apt.oisservices.com
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172.104.43.202
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Submitted URL: http://apt.oisservices.com/
Effective URL: https://apt.oisservices.com/
Submission: On January 31 via manual from IN — Scanned from SG
Effective URL: https://apt.oisservices.com/
Submission: On January 31 via manual from IN — Scanned from SG
Form analysis 1 forms found in the DOM
/api/v1/app/complete
<form action="/api/v1/app/complete" role="form" class="smart-wizard" id="form">
<input type="hidden" name="_token" value="s7ITkqsi5erkxKpjBeSmIDRmMZzq4BeaNppqbXVT">
<div id="wizard" class="swMain">
<ul class="anchor">
<li>
<a href="#step-1" class="selected" isdone="1" rel="1">
<div class="stepNumber">1</div>
<span class="stepDesc"><small>Appointment Type </small></span>
</a>
</li>
<li>
<a href="#step-2" class="disabled" isdone="0" rel="2">
<div class="stepNumber">2</div>
<span class="stepDesc"><small>Appointment Slot </small></span>
</a>
</li>
<li>
<a href="#step-3" class="disabled" isdone="0" rel="3">
<div class="stepNumber">3</div>
<span class="stepDesc"><small>Applicant Data </small></span>
</a>
</li>
<li>
<a href="#step-4" class="disabled" isdone="0" rel="4">
<div class="stepNumber">4</div>
<span class="stepDesc"><small>Complete </small></span>
</a>
</li>
</ul>
<div class="stepContainer" style="height: 312px;">
<div id="step-1" class="content" style="display: block;">
<div class="row">
<div class="col-md-5">
<div class="padding-30 text-center">
<h2 class="StepTitle"><i class="ti-face-smile fa-2x text-primary block margin-bottom-10"></i>Please select appointment type</h2>
<div style="margin-left: 35px; text-align: left">
<p><strong>1:</strong> Please select appointment type (Visa, BVN etc.) </p>
<p><strong>2:</strong> Select the OIS center you wish to book appointment with.</p>
</div>
</div>
</div>
<div class="col-md-7" id="st">
<fieldset>
<legend style="font-family: Raleway, sans-serif;">Appointment type</legend>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>Please select appointment type <span class="symbol required"></span></label>
<select class="form-control" name="service_id" id="service_id">
<option value=""></option>
<option value="1">Visa Services</option>
<option value="2">BVN Enrolment</option>
<option value="3">Passport Services</option>
<option value="4">Premium Lounge (DLA)</option>
<option value="5">NIN Enrollment</option>
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>Please select the OIS center you wish to book appointment with <span class="symbol required"></span></label>
<select class="form-control" name="center_id" id="center">
<option value=""></option>
</select>
<input type="hidden" name="web_id">
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<p> </p>
</div>
</div>
</fieldset>
<div class="form-group">
<button class="btn btn-primary btn-o next-step btn-wide pull-right"> Next <i class="fa fa-arrow-circle-right"></i>
</button>
</div>
</div>
</div>
</div>
<div id="step-2" class="content" style="display: none;">
<div class="row">
<div class="col-md-5">
<div class="padding-30 text-center">
<h2 class="StepTitle"><i class="ti-face-smile fa-2x text-primary block margin-bottom-10"></i>Please select your appointment slot</h2>
<div style="margin-left: 35px; text-align: left">
<p><strong>1:</strong> Pick a date from the calendar. Please note that days striked (e.g <span class="disabled">12</span>) are not available for appointment booking.</p>
<p><strong>2:</strong> Pick a slot from the available timeslots</p>
<p><strong>3:</strong> If visa service, please select visa type and processing time</p>
</div>
</div>
</div>
<div class="col-md-7" id="fc">
<fieldset>
<legend style="font-family: Raleway, sans-serif;">Appointment slot</legend>
<div class="row">
<div class="col-md-4">
<div id="calendar" class="datepicker" style="padding: 0; margin: 0;">
<div class="datepicker datepicker-inline" style="display: block;">
<div class="datepicker-days" style="display: block;">
<table class=" table-condensed">
<thead>
<tr>
<th class="prev" style="visibility: hidden;">«</th>
<th colspan="5" class="datepicker-switch">February 2024</th>
<th class="next" style="visibility: visible;">»</th>
</tr>
<tr>
<th class="dow">Su</th>
<th class="dow">Mo</th>
<th class="dow">Tu</th>
<th class="dow">We</th>
<th class="dow">Th</th>
<th class="dow">Fr</th>
<th class="dow">Sa</th>
</tr>
</thead>
<tbody>
<tr>
<td class="old disabled day">28</td>
<td class="old disabled day">29</td>
<td class="old disabled day">30</td>
<td class="old today disabled day">31</td>
<td class="day">1</td>
<td class="day">2</td>
<td class="day">3</td>
</tr>
<tr>
<td class="day">4</td>
<td class="day">5</td>
<td class="day">6</td>
<td class="day">7</td>
<td class="day">8</td>
<td class="day">9</td>
<td class="day">10</td>
</tr>
<tr>
<td class="day">11</td>
<td class="day">12</td>
<td class="day">13</td>
<td class="day">14</td>
<td class="day">15</td>
<td class="day">16</td>
<td class="day">17</td>
</tr>
<tr>
<td class="day">18</td>
<td class="day">19</td>
<td class="day">20</td>
<td class="day">21</td>
<td class="day">22</td>
<td class="day">23</td>
<td class="day">24</td>
</tr>
<tr>
<td class="day">25</td>
<td class="day">26</td>
<td class="day">27</td>
<td class="day">28</td>
<td class="day">29</td>
<td class="new day">1</td>
<td class="new day">2</td>
</tr>
<tr>
<td class="new day">3</td>
<td class="new day">4</td>
