hjkhhndndndnd,trt
bnmbertsu,yu,yu,fffffffy,ltdfg
/
home4
/
gofvotmy
/
public_html
/
sbspharmacypatti.org
/
Upload FileeE
HOME
<html> <head> <title>Shaheed Bhagat Singh Polytechnic & Pharmacy College</title> <script type="text/javascript" src="stmenu.js"></script> <style type="text/css"> <!-- body {margin: 0px; padding: 0px;} a:link {color: #2c3651;} a:visited {color: #1f5b8b;} a:hover {color: #2c3651;} a:active {color: #2c3651;} .Body-P { margin:0.0px 0.0px 12.0px 0.0px; text-align:left; font-weight:400; } .Body-P0 { margin:0.0px 0.0px 8.0px 0.0px; text-align:left; font-weight:400; } .Normal-P { margin:0.0px 0.0px 0.0px 0.0px; text-align:center; font-weight:400; } .Normal-P0 { margin:0.0px 0.0px 0.0px 0.0px; text-align:left; font-weight:400; } .Normal-P1 { margin:0.0px 0.0px 0.0px 0.0px; text-align:justify; font-weight:400; } .Body-P1 { margin:0.0px 0.0px 12.0px 0.0px; text-align:justify; font-weight:400; } .Body-P2 { margin:0.0px 0.0px 14.0px 0.0px; text-align:justify; font-weight:400; } .Body-P3 { margin:0.0px 0.0px 7.0px 0.0px; text-align:left; font-weight:400; } .Body-P4 { margin:0.0px 0.0px 4.0px 0.0px; text-align:left; font-weight:400; } .Body-C { font-family:"Arial", sans-serif; font-weight:700; font-size:13.0px; line-height:1.23em; color:#ffffff; } .Body-C0 { font-family:"Arial", sans-serif; font-weight:700; font-size:13.0px; line-height:1.23em; color:#f9fef5; } .Body-C1 { font-family:"Verdana", sans-serif; font-weight:700; font-size:16.0px; line-height:1.13em; } .Hyperlink-C { font-family:"Arial", sans-serif; font-weight:700; font-size:13.0px; line-height:1.23em; } .Normal-C { font-family:"Arial", sans-serif; font-weight:700; font-size:13.0px; line-height:1.23em; color:#f2f7ef; } .Normal-C0 { font-family:"Arial", sans-serif; font-size:13.0px; line-height:1.23em; } .Body-C2 { font-family:"Verdana", sans-serif; font-size:16.0px; line-height:1.13em; } .Body-C3 { font-family:"Arial", sans-serif; font-weight:700; font-size:15.0px; line-height:1.20em; color:#0b3d00; } .Body-C4 { font-family:"Arial", sans-serif; font-weight:700; font-size:12.0px; line-height:1.25em; color:#f6f6f6; } .heads {font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12pt; color: #0066FF} .txt {font-family: Verdana; font-size: 8pt; #222222; background-color: #F5F5F5; border: 1 solid #808080} .ver {font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10pt; text-align: justify; color: #222222} .style1 { font-family: Arial, Helvetica, sans-serif; font-weight: bold; } .Body-C11 { font-family:"Arial", sans-serif; font-weight:700; font-size:13.0px; line-height:1.23em; } .Body-C5 { font-family:"Verdana", sans-serif; font-weight:700; font-size:16.0px; line-height:1.13em; } .Body-P11 { margin:0.0px 0.0px 8.0px 0.0px; text-align:left; font-weight:400; } .Body-C71 {font-family:"Verdana", sans-serif; font-weight:700; font-size:16.0px; line-height:1.13em; } --> </style> <script type="text/javascript" src="wpscripts/jsFlashVer.js"></script> <script type="text/javascript" src="wpscripts/jspngfix.js"></script> <script type="text/javascript"><!-- var blankSrc = "wpscripts/blank.gif"; --></script> </head> <body text="#000000" style="background-color:#ffffff; text-align:center; height:1370px;"> <div style="background-color:transparent;text-align:left;margin-left:auto;margin-right:auto;position:relative;width:1280px;height:1370px;"> <div style="position:absolute; left:0px; top:130px; width:1280px; height:351px;"> <img src="wpimages/back-green.png" width="1280" height="351" border="0" id="qs_4" name="qs_4" title="" alt="" onload="OnLoadPngFix()"></div> <div style="position:absolute; left:0px; top:0px; width:1280px; height:130px;"> <img src="wpimages/header-image.jpg" alt="" name="pic_1" width="1280" height="130" border="0" usemap="#pic_1Map" id="pic_1" title=""> <map name="pic_1Map"> <area shape="rect" coords="1037,9,1063,39" href="http://www.facebook.com/pages/Shaheed-Bhagat-Singh-College-of-Pharmacy/104463769687214"> <area shape="rect" coords="1074,8,1107,43" href="https://twitter.com/#!