portal.ubaguio.edu
Open in
urlscan Pro
112.199.103.99
Public Scan
Submitted URL: https://portal.ubaguio.edu/#/login
Effective URL: https://portal.ubaguio.edu/
Submission: On May 18 via manual from PH — Scanned from DE
Effective URL: https://portal.ubaguio.edu/
Submission: On May 18 via manual from PH — Scanned from DE
Form analysis 4 forms found in the DOM
<form id="login-form" class="smart-form client-form ng-pristine ng-invalid ng-invalid-required ng-valid-minlength ng-valid-maxlength" data-smart-validate-form="" novalidate="novalidate">
<header style="background-image: -webkit-linear-gradient(top, #4a4a4a 1%,#3f3f3f 73%,#3f3f3f 100%) !important; color:wheat;">
<div style="font-size:14px;"><i class="fa fa-sign-in"></i> <b>Log In</b></div>
<div style="font-size:12px;">
<i><b>Academic Management System</b></i>
</div>
</header>
<fieldset>
<section align="left" ng-show="selectedaccess == ''" class="">
<div style="margin-bottom:10px; margin-top:-10px;">
<b>Select User :</b>
</div>
<label class="btn btn-default btn-sm btn-block" ng-click="setAccess('Academic')"><b>Academic</b></label>
<label class="btn btn-default btn-sm btn-block" ng-click="setAccess('Faculty')"><b>Faculty / Instructor</b></label>
<label class="btn btn-default btn-sm btn-block" ng-click="setAccess('Student')"><b>Current Student</b></label>
<div style="margin-top:10px;">
<div style="margin-bottom:10px;">
<b> Applicant :</b>
</div>
<label class="btn btn-default btn-sm btn-block" ng-click="applyasstudent();"><b>Apply as a new Student</b></label>
<!--<label class="btn btn-default btn-sm btn-block" ng-click="setAccess('Student Registration')"><b>Applicant Log in</b></label>
<label class="btn btn-default btn-sm btn-block" ng-click="retrieveviaotp();"><b>Retrieve via OTP Code</b></label>-->
<!--<label class="btn btn-default btn-sm btn-block" ng-click="requestanewotp();"><b>Request a new OTP Code</b></label>-->
</div>
</section>
<div ng-show="selectedaccess != ''" class="ng-hide">
<section>
<div style="margin-bottom:10px; margin-top:-10px; font-size:12px;">
<div style="float:right;">
<b class="ng-binding"> Module</b>
</div>
<label ng-click="setAccess('')"><i class="fa fa-arrow-circle-left"></i> <b>Change Access</b></label>
</div>
<div style="margin-top:15px; margin-bottom:15px; font-size:12px;" ng-show="selectedaccess == 'Student'" hidden="" class="ng-hide">
<div align="center">
<b>ATTENTION TO ALL ENROLLED STUDENTS! (REQUIRED)</b>
</div>
<div style="margin-top:5px;">
<i><b>** The following survey is to determine your mode of learning this Second Semester 2020-2021.</b></i>
<div style="margin-top:5px;"> You are required to fill-up this form. Failure to fill-up this form means that you are opting for the <b>"ONLINE MODE"</b> of learning. </div>
<div hidden=""> This survey is available from <b style="color:#c12e2a">January 11-22, 2021</b>
</div> Thank you.