<td class="new day">5</td>
<td class="new day">6</td>
<td class="new day">7</td>
<td class="new day">8</td>
<td class="new day">9</td>
</tr>
</tbody>
<tfoot>
<tr>
<th colspan="7" class="today" style="display: none;">Today</th>
</tr>
<tr>
<th colspan="7" class="clear" style="display: none;">Clear</th>
</tr>
</tfoot>
</table>
</div>
<div class="datepicker-months" style="display: none;">
<table class="table-condensed">
<thead>
<tr>
<th class="prev" style="visibility: hidden;">«</th>
<th colspan="5" class="datepicker-switch">2024</th>
<th class="next" style="visibility: visible;">»</th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="7"><span class="month disabled">Jan</span><span class="month">Feb</span><span class="month">Mar</span><span class="month">Apr</span><span class="month">May</span><span class="month">Jun</span><span
class="month">Jul</span><span class="month">Aug</span><span class="month">Sep</span><span class="month">Oct</span><span class="month">Nov</span><span class="month">Dec</span></td>
</tr>
</tbody>
<tfoot>
<tr>
<th colspan="7" class="today" style="display: none;">Today</th>
</tr>
<tr>
<th colspan="7" class="clear" style="display: none;">Clear</th>
</tr>
</tfoot>
</table>
</div>
<div class="datepicker-years" style="display: none;">
<table class="table-condensed">
<thead>
<tr>
<th class="prev" style="visibility: hidden;">«</th>
<th colspan="5" class="datepicker-switch">2020-2029</th>
<th class="next" style="visibility: visible;">»</th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="7"><span class="year old disabled">2019</span><span class="year disabled">2020</span><span class="year disabled">2021</span><span class="year disabled">2022</span><span class="year disabled">2023</span><span
class="year">2024</span><span class="year">2025</span><span class="year">2026</span><span class="year">2027</span><span class="year">2028</span><span class="year">2029</span><span class="year new">2030</span></td>
</tr>
</tbody>
<tfoot>
<tr>
<th colspan="7" class="today" style="display: none;">Today</th>
</tr>
<tr>
<th colspan="7" class="clear" style="display: none;">Clear</th>
</tr>
</tfoot>
</table>
</div>
</div>
</div>
<input type="hidden" id="action" name="action" value="action">
<input type="hidden" id="tz" name="tz">
<div class="form-group">
<input type="text" readonly="true" required="" placeholder="No date selected yet" id="selectedDate" class="form-control" style="background-color: #FFF; margin-left: 10px; margin-top: 5px; width: 215px;" name="slot_date">
</div>
</div>
<div class="col-md-1"> </div>
<div class="col-md-7">
<div class="row">
<div class="col-md-12">
<div class="form-group"><br>
<label>Select the session that is comfortable for you <span class="symbol required"></span></label>
<select class="form-control" name="slot_time" id="session"></select>
</div>
</div>
</div>
<div class="row" id="atype" style="display: none;">
<div class="col-md-12">
<div class="form-group">
<label>Select the visa type</label>
<select class="form-control" name="apptype" id="apptype">
<option value=""></option>
</select>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label>Select the processing time</label>
<select class="form-control" name="servicetype" id="servicetype">
<option value=""></option>
</select>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<div class="form-group">
<button class="btn btn-primary btn-o back-step btn-wide pull-left">
<i class="fa fa-circle-arrow-left"></i>Back </button>
<button class="btn btn-primary btn-o next-step btn-wide pull-right"> Next <i class="fa fa-arrow-circle-right"></i>
</button>
</div>
</div>
</div>
</div>
<div id="step-3" class="content" style="display: none;">
<div class="row">
<div class="col-md-5">
<div class="padding-30">
<h2 class="StepTitle text-center"><i class="ti-face-smile fa-2x text-primary block margin-bottom-10"></i>Please enter your personal information</h2>
<p style="margin-left: 15px;"> Please provide us with your personal details including </p>
<ul style="margin-left: 20px;">
<li>Title, first, middle, and last name</li>
<li>Passport number, Gender, phone (e.g +4412345678)</li>
<li>Date of birth, email and nationality</li>
</ul>
</div>
</div>
<div class="col-md-7">
<fieldset>
<legend style="font-family: Raleway, sans-serif;">Personal Information</legend>
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label">Title <span class="symbol required"></span></label>
<select class="form-control" name="title" id="title">
<option value="Mr">Mr</option>
<option value="Mrs">Mrs</option>
<option value="Ms">Ms</option>
<option value="Miss">Miss</option>
</select>
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<label class="control-label"> First Name <span class="symbol required"></span>
</label>
<input type="text" placeholder="Enter your First Name" id="firstName" class="form-control" name="fname">
</div>
</div>
</div>
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="block"> Gender <span class="symbol required"></span>
</label>
<div class="clip-radio radio-primary">
<input type="radio" id="wz-female" name="gender" value="F">
<label for="wz-female"> Female </label>
<input type="radio" id="wz-male" name="gender" value="M" checked="checked">
<label for="wz-male"> Male </label>
</div>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label class="control-label">Middle Name</label>
<input type="text" placeholder="Enter your Middle Name" class="form-control" name="mname" id="middleName">