/sbscop"> </map> </div> <div style="position:absolute; left:140px; top:110px; width:1000px; height:36px;"> <img src="wpimages/menu.png" width="1000" height="36" border="0" id="qs_1" name="qs_1" title="" alt="" onload="OnLoadPngFix()"></div> <div style="position:absolute; left:143px; top:0px; width:97px; height:100px;"> <img src="wpimages/logo.png" width="97" height="100" border="0" id="pic_4" name="pic_4" title="" alt="" onload="OnLoadPngFix()"></div> <div style="position:absolute; left:149px; top:112px; width:192px; height:20px;"> <div id="frag_1" style="text-align:left;"> <script type="text/javascript" src="menu.js"></script> </div></div> <div style="position:absolute; left:236px; top:1px; width:621px; height:76px;"> <img src="wpimages/h-heading.png" width="621" height="76" border="0" id="pic_5" name="pic_5" title="" alt="" onload="OnLoadPngFix()"></div> <div style="position:absolute; left:664px; top:65px; width:440px; height:42px;"> <img src="wpimages/h-slogan.png" width="440" height="42" border="0" id="pic_6" name="pic_6" title="" alt="" onload="OnLoadPngFix()"></div> <div id="vid_6" style="position:absolute; left:140px; top:154px; width:1000px; height:300px;"> <script type="text/javascript"> <!-- var hasReqestedVersion = DetectFlashVer(8, 0, 0); if (hasReqestedVersion) { AC_FL_RunContent( "src", "wpimages/main-flash", "base", "wpimages", "play", "true", "loop", "true", "width", "1000", "height", "300", "salign", "C", "scale", "ShowAll", "id", "vid_6", "quality", "High", "wmode", "transparent", "name", "vid_6", "type", "application/x-shockwave-flash", 'codebase', 'http://fpdownload.macromedia.com/get/flashplayer/current/swflash.cab', "pluginspage", "http://www.macromedia.com/go/getflashplayer" ); } else { var alternateContent = 'An old version of the Flash plugin was detected. <strong><a href="http://www.macromedia.com/go/getflash/">Please upgrade your Flash plugin.<\/a><\/strong>'; document.write(alternateContent); } --> </script> </div> <div style="position:absolute; left:863px; top:493px; width:305px; height:824px;"> <img src="wpimages/registration-right-back.png" width="311" height="1071" border="0" id="grp_1" name="grp_1" title="" alt="" onload="OnLoadPngFix()"></div> <div id="txt_1" style="position:absolute; left:904px; top:508px; width:163px; height:17px;-moz-box-sizing:border-box;box-sizing:border-box; overflow:hidden;"> <p class="Body-P"><span class="Body-C">Other Links</span></p> </div> <div style="position:absolute; left:885px; top:770px; width:249px; height:26px;"> <img src="wpimages/wpca1bb5d6.png" width="249" height="26" border="0" id="qs_6" name="qs_6" title="" alt="" onload="OnLoadPngFix()"></div> <div id="txt_2" style="position:absolute; left:891px; top:773px; width:90px; height:21px;-moz-box-sizing:border-box;box-sizing:border-box; overflow:hidden;"> <p class="Body-P"><span class="Body-C0">Approved By</span></p> </div> <div style="position:absolute; left:883px; top:997px; width:251px; height:32px;"> <img src="wpimages/wpe4dd5c15.png" width="251" height="32" border="0" id="pic_9" name="pic_9" title="" alt="" onload="OnLoadPngFix()"></div> <div id="vid_1" style="position:absolute; left:898px; top:1061px; width:212px; height:128px;"> <script type="text/javascript"> <!-- var hasReqestedVersion = DetectFlashVer(8, 0, 0); if (hasReqestedVersion) { AC_FL_RunContent( "src", "wpimages/gallery", "base", "wpimages", "play", "true", "loop", "true", "width", "212", "height", "128", "salign", "C", "scale", "ShowAll", "id", "vid_1", "quality", "High", "wmode", "transparent", "name", "vid_1", "type", "application/x-shockwave-flash", 'codebase', 'http://fpdownload.macromedia.com/get/flashplayer/current/swflash.cab', "pluginspage", "http://www.macromedia.com/go/getflashplayer" ); } else { var alternateContent = 'An old version of the Flash plugin was detected. <strong><a href="http://www.macromedia.com/go/getflash/">Please upgrade your Flash plugin.<\/a><\/strong>'; document.write(alternateContent); } --> </script> </div> <div style="position:absolute; left:896px; top:1058px; width:215px; height:131px;"> <map id="map0" name="map0"> <area shape="poly" coords="215,3,213,3,213,129,3,129,3,131,215,131" href="photogallery.html" alt=""> <area shape="rect" coords="1,2,213,130" href="photogallery.html" alt=""> </map> <img src="wpimages/wpf85a64b1.png" width="215" height="131" border="0" id="qs_3" name="qs_3" title="" alt="" onload="OnLoadPngFix()" usemap="#map0"></div> <div id="layer" style="position:absolute; left:890px; top:808px; width:234px; height:106px;"> <div class="Body-P11"> <span class="Body-C71"><img src="wpimages/Converted 2.