</div>
<div style="margin-top:10px;" align="center">
<label class="btn btn-danger btn-xs" ng-click="goToLink()"><i class="fa fa-link"></i> Survey Link</label>
</div>
</div>
<label class="label ng-hide" ng-show="selectedaccess == 'Student Registration'"><b>Email Address :</b> </label>
<label class="label" ng-hide="selectedaccess == 'Student'"><b>Username :</b></label>
<label class="label ng-hide" ng-show="selectedaccess == 'Student'"><b>ID Number :</b></label>
<label class="input">
<i class="icon-append fa fa-user"></i>
<input type="text" name="email" data-smart-validate-input="" data-required="" data-message-required="Please enter your username" ng-model="username" id="txtUsername" autocomplete="off"
class="ng-pristine ng-untouched ng-invalid ng-invalid-required">
<b class="tooltip tooltip-top-right">
<i class="fa fa-user txt-color-teal"></i>
Please enter username
</b>
</label>
</section>
<section style="font-size:12px;" ng-show="selectedaccess == 'Student'" class="ng-hide">
<div>
<label class="label"><b>Birthdate : (E.g 12/25/1990)</b></label>
<label class="input">
<i class="icon-append fa fa-calendar"></i>
<input name="birthdate" autocomplete="off" data-smart-validate-input="" data-required="" data-minlength="10" data-maxnlength="10" data-message="Please enter your birthdate" ng-model="birthdate" id="txtBirthdate" maxlength="10"
placeholder="MM/DD/YYYY" class="js-date ng-pristine ng-untouched ng-invalid ng-invalid-required ng-valid-minlength ng-valid-maxlength">
<b class="tooltip tooltip-top-right">
<i class="fa fa-lock txt-color-teal"></i> Enter
your birthdate
</b>
</label>
</div>
</section>
<section>
<label class="label"><b>Password :</b></label>
<label class="input">
<i class="icon-append fa fa-lock"></i>
<input type="password" name="password" data-smart-validate-input="" data-required="" data-minlength="1" data-message="Please enter your password" ng-model="password" id="txtPassword"
class="ng-pristine ng-untouched ng-invalid ng-invalid-required ng-valid-minlength">
<b class="tooltip tooltip-top-right">
<i class="fa fa-lock txt-color-teal"></i> Enter
your password
</b>
</label>
</section>
<section style="font-size:12px;">
<div ng-show="selectedaccess == 'Student'" class="ng-hide">
<i class="fa fa-key"></i> <b>Forgot Password?</b>
<div style="margin-top:5px; margin-bottom:5px;">
<i>Proceed to Management Information Systems (MIS) or to your respected department / school to reset your password</i>
</div>
</div>
<div ng-show="selectedaccess != 'Student' && selectedaccess != 'Student Registration'" class="">
<i class="fa fa-key"></i> <b>Forgot Password?</b>
<div style="margin-top:5px;">
<i>Request password reset using Job Requests Ticketing System (JRETS)</i>
</div>
</div>
<div ng-show="selectedaccess == 'Student Registration'" class="ng-hide">
<i class="fa fa-key"></i> <b>Forgot Password?</b>
<div style="margin-top:5px;">
<i>Request a new OTP code</i>
</div>
</div>
<div ng-show="selectedaccess == 'Student Registration'" hidden="" class="ng-hide">
<label class="btn btn-danger btn-sm" style="font-size:10px; padding:4px;" ng-click="applyasstudent();"><i class="fa fa-user-circle"></i> <i>Apply as Student</i></label> <label class="btn btn-danger btn-sm"
style="font-size:10px; padding:4px;" ng-click="retrieveviaotp();"><i class="fa fa-user-circle"></i> <i>Retrieve via OTP</i></label>
</div>
</section>
</div>
</fieldset>
<footer ng-show="selectedaccess != ''" class="ng-hide">
<button type="submit" class="btn btn-danger" ng-click="ValidateAuthentication(username, password)"> Log In</button>
</footer>
</form><form id="registration-form" class="smart-form client-form ng-pristine ng-valid" data-smart-validate-form="" novalidate="novalidate">
<header style="background-image: -webkit-linear-gradient(top, #4a4a4a 1%,#3f3f3f 73%,#3f3f3f 100%) !important; color:wheat;">
<!--<div style="font-size:14px;"><i class="fa fa-pencil"></i> <b>New Student Registration</b></div>-->
<div style="font-size:14px;">
<i class="fa fa-plus-circle"></i> <i><b>STUDENT DIRECTORY</b></i>
</div>
<div style="font-size:12px;">
<i>(Applicants are advised to read briefly read the Consent Agreement)</i>
</div>
</header>
<fieldset>
<section align="left">
<div align="left">
<div align="center" style="margin-top:-5px;font-size:14px;"><b>CONSENT AGREEMENT</b></div>
<div style="font-size:12px;">
<p style="margin-top:10px;"> I have read and understood the University of Baguio Privacy Policy which is posted at <b>www.ubaguio.edu</b> and in a conspicuous place in this office. I understand that the personal
data being collected by this office will be devoted only for the identified primary and secondary purposes posted in a conspicuous place within the office. I also understand that personal data will be handled by the authorized personnel
of this office strictly in accordance with the University of Baguio Privacy Manual. By clicking the agree button, I am hereby giving my consent for the processing of my personal data by the authorized personnel of this office for the
identified primary and secondary purposes. The processing of my personal data may include any, several or all of the following: (1) collection, (2) use, (3) retention, (4) storage, (5) disposal, (6) disclosure, (7) sharing, and (8) other
