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<html>
<head>
<title>RTI Application Form</title>
<link rel="stylesheet" href="css/background.css">
<meta charset="utf-8">
<link rel="stylesheet" href="bootstrap/css/bootstrap.min.css">
<script src="bootstrap/jQuery/jquery.min.js"></script>
<script src="bootstrap/js/bootstrap.min.js"></script>
</head>
<body>
<div class="container">
<h2><strong>New RTI</strong></h2>
<h4><strong>Personal Details of RTI Applicant:</strong></h4>
<form action="save_details.php" method="post" class="form-horizontal" name="add_rti" role="form">
<table class="table table-bordered table-condensed">
<tbody>
<tr>
<th>Name of Applicant</th>
<td><input type="text" name="name" pattern="[a-zA-Z ]+" title="Only Alphabets are allowed" required></td>
</tr>
<tr>
<th>Gender </th>
<td>
<input type="radio" name="gender" id="gender" checked="checked" value="Male"> Male   
<input type="radio" name="gender" id="gender" value="Female"> Female   
<input type="radio" name="gender" id="gender" value="Third Gender"> Third Gender
</td>
</tr>
<tr>
<th> Address</th>
<td><input type="text" name="address" id="address1" class="address" required></td>
</tr>
<tr>
<th>Pin code</th>
<td><input type="text" pattern="^\d{6}$" name="pc" minlength="6" maxlength="6" required></td>
</tr>
<!-- Script to change state/country as per user line in India or Other
And to block user editing if user is not Indian -->
<script type="text/javascript">
function test(){
if(document.getElementById('chkstate').value=='India'){
document.getElementById('cngStateName').innerHTML='State';
}
}
function test1(){
if(document.getElementById('chkcountry').value=='Other'){
document.getElementById('cngStateName').innerHTML='Country Name';
}
}
function chkCitizenship(citizenship){
var strCitizenship = citizenship.options[citizenship.selectedIndex].value;
if(strCitizenship == 'Indian'){
document.getElementById('date_of_receipt').disabled=false;
document.getElementById('date_of_receipt_cpio').disabled=false;
document.getElementById('fee_paid').disabled=false;
document.getElementById('fee_not_paid').disabled=false;
document.getElementById('fee_deposit_date').disabled=false;
document.getElementById('pay_mode').disabled=false;
}
else if(strCitizenship == 'Other'){
document.getElementById('date_of_receipt').disabled=true;
document.getElementById('date_of_receipt_cpio').disabled=true;
document.getElementById('fee_paid').disabled=true;
document.getElementById('fee_not_paid').disabled=true;
document.getElementById('fee_deposit_date').disabled=true;
document.getElementById('pay_mode').disabled=true;
}
}
</script>
<tr>
<th>Country</th>
<td>
<input type="radio" name="country" id="chkstate" checked="checked" value="India" onclick="test();"> India   
<input type="radio" name="country" id="chkcountry" value="Other" onclick="test1();"> Other
</td>
</tr>
<tr>
<th><span id="cngStateName">State</span>
<td><span><input type="text" name="state" id="txtCountry" required></span></td>
</tr>
<tr>
<th>Phone Number</th>
<td>
<input type="text" name="phone" id="phone" maxlength="18" pattern="^\d{8}$" class="numeric" value="" required>
<cite>Do not provide STD code eg.23456789</cite>
</td>
</tr>
<tr>
<th>Mobile Number (For receiving SMS alerts)</th>
<td><input type="text" name="mobile" id="cell" maxlength="15" pattern="^\d{10}$" value="" required>
<cite>Provide a 10-digit no.</cite>
</td>
</tr>
<tr>
<th>Email-ID</th>
<td><input type="email" name="email" maxlength="70" value="" id="Email" required></td>
</tr>
<tr>
<th>Citizenship (Only Indian citizens can file RTI Request application)</th>
<td>
<select class="btn" style="background:white; color:black" name="citizenship" id="citizenship" onchange="chkCitizenship(this);" required>
<option value="Indian" id="IndianCitizenship">Indian</option>
<option value="Other" id="OtherCitizenship">Other</option>
</select></td>
</tr>
</tbody>
</table>
<h4><strong>Receipt of RTI Application (Section 7):</strong></h4>
<table class="table table-bordered table-condensed">
<tbody>
<tr>
<th>Date of receipt of RTI application by R & I section of public authority</th>
<th><input name="date_of_receipt" id="date_of_receipt" maxlength="50" value="" class="name" placeholder="YYYY-MM-DD" required></th>
</tr>
<tr>
<th>Date of its receipt by CPIO</th><th><input id="date_of_receipt_cpio" name="date_of_receipt_cio" maxlength="50" value="" class="name" placeholder="YYYY-MM-DD" required></th>
</tr>
</tbody>
</table>
<h4><strong>Fee Payment Details (Rule-3 of RTI regulation of fee and cost rules):</strong></h4>
<table class="table table-bordered table-condensed">
<tbody>
<tr>
<th>Whether fee is enclosed with RTI application</th>
<th>
<input type="radio" value="yes" checked="checked" name="fee" id="fee_paid" required> Yes  
<input type="radio" value="no" name="fee" id="fee_not_paid" required> No
</th>
</tr>
<tr>
<th>Date of depositing fee</th>
<th><input id="fee_deposit_date" name="fee_deposit_date" maxlength="50" placeholder="YYYY-MM-DD" required></th>
</tr>
<tr>
<th>Mode of payment(cheque/DD/cash/IPO)</th>
<th><input type="text" id="pay_mode" name="pay_mode" maxlength="50" required></th>
</tr>
</tbody>
</table>
<input type="submit" name="add" value="Add Queries" class="btn" onclick="return validateDate()">  
<input type="submit" name="submit" value="Save and Exit" class="btn" onclick="return validateDate()">
<!-- Script to validate dates in form id user have entered them correctly -->
<script type="text/javascript">
function validateDate(){
var bool1 = validatedate1(document.add_rti.date_of_receipt);
var bool2, bool3;
if(bool1 == true){
bool2 = validatedate2(document.add_rti.date_of_receipt_cio);
if(bool2 == true){
bool3 = validatedate3(document.add_rti.fee_deposit_date);
}
}
if(bool1 == false || bool2 == false || bool3 == false){
return false;
}
}
</script>
<script src="date_validation_add_rti.js"></script>
</form>
</div>
</body>
</html>