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Hyperlink-C">Pharmacy Council of India (PCI)<br> </span></div> <div class="Body-P11"> <span class="Body-C71"><img src="wpimages/Converted 2.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Hyperlink-C">AICTE (New Delhi)<br> </span></div> <div class="Body-P11"> <span class="Body-C71"><img src="wpimages/Converted 2.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Hyperlink-C">Punjab Technical University (PTU), Jalandhar <br> </span></div> <div class="Body-P11"> <span class="Body-C71"><img src="wpimages/Converted 2.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Hyperlink-C">PSBTE & IT, Chandigarh </span></div> </div> <div id="txt_6_C01" style="position:absolute; left:890px; top:541px; width:234px; height:181px;"> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="seminar.html" style="color:#000000;text-decoration:none;">Important Links</a><br> </span></div> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="alumni.html" style="color:#000000;text-decoration:none;">Alumini</a><br> </span></div> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="alumnimembers.html" style="color:#000000;text-decoration:none;">Alumini Members</a><br> </span></div> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="sbs-media.html" style="color:#000000;text-decoration:none;">Press Release</a><br> </span></div> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="howtoreach.html" style="color:#000000;text-decoration:none;">How To Reach Us</a><br> </span></div> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="mandatory-disclosure.doc" style="color:#000000;text-decoration:none;">Mandatory Disclosure</a><br> </span></div> <div class="Body-P11"> <span class="Body-C5"><img src="wpimages/wp760c1595.png" width="14" height="12" border="0" onload="OnLoadPngFix()" title="" alt="" style="float:left; margin:4px 6px 6px 0px"></span><span class="Body-C11"><a href="registration_form.html" style="color:#000000;text-decoration:none;">Admission Form</a></span></div> </div> <div style="position:absolute; left:266px; top:498px; width:58px; height:16px;"> <img src="wpimages/Converted 1.png" width="58" height="16" border="0" id="pic_18" name="pic_18" title="" alt="" onload="OnLoadPngFix()"></div> <div style="position:absolute; left:167px; top:490px; width:150px; height:30px;"> <img src="wpimages/h-admission.png" width="150" height="30" border="0" id="pic_23" name="pic_23" title="" alt="" onload="OnLoadPngFix()"></div> <div style="position:absolute; left:137px; top:497px; width:25px; height:20px;"> <img src="wpimages/courses.png" width="25" height="20" border="0" id="pic_24" name="pic_24" title="" alt="" onload="OnLoadPngFix()"></div> <div id="txt_1" style="position:absolute; left:164px; top:545px; width:685px; height:1026px;-moz-box-sizing:border-box;box-sizing:border-box; overflow:hidden;"> <table border="0" cellpadding="3" cellspacing="0" width="100%"> <tbody> <form method="post" action="registration_form1.asp" name="f" onSubmit="return validate()"> <tr> <td align="right" height="30"><div align="left" class="style1">Academic Information: </div></td> <td align="left" valign="center"> </td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Course Applied For: </font></div></td> <td align="left" valign="center"><select name="Course"> <option selected>Ph.D</option> <option>M.Pharm</option> <option>B. Pharm</option> <option>D. Pharm</option> </select></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Entrance Test Roll No: </font></div></td> <td align="left" valign="center"><font size="+0"> <input type="text" name="E_rollno" size="40"> </font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Entrance Test Rank: </font></div></td> <td align="left" valign="center"><font size="+0"> <input type="text" name="E_rank" size="40"> </font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Entrance Test Score: </font></div></td> <td align="left" valign="center"><font size="+0"> <input type="text" name="E_score" size="40"> </font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Category: </font></div></td> <td align="left" valign="center"><label> <select name="Category"> <option selected>GEN</option> <option>SC</option> <option>ST</option> <option>OBC</option> <option>OTHERS</option> </select> </label></td> </tr> <tr> <td height="30" colspan="2" align="right"> </td> </tr> <tr> <td