similar acts. I am hereby giving my written consent for disclosure of my personal and sensitive data to my Parents (Father and Mother), including my Guardian stated in my Directory </p>
<p style="margin-top:10px;"> This is without prejudice to my right to withdraw my consent at a later date or to object to the further processing of my personal data in accordance with the Data Privacy Act and its
Implementing Rules and Regulations, the University of Baguio Privacy Policy, and the University of Baguio Privacy Manual. </p>
</div>
</div>
</section>
</fieldset>
<footer>
<button type="submit" class="btn btn-sm btn-danger" ng-click="setAccess(''); setstudent = false;">Disagree</button>
<button type="submit" class="btn btn-sm btn-danger" ng-click="agreetocomply()"> Agree</button>
</footer>
</form><form class="smart-form ng-pristine ng-invalid ng-invalid-required ng-valid-pattern" ng-submit="submitNewRegistration(studentData,ccaptcha)">
<div class="form-inline" style="margin-bottom:5px; margin-top:10px;">
<article class="col-sm-12 col-md-12 col-lg-12" style="margin-bottom:50px;">
<div id="birda-eye-widget" data-jarvis-widget="" data-widget-colorbutton="false" data-widget-editbutton="false" class="jarviswidget">
<div class="col-sm-12" style="margin-top:5px; margin-bottom:2px;font-size:14px;">
<div class="col-sm-4">
<img src="styles/img/ub-whitebg.png" width="100" height="30"><!--styles/img/ub-whitebg.pn-->
</div>
<div class="col-sm-4"> <label><b style="color:#c12e2a">STUDENT DIRECTORY</b></label></div>
</div>
<div class="col-sm-3" style="font-size:10px;">
<input type="radio" name="group1" ng-model="coursetyperegistration" value="College" class="ng-pristine ng-untouched ng-valid"> <b>Baccalaureate / College / Graduate School</b>
<input type="radio" name="group1" ng-model="coursetyperegistration" value="BasicED" class="ng-pristine ng-untouched ng-valid"> <b>Kinder /Elementary / High School</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.department.$invalid && !profileform.department.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Department:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.deptid"
ng-options="x.id as x.description for x in departmentlist | orderBy: ['description'] | filter:criteriaMatch(coursetyperegistration)" required="" name="department">
<option value="" class="" selected="selected"></option>
</select>
</div>
</div>
<div class="form-group ng-hide" ng-hide="!studentData.deptid" ng-class="{ 'has-error' : profileform.course.$invalid && !profileform.course.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Course/Grade Level/Strand:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.courseid"
ng-options="x.id as x.description for x in courselist | orderBy: ['description'] | filter:{department_Id:studentData.deptid} :true" required="" name="course">
<option value="" class="" selected="selected"></option>
</select>
</div>
</div>
<div class="col-sm-3 ng-hide" style="font-size:10px;" ng-hide="!studentData.courseid">
<input type="radio" name="group" ng-model="studEnrollStat" value="NW" ng-change="getLabel(studEnrollStat)" id="radio1" class="ng-pristine ng-untouched ng-valid"><b>FRESHMAN</b>
<input type="radio" name="group" ng-model="studEnrollStat" value="TR" ng-change="getLabel(studEnrollStat)" id="radio2" class="ng-pristine ng-untouched ng-valid"><b>TRANSFEREE</b>
<input type="radio" name="group" ng-model="studEnrollStat" value="CR" ng-change="getLabel(studEnrollStat)" id="radio3" class="ng-pristine ng-untouched ng-valid"><b>CROSS ENROLEE</b>
<input type="radio" name="group" ng-model="studEnrollStat" value="RF" ng-change="getLabel(studEnrollStat)" id="radio4" class="ng-pristine ng-untouched ng-valid"><b>REFRESHER</b>
</div>
<div>
<div style="margin-top:5px;" ng-hide="!studentData.courseid" class="ng-hide">
<div class="col-lg-12">
<div>
<b style="color:#c12e2a">I. PERSONAL INFORMATION </b>
<b style="color:red; font-size:8px;"> ** Note: if no middle name please put </b>. (dot)
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.lastName.$invalid && !profileform.lastName.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Family Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control input state-error ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.lastName" required="" name="lastName" id="lastName" autocomplete="off">
<span class="help-block note" ng-style="studentData.lastName == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.firstName.$invalid && !profileform.firstName.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">First Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.firstName" required="" name="firstName" autocomplete="off">
<span class="help-block note" ng-style="studentData.firstName == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.middlename.$invalid && !profileform.middlename.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Middle Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.middlename" required="" name="middlename" autocomplete="off">