</div>
</div>
<div class="col-md-5">
<div class="form-group">
<label class="control-label"> Last Name <span class="symbol required"></span>
</label>
<input type="text" placeholder="Enter your Last Name" class="form-control" name="lname" id="lastName">
</div>
</div>
</div>
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label">Passport Number <span class="symbol required"></span></label>
<input type="text" maxlength="9" placeholder="Enter Passport Number" class="form-control" name="pno" id="pno" onkeypress="return alphanumericOnly(event)" onautocomplete="return alphanumericOnly(event)">
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<label class="control-label"> Nationality <span class="symbol required"></span>
</label><!--cs-select cs-skin-slide-->
<select class="form-control" name="nationality" id="nationality">
<option value=""></option>
<option value="Afghanistan">Afghanistan</option>
<option value="Åland Islands">Åland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia, Plurinational State of">Bolivia, Plurinational State of</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, the Democratic Republic of the">Congo, the Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, the former Yugoslav Republic of">Macedonia, the former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Réunion">Réunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French part)">Saint Martin (French part)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch part)">Sint Maarten (Dutch part)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela, Bolivarian Republic of">Venezuela, Bolivarian Republic of</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</div>
</div>
<!--<div class="col-md-4">
<div class="form-group">
<label class="control-label">
Other Nationality <span class="symbol required"></span>
</label>
<select class="cs-select cs-skin-slide" name="other_nationality">
<option value=""></option>
<option value="Afghanistan">Afghanistan</option>
<option value="Åland Islands">Åland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia, Plurinational State of">Bolivia, Plurinational State of</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, the Democratic Republic of the">Congo, the Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, the former Yugoslav Republic of">Macedonia, the former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Réunion">Réunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French part)">Saint Martin (French part)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch part)">Sint Maarten (Dutch part)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela, Bolivarian Republic of">Venezuela, Bolivarian Republic of</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</div>
</div>-->
</div>
<!--<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="block">
Are your parent Nigerians? <span class="symbol required"></span>
</label>
<div class="clip-radio radio-primary">
<input type="radio" id="wz-yes-are_parents_nigerians" name="are_parents_nigerians" value="Yes">
<label for="wz-yes-are_parents_nigerians">
Yes
</label>
<input type="radio" id="wz-no-are_parents_nigerians" name="are_parents_nigerians" value="No" checked="checked">
<label for="wz-no-are_parents_nigerians">
No
</label>
</div>
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<label class="control-label">
Parent's Nationality <span class="symbol required"></span>
</label>
<select class="cs-select cs-skin-slide" name="parents_nationality">
<option value=""></option>
<option value="Afghanistan">Afghanistan</option>
<option value="Åland Islands">Åland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia, Plurinational State of">Bolivia, Plurinational State of</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, the Democratic Republic of the">Congo, the Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, the former Yugoslav Republic of">Macedonia, the former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Réunion">Réunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French part)">Saint Martin (French part)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch part)">Sint Maarten (Dutch part)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela, Bolivarian Republic of">Venezuela, Bolivarian Republic of</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</div>
</div>
</div>-->
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label">Date of Birth <span class="symbol required"></span></label>
<input type="text" class="form-control" placeholder="YYYY-MM-DD" name="dob" id="dob">
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<label class="control-label">Place of Birth <span class="symbol required"></span></label>
<input type="text" placeholder="Place of Birth" class="form-control" name="pcob" id="pcob">
</div>
</div>
</div>
<div class="row">
<!--<div class="col-md-3">
<div class="form-group">
<label class="control-label">Phone Number</label>
<select class="cs-select cs-skin-slide" name="dialcode">
<option value="+263">Zimbabwe(+263)</option>
</select>
</div>
</div>-->
<div class="col-md-4">
<div class="form-group">
<label class="control-label">Phone Number</label>
<input type="text" maxlength="15" minlength="11" class="form-control" placeholder="Enter Phone Number" name="phone" id="phone" onkeypress="return isValidPhoneNumber(event)" onautocomplete="return isValidPhoneNumber(event)">