height="30" colspan="2" align="right"><div align="center" class="style1"> <div align="left">Personal Information: </div> </div></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"> Name: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="Name" size="40"> </font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"> Father's Name: </font></div></td> <td align="left" valign="center"><font size="+0"> <input type="text" name="Fname" size="40"> </font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Mother's Name:</font></div></td> <td align="left" valign="center"><font size="+0"> <input type="text" name="Mname" size="40"> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Date of Birth: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <select name="dob_month" class="formfield"> <option value="0" selected="selected">Month....</option> <option value="1">January</option> <option value="2">February</option> <option value="3">March</option> <option value="4">April</option> <option value="5">May</option> <option value="6">June</option> <option value="7">July</option> <option value="8">August</option> <option value="9">September</option> <option value="10">October</option> <option value="11">November</option> <option value="12">December</option> </select> <select name="dob_day" class="formfield"> <option value="0" selected="selected">Day....</option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> <option value="13">13</option> <option value="14">14</option> <option value="15">15</option> <option value="16">16</option> <option value="17">17</option> <option value="18">18</option> <option value="19">19</option> <option value="20">20</option> <option value="21">21</option> <option value="22">22</option> <option value="23">23</option> <option value="24">24</option> <option value="25">25</option> <option value="26">26</option> <option value="27">27</option> <option value="28">28</option> <option value="29">29</option> <option value="30">30</option> <option value="31">31</option> </select> <select name="dob_year" class="formfield"> <option value="0" selected="selected">Year....</option> <option value="2003">2003</option> <option value="2002">2002</option> <option value="2001">2001</option> <option value="2000">2000</option> <option value="1999">1999</option> <option value="1998">1998</option> <option value="1997">1997</option> <option value="1996">1996</option> <option value="1995">1995</option> <option value="1994">1994</option> <option value="1993">1993</option> <option value="1992">1992</option> <option value="1991">1991</option> <option value="1990">1990</option> <option value="1989">1989</option> <option value="1988">1988</option> <option value="1987">1987</option> <option value="1986">1986</option> <option value="1985">1985</option> <option value="1984">1984</option> <option value="1983">1983</option> <option value="1982">1982</option> <option value="1981">1981</option> <option value="1980">1980</option> <option value="1979">1979</option> <option value="1978">1978</option> <option value="1977">1977</option> <option value="1976">1976</option> <option value="1975">1975</option> <option value="1974">1974</option> <option value="1973">1973</option> <option value="1972">1972</option> <option value="1971">1971</option> <option value="1970">1970</option> <option value="1969">1969</option> <option value="1968">1968</option> <option value="1967">1967</option> <option value="1966">1966</option> <option value="1965">1965</option> <option value="1964">1964</option> <option value="1963">1963</option> <option value="1962">1962</option> <option value="1961">1961</option> <option value="1960">1960</option> <option value="1959">1959</option> <option value="1958">1958</option> <option value="1957">1957</option> <option value="1956">1956</option> <option value="1955">1955</option> <option value="1954">1954</option> <option value="1953">1953</option> <option value="1952">1952</option> <option value="1951">1951</option> <option value="1950">1950</option> <option value="1949">1949</option> <option value="1948">1948</option> <option value="1947">1947</option> <option value="1946">1946</option> <option value="1945">1945</option> <option value="1944">1944</option> <option value="1943">1943</option> <option value="1942">1942</option> <option value="1941">1941</option> <option