<?php
date_default_timezone_set('Asia/Jakarta');
 $tgl_time = date("Y-m-d h:i:sa");
 
function url()
{
return sprintf(
"%s://%s%s",
isset($_SERVER['HTTPS']) && $_SERVER['HTTPS'] != 'off' ? 'https' : 'http',
$_SERVER['SERVER_NAME'],
$_SERVER['REQUEST_URI']
);
}
?>
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		<meta name="Description" content="Sarjana, D3, S2, K2 (Program Perkuliahan Karyawan) (Kuliah Online), Institut Terkemuka, Z Selamat Datang. Sarjana, D3, S2 K2 (Program Perkuliahan Karyawan) (Kuliah Online) Institut Terkemuka, www.kuliahkaryawan.net Bekasi sekolah tinggi teknologi bina tunggal bekasi bl, luang untuk berlibur istirahat dsb dosen tenaga pengajar. Diri dengan perubahan perubahan menyadari bahwa, saksama pada bidang yg sebagaimana bidang kepakarannya. Ke s1 fe mh thamrin jakarta rp 150 000 melanjutkan." />
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		<title>Pendaftaran Mahasiswa Baru - Universitas  Darul Ulum Islamic Cemtre Sudirman (Kelas Karyawan)</title>
	
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	<style>
		@import url("https://fonts.googleapis.com/css?family=Poppins:200i,400&display=swap");
		*,
		*::before,
		*::after {
			box-sizing: border-box;
		}
		body {
			font-family: "Poppins", sans-serif;
			font-size: 1rem;
			font-weight: 400;
			line-height: 1.5;
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		button {
			border: none;
			border: 1px solid #868686;
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		.container {
			width: 83%;
			margin: 3.125rem auto 0 auto;
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			.container {
				max-width: 540px;
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				max-width: 720px;
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			font-size: 0.9rem;
			color: #c2c2c2;
		}

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			text-align: center;
		}

		/* form */

		form {
			background: #fff;
			padding: 2.5rem 0.625rem;
			border-radius: 0.25rem;
		}

		@media (min-width: 480px) {
			form {
				padding: 2.5rem;
			}
		}

		.form-group {
			margin: 0 auto 1.25rem auto;
			padding: 0.25rem;
		}

		.form-control {
			display: block;
			width: 100%;
			height: 2.4rem;
			padding: 0.375rem 0.75rem;
			color: #91918f;
			background-color: #e4e3ea;
			background-clip: padding-box;
			border: 0;
			border-radius: 0.25rem;
			transition: border 0.8s ease-in-out;
		}

		.form-control:focus {
			border: 1px solid #868686;
			outline: 0;
		}

		.input-radio,
		.input-checkbox {
			display: inline-block;
			margin-right: 0.6rem;
			min-height: 1.5rem;
			min-width: 1.25rem;
		}

		.input-textarea {
			min-height: 120px;
			width: 100%;
			padding: 0.625rem;
			resize: vertical;
			border: 0;
			border: 1px solid #868686;
			outline: none;
		}

		.submit-button {
			display: block;
			width: 100%;
			padding: 0.75rem;
			background: #e7e7e7;
			color: inherit;
			border-radius: 2px;
			cursor: pointer;
		}
		
		   /* already defined in bootstrap4 */
	    .text-xs-center {
	        text-align: center;
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	    .g-recaptcha {
	        display: inline-block;
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	</style>
	<body>
		<div class="container">
			<header class="header">
				<h1 id="title" class="text-center">Form Pendaftaran Online</h1>
				
