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Path: /home2/outerorb/emp.outerorbittech.in/onboarding.php
Size: 25.94 KB
Permissions: 0666
<?php
require __DIR__ . '/includes/helpers.php';
$flash = flash();
$errors = $flash['errors'] ?? [];
$old = $flash['old'] ?? [];
$documentFields = [
'tenth_marksheet' => [
'label' => '10th Marksheet',
'helper' => 'Mandatory. PDF, JPG, or PNG. Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
'required' => true,
],
'twelfth_marksheet' => [
'label' => '12th Marksheet',
'helper' => 'Mandatory. PDF, JPG, or PNG. Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
'required' => true,
],
'aadhaar_front' => [
'label' => 'Aadhaar Front',
'helper' => 'Front side (PDF, JPG, or PNG). Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
],
'aadhaar_back' => [
'label' => 'Aadhaar Back',
'helper' => 'Back side (PDF, JPG, or PNG). Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
],
'pan' => [
'label' => 'PAN Document',
'helper' => 'PDF, JPG, or PNG. Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
],
'qualification' => [
'label' => 'Graduation',
'helper' => 'Optional. PDF, JPG, or PNG. Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
],
'bank_proof' => [
'label' => 'Bank Proof',
'helper' => 'Cancelled cheque or passbook. Max 5 MB.',
'accept' => 'application/pdf,image/jpeg,image/png',
],
'photo' => [
'label' => 'Photo',
'helper' => 'JPG or PNG. Max 3 MB. Passport Size.',
'accept' => 'image/jpeg,image/png',
],
];
$selectedDocs = $old['docs'] ?? []; // default to none selected
$stagedUploads = staged_uploads();
$departments = list_departments();
$designations = list_designations(true);
$maritalStatusOptions = ['Single', 'Married', 'Divorced', 'Widowed', 'Separated'];
$genderOptions = ['Male', 'Female', 'Other', 'Prefer not to say'];
$bloodGroupOptions = ['A+', 'A-', 'B+', 'B-', 'AB+', 'AB-', 'O+', 'O-'];
$qualificationOptions = ['10th Pass', '12th Pass', 'Diploma', "Bachelor's Degree", "Master's Degree", 'PhD', 'Other'];
$maritalStatusChoices = $maritalStatusOptions;
$genderChoices = $genderOptions;
$bloodGroupChoices = $bloodGroupOptions;
$maritalOld = trim((string) ($old['marital_status'] ?? ''));
if ($maritalOld !== '' && !in_array($maritalOld, $maritalStatusChoices, true)) {
$maritalStatusChoices[] = $maritalOld; // preserve previously entered value
}
$genderOld = trim((string) ($old['gender'] ?? ''));
if ($genderOld !== '' && !in_array($genderOld, $genderChoices, true)) {
$genderChoices[] = $genderOld; // preserve previously entered value
}
$bloodOld = trim((string) ($old['blood_group'] ?? ''));
if ($bloodOld !== '' && !in_array($bloodOld, $bloodGroupChoices, true)) {
$bloodGroupChoices[] = $bloodOld; // preserve previously entered value
}
$qualificationChoices = $qualificationOptions;
$qualificationOld = trim((string) ($old['highest_qualification'] ?? ''));
if ($qualificationOld !== '' && !in_array($qualificationOld, $qualificationChoices, true)) {
$qualificationChoices[] = $qualificationOld; // preserve previously entered value
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=device-width, initial-scale=1.0" />
<title>Outer Orbit Technologies — Employee Onboarding</title>
<link rel="stylesheet" href="assets/css/style.css?v=<?php echo filemtime(__DIR__ . '/assets/css/style.css'); ?>" />
<link rel="stylesheet" href="assets/css/polish.css?v=<?php echo filemtime(__DIR__ . '/assets/css/polish.css'); ?>" />
</head>
<body>
<div class="container">
<div class="header">
<div class="brand">
<div class="brand-title">
<h1 style="margin:0;">Employee Onboarding Form</h1>
<p class="helper" style="margin:2px 0 0 0;">Complete the form and upload required documents.</p>
</div>
</div>
<div>
<a class="badge" href="upload_request.php" style="margin-right:8px;">Upload Request</a>
<a class="badge" href="index.php">← Back to Login</a>
</div>
</div>
<div class="card">
<?php if ($flash): ?>
<div class="alert <?php echo $flash['type'] === 'error' ? 'alert-error' : 'alert-success'; ?>">
<?php echo htmlspecialchars($flash['message'], ENT_QUOTES, 'UTF-8'); ?>
</div>
<?php endif; ?>
<form id="onboarding-form" action="<?php echo htmlspecialchars(app_url('submit.php?from=onboarding'), ENT_QUOTES, 'UTF-8'); ?>" method="post" enctype="multipart/form-data" novalidate>
<input type="hidden" name="csrf_token" value="<?php echo csrf_token(); ?>" />
<h3 class="section-title">Personal Details</h3>
<div class="form-grid">
<div>
<label for="first_name">Full Name</label>
<input id="first_name" name="first_name" type="text" required class="<?php echo !empty($errors['first_name']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['first_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="first_name"><?php echo htmlspecialchars($errors['first_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="last_name">Father's Name</label>
<input id="last_name" name="last_name" type="text" required class="<?php echo !empty($errors['last_name']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['last_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="last_name"><?php echo htmlspecialchars($errors['last_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="mother_name">Mother's Name</label>