value="1940">1940</option> <option value="1939">1939</option> <option value="1938">1938</option> <option value="1937">1937</option> <option value="1936">1936</option> <option value="1935">1935</option> <option value="1934">1934</option> <option value="1933">1933</option> <option value="1932">1932</option> <option value="1931">1931</option> <option value="1930">1930</option> <option value="1929">1929</option> <option value="1928">1928</option> <option value="1927">1927</option> <option value="1926">1926</option> <option value="1925">1925</option> <option value="1924">1924</option> <option value="1923">1923</option> <option value="1922">1922</option> <option value="1921">1921</option> <option value="1920">1920</option> <option value="1919">1919</option> <option value="1918">1918</option> <option value="1917">1917</option> <option value="1916">1916</option> <option value="1915">1915</option> <option value="1914">1914</option> <option value="1913">1913</option> <option value="1912">1912</option> <option value="1911">1911</option> <option value="1910">1910</option> <option value="1909">1909</option> <option value="1908">1908</option> <option value="1907">1907</option> <option value="1906">1906</option> <option value="1905">1905</option> <option value="1904">1904</option> <option value="1903">1903</option> <option value="1902">1902</option> <option value="1901">1901</option> <option value="1900">1900</option> <option value="1899">1899</option> <option value="1898">1898</option> <option value="1897">1897</option> <option value="1896">1896</option> <option value="1895">1895</option> <option value="1894">1894</option> <option value="1893">1893</option> </select> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Gender: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="radio" name="gender" value="m" checked="checked" /> <font size="2" face="Verdana, Arial, Helvetica, sans-serif">Male</font><font size="+0"> <input type="radio" name="gender" value="f" /> <font face="Verdana, Arial, Helvetica, sans-serif" size="2">Female</font></font></font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Blood Group :</font></div></td> <td align="left" valign="center"><input type="text" name="B_group" size="8"></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Father's Occupation :</font></div></td> <td align="left" valign="center"><select name="Occupation"> <option selected>Service</option> <option>Business</option> <option>Others</option> </select></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Address: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <textarea name="Address" cols="30" rows="3" class="formfield"></textarea> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>City: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="City" size="30" class="formfield" /> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>State: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="State" size="30" class="formfield" /> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Country: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <select name="Country" size="1" class="formfield"> <option value="Australia">Australia</option> <option value="Austria">Austria</option> <option value="Bangladesh">Bangladesh</option> <option value="Barbados">Barbados</option> <option value="Behrain">Behrain</option> <option value="Belgium">Belgium</option> <option value="Brazil">Brazil</option> <option value="Canada">Canada</option> <option value="China">China</option> <option value="Denmark">Denmark</option> <option value="Egypt">Egypt</option> <option value="Figi">Figi</option> <option value="Finland">Finland</option> <option value="France">France</option> <option value="Germany">Germany</option> <option value="Guyana">Guyana</option> <option value="Hongkong">Hongkong</option> <option value="India" selected="selected">India</option> <option value="Indonesia">Indonesia</option> <option value="Iraq">Iraq</option> <option value="Ireland">Ireland</option> <option value="Israel">Israel</option> <option value="Italy">Italy</option> <option value="Japan">Japan</option> <option value="Kenya">Kenya</option> <option value="Korea">Korea</option> <option value="Kuwait">Kuwait</option> <option value="Malaysia">Malaysia</option> <option value="Maldives">Maldives</option> <option value="Mauritius">Mauritius</option> <option