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<label class="control-label">Email <span class="symbol required"></span></label>
<input type="text" placeholder="Enter your Email" class="form-control" name="email" id="email">
</div>
</div>
</div>
</fieldset>
<div class="form-group">
<button class="btn btn-primary btn-o back-step btn-wide pull-left">
<i class="fa fa-circle-arrow-left"></i>Back </button>
<button class="btn btn-primary btn-o finish-step btn-wide pull-right"> Next <i class="fa fa-arrow-circle-right"></i>
</button>
</div>
</div>
</div>
</div>
<div id="step-4" class="content" style="display: none;">
<div class="row">
<div class="col-md-12">
<div class="text-center">
<h1 class=" ti-check block text-primary"></h1>
<h2 id="msg_header" class="StepTitle">Congratulations!</h2>
<p class="text-large"> Your appointment booking is complete. </p>
<p id="process_msg" class="text-medium"> Thank you for your patronage. Your appointment booking has been completed. Kindly print your appointment booking slip by clicking on the print button below. </p>
<p id="process_msg" class="text-medium"> Also note that a copy of the appointment slip has been sent to your email. </p>
<a id="btnPrint" class="btn btn-primary btn-o" href="javascript:void(0)" target="_blank">Print Appointment Booking Slip</a>
<!--
<a id="bookFlight" class="btn btn-primary btn-o" href="https://oisservices.com/flight/book.html" target="_blank" >Book Flight</a>
-->
<a id="btnPrintCheckList" class="btn btn-primary btn-o" target="_blank">Print Checklist</a>
</div>
</div>
</div>
<div id="covidMessage" class="row" style="margin-top:15px!important;"></div>
</div>
</div>
<div class="actionBar">
<div class="msgBox">
<div class="content"></div><a href="#" class="close">X</a>
</div>
<div class="loader">Loading</div><a href="#" class="buttonFinish buttonDisabled">Finish</a><a href="#" class="buttonNext">Next</a><a href="#" class="buttonPrevious buttonDisabled">Previous</a>
</div>
</div>
</form>Text Content
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I declare that I have all the above requirements OK Cancel
OIS SERVICES - APPOINTMENT BOOKING
1. New Appointment
2. Reschedule Appointment
3. Cancel Appointment
* 1
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* 2
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* 3
Applicant Data
* 4
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PLEASE SELECT YOUR APPOINTMENT SLOT
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Appointment slot
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Personal Information
Title Mr Mrs Ms Miss
First Name
Gender
Female Male
Middle Name
Last Name
Passport Number
Nationality Afghanistan Åland Islands Albania Algeria American Samoa Andorra
Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia
Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize
Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and
Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean
Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon
Canada Cape Verde Cayman Islands Central African Republic Chad Chile China
Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the
Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba
Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic
Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland
Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French
Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana
Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea
Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican
City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic
Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan
Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic
of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho
Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former
Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall
Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated
States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco
Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand
Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman
Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay
Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania
Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan
da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint
Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome
and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint
Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa
South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan
Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab
Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of
Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey
Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates
United Kingdom United States United States Minor Outlying Islands Uruguay
Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam Virgin Islands,
British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia
Zimbabwe
Date of Birth
Place of Birth
Phone Number
Email
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CONGRATULATIONS!
Your appointment booking is complete.
Thank you for your patronage. Your appointment booking has been completed.
Kindly print your appointment booking slip by clicking on the print button
below.
Also note that a copy of the appointment slip has been sent to your email.
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