<input id="mother_name" name="mother_name" type="text" required class="<?php echo !empty($errors['mother_name']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['mother_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="mother_name"><?php echo htmlspecialchars($errors['mother_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="email">Email</label>
<input id="email" name="email" type="email" required class="<?php echo !empty($errors['email']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['email'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="email"><?php echo htmlspecialchars($errors['email'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="phone">Contact Number</label>
<input id="phone" name="phone" type="tel" required class="<?php echo !empty($errors['phone']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['phone'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="phone"><?php echo htmlspecialchars($errors['phone'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="emergency_contact_name">Emergency Contact Name</label>
<input id="emergency_contact_name" name="emergency_contact_name" type="text" required class="<?php echo !empty($errors['emergency_contact_name']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['emergency_contact_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="emergency_contact_name"><?php echo htmlspecialchars($errors['emergency_contact_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="emergency_contact_number">Emergency Contact Number</label>
<input id="emergency_contact_number" name="emergency_contact_number" type="tel" required class="<?php echo !empty($errors['emergency_contact_number']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['emergency_contact_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="emergency_contact_number"><?php echo htmlspecialchars($errors['emergency_contact_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="emergency_contact_relation">Relation with Emergency Contact</label>
<select id="emergency_contact_relation" name="emergency_contact_relation" required class="<?php echo !empty($errors['emergency_contact_relation']) ? 'input-invalid' : ''; ?>">
<option value="">Select relation</option>
<?php foreach (['Father','Mother','Brother','Sister','Spouse','Relative','Friend','Other'] as $relation): ?>
<option value="<?php echo htmlspecialchars($relation, ENT_QUOTES, 'UTF-8'); ?>" <?php echo (isset($old['emergency_contact_relation']) && $old['emergency_contact_relation'] === $relation) ? 'selected' : ''; ?>><?php echo htmlspecialchars($relation, ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="emergency_contact_relation"><?php echo htmlspecialchars($errors['emergency_contact_relation'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="dob">Date of Birth</label>
<input id="dob" name="dob" type="date" required class="<?php echo !empty($errors['dob']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['dob'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="dob"><?php echo htmlspecialchars($errors['dob'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="date_of_joining">Date of Joining</label>
<input id="date_of_joining" name="date_of_joining" type="date" required class="<?php echo !empty($errors['date_of_joining']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['date_of_joining'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="date_of_joining"><?php echo htmlspecialchars($errors['date_of_joining'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="pan_number">PAN Number</label>
<input id="pan_number" name="pan_number" type="text" required class="<?php echo !empty($errors['pan_number']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['pan_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="pan_number"><?php echo htmlspecialchars($errors['pan_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="aadhaar_number">UIDAI / Aadhaar Number</label>
<input id="aadhaar_number" name="aadhaar_number" type="text" required class="<?php echo !empty($errors['aadhaar_number']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['aadhaar_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="aadhaar_number"><?php echo htmlspecialchars($errors['aadhaar_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="highest_qualification">Highest Qualification</label>
<select id="highest_qualification" name="highest_qualification" required class="<?php echo !empty($errors['highest_qualification']) ? 'input-invalid' : ''; ?>">
<option value="">Select qualification</option>
<?php foreach ($qualificationChoices as $qual): ?>
<option value="<?php echo htmlspecialchars($qual, ENT_QUOTES, 'UTF-8'); ?>" <?php echo (isset($old['highest_qualification']) && $old['highest_qualification'] === $qual) ? 'selected' : ''; ?>><?php echo htmlspecialchars($qual, ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="highest_qualification"><?php echo htmlspecialchars($errors['highest_qualification'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="department">Department / Process</label>
