<div class="ct-site--map ct-u-backgroundGradient">
    <div class="container">
        <div class="ct-u-displayTableVertical text-capitalize">
            <div class="ct-u-displayTableCell">
                <span class="ct-u-textBig">
                    Student's Registration Form
                </span>
            </div>
            <div class="ct-u-displayTableCell text-right">
                <span class="ct-u-textNormal ct-u-textItalic">
                    <a href="index.html">Home</a> / <a href="blog.html">Blog</a>
                </span>
            </div>
        </div>
    </div>
</div>
<section class="ct-u-paddingBoth100 ct-blog" itemscope itemtype="http://schema.org/Blog">
    <div class="container">
        <div class="row">

            <div class="col-md-8">
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Select Program</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <select class="form-control select">
                                <option></option>
                                <option>Option 1</option>
                                <option>Option 2</option>
                                <option>Option 3</option>
                                <option>Option 4</option>
                                <option>Option 5</option>
                            </select>
                        </div>
                        <span class="help-block">Select box example</span>

                    </div>
                </div>
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Applicant Name</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <input type="text" class="form-control"/>
                        </div>
                        <span class="help-block">This is sample of text field</span>

                    </div>
                </div>
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Father's Name</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <input type="text" class="form-control"/>
                        </div>
                        <span class="help-block">This is sample of text field</span>

                    </div>
                </div>
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Mother's Name</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <input type="text" class="form-control"/>
                        </div>
                        <span class="help-block">This is sample of text field</span>

                    </div>
                </div>
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Present Address</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <input type="text" class="form-control"/>
                        </div>
                        <span class="help-block">This is sample of text field</span>

                    </div>
                </div>
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Permanent Address</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <input type="text" class="form-control"/>
                        </div>
                        <span class="help-block">This is sample of text field</span>

                    </div>
                </div>
                <div class="form-group">
                    <label class="col-md-2 col-xs-12 control-label">Date Of Birth</label>

                    <div class="col-md-10 col-xs-12">
                        <div class="input-group">
                            <span class="input-group-addon"><span class="fa fa-pencil"></span></span>
                            <input type="text" class="form-control datepicker" value="12-02-2012 "/>
                        </div>
                        <span class="help-block">This is sample of text field</span>

                    </div>
                </div>

            </div>
            <?php include('right_sidebar.php'); ?>
        </div>
    </div>
</section>