<span class="help-block note" ng-style="studentData.middlename == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">Suffix (eg. Jr, I):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.suffix" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.birthday.$invalid && !profileform.birthday.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Birthdate: (Format: MM/DD/YYYY)</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-isolate-scope hasDatepicker ng-invalid ng-invalid-required" ng-model="studentData.birthday" required="" name="birthday" data-smart-datepicker="" date="MM/dd/yyyy"
autocomplete="off" id="dp1715995993018">
<span class="help-block note" ng-style="studentData.birthday == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.birthPlace.$invalid && !profileform.birthPlace.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Birthplace:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.birthPlace" required="" name="birthPlace" autocomplete="off">
<span class="help-block note" ng-style="studentData.birthPlace == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.religion.$invalid && !profileform.religion.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Religion:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<div ng-controller="religionCtrl" ng-app="app.religion" class="ng-scope">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.religion_Id" ng-options="item.id as item.name for item in religionList | orderBy: 'name'" required="" name="religion">
<option value="" class="" selected="selected"></option>
</select>
</div>
<span class="help-block note" ng-style="studentData.religion_Id == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.civilstatus.$invalid && !profileform.civilstatus.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Civil Status:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.civilStatus" required="" name="civilstatus">
<option value=""></option>
<option value="Single">Single</option>
<option value="Married">Married</option>
<option value="Legally Separated">Legally Separated</option>
<option value="Widowed">Widowed</option>
</select>
<span class="help-block note" ng-style="studentData.civilStatus == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mothertongue.$invalid && !profileform.mothertongue.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Mother Tongue (eg. English):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.motherTongue" name="mothertongue" autocomplete="off">
<span class="help-block note" ng-style="studentData.motherTongue == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.nationality.$invalid && !profileform.nationality.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Nationality:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.nationality_id" ng-options="x.id as x.nationality for x in nationalityList | orderBy: ['nationality']" required=""
name="nationality">
<option value="" class="" selected="selected"></option>
</select>
<span class="help-block note" ng-style="studentData.nationality_id == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">PWD ID :</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.pwdId" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
</div>
<div class="col-lg-12">
<div class="form-group" ng-class="{ 'has-error' : profileform.genderid.$invalid && !profileform.genderid.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Gender:</b>
<p><i style="font-size:smaller"><b>Cisgender (Cis)</b>- Someone whose gender identity corresponds with sex they have at birth. </i></p>
<!--<i style="font-size:smaller"><b>Transgender (Cis)</b>- Someone whose gender identity corresponds with sex they have at birth. </i>-->
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.genderid" required="" name="gender">
<option value=""></option>
<option value="Cis">Cis</option>
<option value="Trans">Transgender</option>
</select>
<span class="help-block note" ng-style="studentData.genderid == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.gender.$invalid && !profileform.gender.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">SEX:</b>
<p><i style="font-size:smaller"><b>Personal identification of one's own gender</b> </i></p>
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.gender" required="" name="gender">
<option value=""></option>
<option value="1">Male</option>
<option value="2">Female</option>
</select>
<span class="help-block note" ng-style="studentData.gender == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
<div class="col-lg-6">
<div class="form-group" ng-class="{ 'has-error' : profileform.firstgen.$invalid && !profileform.firstgen.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Are you a first generation student:</b>
<div style="font-size:smaller">
<i>if you are the first person in your immediate familty to attend a university at any level </i>
</div>
<div style="margin-top:5px; margin-bottom:5px;">
<select class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" ng-model="studentData.firstgen" required="" name="firstgen">
<option value=""></option>
<option value="False">No</option>
<option value="True">Yes</option>