<select id="department" name="department" required class="<?php echo !empty($errors['department']) ? 'input-invalid' : ''; ?>">
<option value="">Select department</option>
<?php foreach ($departments as $dept): ?>
<option value="<?php echo htmlspecialchars($dept, ENT_QUOTES, 'UTF-8'); ?>" <?php echo (isset($old['department']) && $old['department'] === $dept) ? 'selected' : ''; ?>><?php echo htmlspecialchars($dept, ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="department"><?php echo htmlspecialchars($errors['department'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
<?php if (empty($departments)): ?>
<p class="helper">No departments configured. Please contact an admin.</p>
<?php endif; ?>
</div>
<div>
<label for="designation_id">Designation</label>
<select id="designation_id" name="designation_id" required class="<?php echo !empty($errors['designation_id']) ? 'input-invalid' : ''; ?>">
<option value="">Select designation</option>
<?php foreach ($designations as $desig): ?>
<option value="<?php echo (int) $desig['id']; ?>" <?php echo (isset($old['designation_id']) && (int) $old['designation_id'] === (int) $desig['id']) ? 'selected' : ''; ?>><?php echo htmlspecialchars($desig['name'], ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="designation_id"><?php echo htmlspecialchars($errors['designation_id'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
<?php if (empty($designations)): ?>
<p class="helper">No designations configured. Please contact an admin.</p>
<?php endif; ?>
</div>
<div>
<label for="marital_status">Marital Status</label>
<select id="marital_status" name="marital_status" required class="<?php echo !empty($errors['marital_status']) ? 'input-invalid' : ''; ?>">
<option value="">Select marital status</option>
<?php foreach ($maritalStatusChoices as $status): ?>
<option value="<?php echo htmlspecialchars($status, ENT_QUOTES, 'UTF-8'); ?>" <?php echo (isset($old['marital_status']) && $old['marital_status'] === $status) ? 'selected' : ''; ?>><?php echo htmlspecialchars($status, ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="marital_status"><?php echo htmlspecialchars($errors['marital_status'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="gender">Gender</label>
<select id="gender" name="gender" required class="<?php echo !empty($errors['gender']) ? 'input-invalid' : ''; ?>">
<option value="">Select gender</option>
<?php foreach ($genderChoices as $gender): ?>
<option value="<?php echo htmlspecialchars($gender, ENT_QUOTES, 'UTF-8'); ?>" <?php echo (isset($old['gender']) && $old['gender'] === $gender) ? 'selected' : ''; ?>><?php echo htmlspecialchars($gender, ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="gender"><?php echo htmlspecialchars($errors['gender'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="identity_mark">Identity Mark</label>
<input id="identity_mark" name="identity_mark" type="text" required class="<?php echo !empty($errors['identity_mark']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['identity_mark'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="identity_mark"><?php echo htmlspecialchars($errors['identity_mark'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="blood_group">Blood Group</label>
<select id="blood_group" name="blood_group" required class="<?php echo !empty($errors['blood_group']) ? 'input-invalid' : ''; ?>">
<option value="">Select blood group</option>
<?php foreach ($bloodGroupChoices as $blood): ?>
<option value="<?php echo htmlspecialchars($blood, ENT_QUOTES, 'UTF-8'); ?>" <?php echo (isset($old['blood_group']) && $old['blood_group'] === $blood) ? 'selected' : ''; ?>><?php echo htmlspecialchars($blood, ENT_QUOTES, 'UTF-8'); ?></option>
<?php endforeach; ?>
</select>
<p class="error" data-error-for="blood_group"><?php echo htmlspecialchars($errors['blood_group'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="address">Present Address</label>
<textarea id="address" name="address" rows="2" required class="<?php echo !empty($errors['address']) ? 'input-invalid' : ''; ?>"><?php echo htmlspecialchars($old['address'] ?? '', ENT_QUOTES, 'UTF-8'); ?></textarea>
<p class="error" data-error-for="address"><?php echo htmlspecialchars($errors['address'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="permanent_address">Permanent Address</label>
<textarea id="permanent_address" name="permanent_address" rows="2" required class="<?php echo !empty($errors['permanent_address']) ? 'input-invalid' : ''; ?>"><?php echo htmlspecialchars($old['permanent_address'] ?? '', ENT_QUOTES, 'UTF-8'); ?></textarea>
<p class="error" data-error-for="permanent_address"><?php echo htmlspecialchars($errors['permanent_address'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="zip">Present ZIP / PIN</label>