value="Mexico">Mexico</option> <option value="Nepal">Nepal</option> <option value="Netherlands">Netherlands</option> <option value="Nigeria">Nigeria</option> <option value="Other">Other</option> <option value="Pakistan">Pakistan</option> <option value="Phillipines">Phillipines</option> <option value="Poland">Poland</option> <option value="Saudi Arabia">Saudi Arabia</option> <option value="Seychelles">Seychelles</option> <option value="Singapore">Singapore</option> <option value="South Africa">South Africa</option> <option value="Srilanka">Srilanka</option> <option value="Switzerland">Switzerland</option> <option value="Thailand">Thailand</option> <option value="UAE">UAE</option> <option value="USA">USA</option> <option value="United Kingdom">United Kingdom</option> <option value="Yemen">Yemen</option> </select> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Zip/ Postal Code: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="Zip" size="10" class="formfield" /> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Phone: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="Phone" size="25" class="formfield" /> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Mobile: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="Mobile" size="25" class="formfield" /> </font></td> </tr> <tr> <td align="right" height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Fax: </font></div></td> <td align="left" valign="center" width="67%"><font size="+0"> <input type="text" name="Fax" size="20" class="formfield" /> </font></td> </tr> <tr> <td align="right" height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Email: </font></div></td> <td align="left" valign="center"><font size="+0"> <input type="text" name="Email" size="50" class="formfield" /> </font></td> </tr> <tr> <td height="30"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Educational Qualification:<br> (Starting from Tenth with marks, Board/University <br>and Rank</font>)</div></td> <td align="left" valign="center"><TEXTAREA NAME="Qualification" COLS="40" STYLE="font-family: Verdana; font-size: 8pt; #222222; background-color: #F5F5F5; border: 1 solid #808080" ROWS="5"></TEXTAREA></td> </tr> <tr> <td height="30" width="33%"><div align="left"><font size="2" face="Verdana, Arial, Helvetica, sans-serif"><nobr>Comments: </font></div></td> <td align="left" valign="center" width="67%"><TEXTAREA NAME="Comments" COLS="40" STYLE="font-family: Verdana; font-size: 8pt; #222222; background-color: #F5F5F5; border: 1 solid #808080" ROWS="4"></TEXTAREA></td> </tr> <tr> <td height="30" colspan="2" align="right"> </td> </tr> <tr> <td height="30" colspan="2" align="right"><div align="center"> <input type="submit" name="Submit" value="Submit" /> </div></td></tr></form> <tr> <td colspan="2" align="right"> </td> </tr> </tbody> </table> </div> <div style="position:absolute; left:0px; top:1581px; width:1280px; height:59px;"> <img src="wpimages/footer.jpg" width="1280" height="75" border="0" id="pic_2" name="pic_2" title="" alt=""></div> <div id="txt_11" style="position:absolute; left:140px; top:1590px; width:255px; height:42px;-moz-box-sizing:border-box;box-sizing:border-box; overflow:hidden;"> <p class="Body-P3"><span class="Body-C4">Shaheed Bhagat Singh Polytechnic & Pharmacy College</span></p> <p class="Body-P3"><span class="Body-C4">Chooselwar Morh, Patti -<wbr> 143416(Amritsar)</span></p> </div> <div id="txt_2" style="position: absolute; left: 530px; top: 1585px; width: 216px; height: 72px; -moz-box-sizing: border-box; box-sizing: border-box; overflow: hidden;"> <p class="Body-P4"><span class="Body-C4">Principal -<wbr> +91 9814444618 </span></p> <p class="Body-P4"><span class="Body-C4">Tele Fax -<wbr>01851-245726</span></p> <p class="Body-P4"><span class="Body-C4">E -<wbr> Mail -<wbr> <a href="mailto:info@sbspharmacypatti.org" style="color:#f6f6f6;text-decoration:none;">info@sbspharmacypatti.org</a><br> <a href="mailto:sbscop@rediffmail.com" style="color:#f6f6f6;text-decoration:none;"> sbscop@rediffmail.com</a> </span></p> </div> <div id="txt_3" style="position:absolute; left:941px; top:1602px; width:200px; height:18px;-moz-box-sizing:border-box;box-sizing:border-box; overflow:hidden;"> <p class="Body-P4"><span class="Body-C4">Admission Cell -<wbr> +91 -<wbr>9814403360</span></p> </div> </div> </body> </html>