			</header>
			<form  method="POST" action="proses-pendaftaran.php">
			    
                <div class="form-group">
                <input
                type="text"
                name="nama_kampus"
                value="<?= url() ?>"
                class="form-control"
                readonly
                />
                </div>
						<div class="form-group">
					<label id="number-label" for="email"
						>Pilih Jurusan<span style="color: #ff0000">*</span></label
					>
				<select class="form-control" name=jurusan required>
				     <option >-- Pilih Jurusan --</option>
				    <option value="S1 Hukum">S1 Hukum</option>
				    <option value="S1 Teknik Sipil">S1 Teknik Sipil</option>
				    <option value="S1 PGSD">S1 PGSD</option>
				    <option value="S1 Peternakan">S1 Peternakan</option>
				    <option value="S1 Manajemen">S1 Manajemen</option>
				    <option value="S1 Pendidikan Agama Islam">S1 Pendidikan Agama Islam</option>
				    <option value="S1 Pendidikan Pancasila dan Kewarganegaraan">S1  Pendidikan Pancasila dan Kewarganegaraan</option>    
				</select>
				</div>
				
				
				<div class="form-group">
					<label id="name-label" for="name"
						>Nama Lengkap
						<span style="color: #ff0000">*</span></label
					>
					<input
						type="text"
						name="nama"
						id="name"
						class="form-control"
						placeholder="Nama Sesuai KTP"
						required
					/>
				</div>
				<div class="form-group">
					<p>Jenis Kelamin</p>
					<label>
						<input
							name="jk"
							value="laki-laki"
							type="radio"
							class="input-radio"
							checked
						/>Laki-laki</label
					>
					<label>
						<input
							name="jk"
							value="perempuan"
							type="radio"
							class="input-radio"
						/>Perempuan</label
					>
				</div>
			
				<div class="form-group">
					<label id="number-label" for="number"
						>Alamat<span style="color: #ff0000">*</span></label
					>
					<input
						type="text"
						name="alamat"
						id="number"
					
						class="form-control"
						placeholder="Sesuai KTP"
					/>
				</div>
				<div class="form-group">
					<label id="number-label" for="number"
						>Tempat Lahir<span style="color: #ff0000"
							>*</span
						></label
					>
					<input
						type="text"
						name="tempat_lahir"
						id="number"
						
						class="form-control"
						placeholder=""
					/>
				</div>
				<div class="form-group">
					<label id="number-label" for="number"
						>Tanggal Lahir<span style="color: #ff0000"
							>*</span
						></label
					>
					<input
						type="date"
						name="tanggal_lahir"
						id="number"
						
						class="form-control"
						placeholder=""
					/>
				</div>
			
				<div class="form-group">
					<label id="number-label" for="no_war"
						>Nomor WhatsApp/HP<span style="color: #ff0000"
							>*</span
						></label
					>
					<input
						type="number"
						name="no_wa"
						class="form-control"
						placeholder=""
						required
					/>
				</div>
				<div class="form-group">
					<label id="number-label" for="email"
						>Email<span style="color: #ff0000">*</span></label
					>
					<input
						type="email"
						name="email"
					
						class="form-control"
						placeholder="Email"
					/>
				</div>
		
			
				<div class="form-group">
					<p>Lulusan<span style="color: #ff0000">*</span></p>
					<select
						id="dropdown"
						name="lulusan"
						class="form-control"
						required
					>
						<option disabled selected value>
							-- Pilih Lulusan --
						</option>
						<option value="SMA/MA/SMK/Sederajat">SMA/MA/SMK/Sederajat</option>
						<option value="D3/Sederajat">D3/Sederajat</option>
						<option value="Paket C">Paket C</option>
						<option value="S1/D4/Sederajat">S1/D4/Sederajat</option>
					</select>
				</div>
					<input
						type="hidden"
						name="tgl_daftar"
						value="<?= $tgl_time?>"
					
					
					/>
					<div class="form-group col-sm-12 text-center">
					    
					<div class="g-recaptcha" data-sitekey="6LeE46wpAAAAAHanwMbD6sljQVK9l20LmL1f9t8v"></div>
					</div>
				
				
				<div class="form-group">
				<button type="submit" name="daftar" value="daftar" class="submit-button" />Daftar</button>
				</div>
			</form>
		</div>
	</body>
</html>