<input id="zip" name="zip" type="text" required class="<?php echo !empty($errors['zip']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['zip'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="zip"><?php echo htmlspecialchars($errors['zip'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
</div>
<hr style="margin: 20px 0; border: none; border-top: 1px solid #e5e7eb;" />
<h3 class="section-title">Bank Details</h3>
<div class="form-grid">
<div>
<label for="account_number">Account Number</label>
<input id="account_number" name="account_number" type="text" required class="<?php echo !empty($errors['account_number']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['account_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="account_number"><?php echo htmlspecialchars($errors['account_number'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="ifsc_code">IFSC Code</label>
<input id="ifsc_code" name="ifsc_code" type="text" required class="<?php echo !empty($errors['ifsc_code']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['ifsc_code'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="ifsc_code"><?php echo htmlspecialchars($errors['ifsc_code'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div>
<label for="bank_name">Bank Name</label>
<input id="bank_name" name="bank_name" type="text" required class="<?php echo !empty($errors['bank_name']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['bank_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="bank_name"><?php echo htmlspecialchars($errors['bank_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
</div>
<hr style="margin: 20px 0; border: none; border-top: 1px solid #e5e7eb;" />
<h3 class="section-title">Referral Details</h3>
<div class="form-grid">
<div>
<label for="referred_by">Referred By</label>
<select id="referred_by" name="referred_by" required class="<?php echo !empty($errors['referred_by']) ? 'input-invalid' : ''; ?>">
<option value="">Select an option</option>
<option value="consultancy" <?php echo (isset($old['referred_by']) && $old['referred_by'] === 'consultancy') ? 'selected' : ''; ?>>Consultancy</option>
<option value="person" <?php echo (isset($old['referred_by']) && $old['referred_by'] === 'person') ? 'selected' : ''; ?>>Person</option>
<option value="walkin" <?php echo (isset($old['referred_by']) && $old['referred_by'] === 'walkin') ? 'selected' : ''; ?>>Walk-in (Self)</option>
</select>
<p class="error" data-error-for="referred_by"><?php echo htmlspecialchars($errors['referred_by'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<div data-referral-detail style="display:none;">
<label for="referral_name" data-referral-label>Referral Name</label>
<input id="referral_name" name="referral_name" type="text" class="<?php echo !empty($errors['referral_name']) ? 'input-invalid' : ''; ?>" value="<?php echo htmlspecialchars($old['referral_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?>" />
<p class="error" data-error-for="referral_name"><?php echo htmlspecialchars($errors['referral_name'] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
</div>
<hr style="margin: 20px 0; border: none; border-top: 1px solid #e5e7eb;" />
<h3 class="section-title">Documents</h3>
<p class="helper">Select the documents you can upload now. Unselected documents will be marked as pending.</p>
<div class="form-grid">
<?php foreach ($documentFields as $key => $doc): ?>
<?php $isRequired = !empty($doc['required']); ?>
<?php $checked = $isRequired || in_array($key, $selectedDocs, true); ?>
<?php $hasStaged = !empty($stagedUploads[$key]); ?>
<div class="doc-field">
<label class="doc-checkbox" for="toggle-<?php echo $key; ?>">
<?php if ($isRequired): ?>
<input type="hidden" name="docs[]" value="<?php echo $key; ?>" />
<?php endif; ?>
<input type="checkbox" id="toggle-<?php echo $key; ?>" name="docs[]" value="<?php echo $key; ?>" data-doc-toggle="<?php echo $key; ?>" <?php echo $checked ? 'checked' : ''; ?> <?php echo $isRequired ? 'disabled' : ''; ?> />
<span><?php echo htmlspecialchars($doc['label'], ENT_QUOTES, 'UTF-8'); ?></span>
</label>
<input
id="<?php echo $key; ?>"
name="<?php echo $key; ?>"
type="file"
accept="<?php echo htmlspecialchars($doc['accept'], ENT_QUOTES, 'UTF-8'); ?>"
data-doc-input="<?php echo $key; ?>"
data-has-staged="<?php echo $hasStaged ? '1' : '0'; ?>"
class="<?php echo !empty($errors[$key]) ? 'input-invalid' : ''; ?>"
<?php echo $checked ? '' : 'disabled'; ?>
/>
<p class="helper"><?php echo htmlspecialchars($doc['helper'], ENT_QUOTES, 'UTF-8'); ?><?php echo $isRequired ? ' This document is mandatory.' : ' If unchecked, this document remains pending.'; ?></p>
<?php if ($hasStaged): ?>
<p class="helper" style="color:#059669;">Previously uploaded file will be kept if you do not choose a new one.</p>
<?php endif; ?>
<p class="error" data-error-for="<?php echo $key; ?>"><?php echo htmlspecialchars($errors[$key] ?? '', ENT_QUOTES, 'UTF-8'); ?></p>
</div>
<?php endforeach; ?>
</div>
<div style="margin-top: 18px; display: flex; justify-content: flex-end;">
<button type="submit">Submit Onboarding</button>
</div>
</form>
</div>
</div>
<script src="assets/js/app.js"></script>
</body>
</html>