</select>
<span class="help-block note" ng-style="studentData.firstgen == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.ethnicity.$invalid && !profileform.ethnicity.$pristine }">
<b style="color:red;">*</b><b style="font-size:smaller"> ETHNICITY:</b>
<div style="font-size:smaller">
<i>Based on youf family language, please specify the ethnic group that you belong to. </i>
</div>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.ethnicity" required="" name="ethnicity" autocomplete="off">
<span class="help-block note" ng-style="studentData.ethnicity == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="col-lg-6 ng-hide" ng-hide="!studentData.courseid">
<div>
<b style="color:red;">*</b><b style="font-size:smaller">MONTHLY FAMILY INCOME:</b>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="1" required="">
<label class="form-check-label"> Less than 10,957 </label>
</div>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="2" required="">
<label class="form-check-label"> Greater then or equal to 10,957 but less than 21,194 </label>
</div>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="3" required="">
<label class="form-check-label"> Greater then or equal to 21,194 but less than 43,828 </label>
</div>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="4" required="">
<label class="form-check-label"> Greater then or equal to 43,828 but less than 76,669 </label>
</div>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="5" required="">
<label class="form-check-label"> Greater then or equal to 76,669 but less than 131,484 </label>
</div>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="6" required="">
<label class="form-check-label"> Greater then or equal to 131,484 but less than 219,140 </label>
</div>
<div class="form-check" style="font-size:smaller">
<input class="form-check-input ng-pristine ng-untouched ng-invalid ng-invalid-required" type="radio" name="familyIncome" ng-model="studentData.familyIncome" value="7" required="">
<label class="form-check-label"> Greater then or equal to 219,140 </label>
</div>
<span class="help-block note" ng-style="studentData.familyIncome == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="col-lg-12 ng-hide" ng-hide="!studentData.courseid">
<div ng-hide="coursetyperegistration == 'College'" class="ng-hide">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">I-A. PHYSICAL INFORMATION</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.height.$invalid && !profileform.height.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Height (cm):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-pattern" style="text-transform:uppercase;" ng-model="studentData.height" name="height" autocomplete="off" ng-pattern="/^\d*$/">
<span class="help-block note" ng-style="studentData.height == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field. (If you are not aware in this field, just type 0)</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.weight.$invalid && !profileform.weight.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Weight (k):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-pattern" ng-model="studentData.weight" name="weight" autocomplete="off" ng-pattern="/^\d*$/">
<span class="help-block note" ng-style="studentData.weight == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field. (If you are not aware in this field, just type 0)</span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">Body Mass Index:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" ng-model="studentData.bmi" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
</div>
</div>
<div class="col-lg-6">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">II. CONTACT INFORMATION</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mobile.$invalid && !profileform.mobile.$pristine }">
<b style="color:red;" ng-show="profileform.mobile == null" class="">*</b> <b style="font-size:smaller">Mobile No:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mobile" required="" name="mobile" id="mobile" autocomplete="off"
oninput="this.value=this.value.replace(/[^0-9]/g,'');">
<span class="help-block note" ng-style="studentData.mobile == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
<span style="color:red" class="error ng-hide" ng-show="studentData.mobile.$error.pattern">mobile not valid</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.email.$invalid && !paymentform.email.$pristine }">
<b style="color:red;" ng-show="profileform.email == null" class="">*</b> <b style="font-size:smaller">E-mail Address:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control input state-error ng-pristine ng-untouched ng-invalid ng-invalid-required ng-valid-pattern" ng-model="studentData.email" required="" name="email" id="email" autocomplete="off"
ng-pattern="/^[\w-]+(\.[\w-]+)*@([a-z0-9-]+(\.[a-z0-9-]+)*?\.[a-z]{2,6}|(\d{1,3}\.){3}\d{1,3})(:\d{4})?$/" noncapitalize="">
<span class="help-block note" ng-style="studentData.email == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
<span style="color:red" class="error ng-hide" ng-show="studentData.email.$error.pattern">Email not valid</span>
