Copyright 2014 Bal Hitkari Samiti. All rights reserved.</td>
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              <td colspan="4" align="right" class="svs3">Powerde by : <a href="http://www.gradientsoftech.com" target="_blank" title="website development company in kota "> Gradient Softech </a></td>
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