</div>
</div>
</div>
<div class="col-lg-12">
<div> <b style="font-size:smaller;">Current Address:</b></div>
<div class="form-group" ng-class="{ 'has-error' : profileform.residential.$invalid && !profileform.residential.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">House Number and Street:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control input state-error ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.home_Street" required="" name="home_Street" id="home_Street"
autocomplete="off">
<span class="help-block note" ng-style="studentData.home_Street == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.home_Barangay.$invalid && !profileform.home_Barangay.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Barangay</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.home_Barangay" required="" name="home_Barangay" autocomplete="off">
<span class="help-block note" ng-style="studentData.home_Barangay == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.home_City.$invalid && !profileform.home_City.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">City/Municipality</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.home_City" required="" name="home_City" autocomplete="off">
<span class="help-block note" ng-style="studentData.home_City == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field </span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.home_Province.$invalid && !profileform.home_Province.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Province</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.home_Province" required="" name="home_Province" autocomplete="off">
<span class="help-block note" ng-style="studentData.home_Province == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.home_ZipCode.$invalid && !profileform.home_ZipCode.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">ZIP Code</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.home_ZipCode" required="" name="home_ZipCode" autocomplete="off">
<span class="help-block note" ng-style="studentData.home_ZipCode == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
<div class="col-lg-12">
<div> <b style="font-size:smaller">Permanent Address:</b> <input type="checkbox" ng-click="sameToResidential($event)"><label>Same (Residential)</label></div>
<div class="form-group" ng-class="{ 'has-error' : profileform.residential.$invalid && !profileform.residential.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">House Number and Street:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control input state-error ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.prov_Street" required="" name="prov_Street" id="prov_Street"
autocomplete="off">
<span class="help-block note" ng-style="studentData.prov_Street == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.prov_Barangay.$invalid && !profileform.prov_Barangay.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Barangay</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.prov_Barangay" required="" name="prov_Barangay" autocomplete="off">
<span class="help-block note" ng-style="studentData.prov_Barangay == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.prov_City.$invalid && !profileform.prov_City.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">City/Municipality</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.prov_City" required="" name="prov_City" autocomplete="off">
<span class="help-block note" ng-style="studentData.prov_City == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field </span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.prov_Province.$invalid && !profileform.prov_Province.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Province</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.prov_Province" required="" name="prov_Province" autocomplete="off">
<span class="help-block note" ng-style="studentData.prov_Province == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.prov_ZipCode.$invalid && !profileform.prov_ZipCode.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">ZIP Code</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.prov_ZipCode" required="" name="prov_ZipCode" autocomplete="off">
<span class="help-block note" ng-style="studentData.prov_ZipCode == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
</div>
</div>
<div class="col-lg-12 ng-hide" ng-hide="!studentData.courseid">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">III. EDUCATIONAL BACKGROUND</b>
</div>
<div>
<div style="margin-bottom:5px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a"><input type="checkbox" ng-model="isCheckElem" ng-click="LoadElemData($event)" class="ng-pristine ng-untouched ng-valid"> ELEMENTARY SCHOOL</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.elemschool.$invalid && !profileform.elemschool.$pristine && eleminfo == true }">
<b style="color:red;" ng-show="eleminfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Name of School:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.elemschool" ng-disabled="eleminfo == false" ng-required="eleminfo == true" name="elemschool"
autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding" ng-style="studentData.elemschool == null && eleminfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i>
Fill out if applicable</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.elemaddress.$invalid && !profileform.elemaddress.$pristine && eleminfo == true }">
<b style="color:red;" ng-show="eleminfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Address of School:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.elemaddress" ng-disabled="eleminfo == false" ng-required="eleminfo == true" name="elemaddress"
autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding" ng-style="studentData.elemaddress == null && eleminfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i>
Fill out if applicable</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.elemdategraduated.$invalid && !profileform.elemdategraduated.$pristine && eleminfo == true }">
<b style="color:red;" ng-show="eleminfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Year Graduated:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.elemdategraduated" ng-disabled="eleminfo == false" ng-required="eleminfo == true"
name="elemdategraduated" oninput="this.value=this.value.replace(/[^0-9]/g,'');" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding"
ng-style="studentData.elemdategraduated == null && eleminfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
<div style="margin-bottom:5px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a"><input type="checkbox" ng-model="isCheckJH" ng-click="LoadJuniorHighData($event)" class="ng-pristine ng-untouched ng-valid"> JUNIOR HIGH SCHOOL</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.jhschool.$invalid && !profileform.jhschool.$pristine && juniorhighinfo == true }">
<b style="color:red;" ng-show="juniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Name of School:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.jhschool" ng-disabled="juniorhighinfo == false" ng-required="juniorhighinfo == true"
name="jhschool" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding" ng-style="studentData.jhschool == null && juniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i>
Fill out if applicable</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.jhaddress.$invalid && !profileform.jhaddress.$pristine && juniorhighinfo == true }">
<b style="color:red;" ng-show="juniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Address of School:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.jhaddress" ng-disabled="juniorhighinfo == false" ng-required="juniorhighinfo == true"
name="jhaddress" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding"
ng-style="studentData.jhaddress == null && juniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.jhdategraduated.$invalid && !profileform.jhdategraduated.$pristine && juniorhighinfo == true }">
<b style="color:red;" ng-show="juniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Year Graduated:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.jhdategraduated" ng-disabled="juniorhighinfo == false" ng-required="juniorhighinfo == true"
name="jhdategraduated" oninput="this.value=this.value.replace(/[^0-9]/g,'');" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding"
ng-style="studentData.jhdategraduated == null && juniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
</div>
<div ng-show="coursetyperegistration == 'College'" class="">
<div style="margin-bottom:5px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a"><input type="checkbox" ng-model="isCheckSH" ng-click="LoadSeniorHighData($event)" class="ng-pristine ng-untouched ng-valid"> SENIOR HIGH SCHOOL</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.shschool.$invalid && !profileform.shschool.$pristine && seniorhighinfo == true }">
<b style="color:red;" ng-show="seniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Name of School:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.shschool" ng-disabled="seniorhighinfo == false" ng-required="seniorhighinfo == true"
name="shschool" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding" ng-style="studentData.shschool == null && seniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i>
This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.shaddress.$invalid && !profileform.shaddress.$pristine && seniorhighinfo == true }">
<b style="color:red;" ng-show="seniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Address of School:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.shaddress" ng-disabled="seniorhighinfo == false" ng-required="seniorhighinfo == true"
name="shaddress" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding"
ng-style="studentData.shaddress == null && seniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.shdategraduated.$invalid && !profileform.shdategraduated.$pristine && seniorhighinfo == true }">
<b style="color:red;" ng-show="seniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Year Graduated:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.shdategraduated" ng-disabled="seniorhighinfo == false" ng-required="seniorhighinfo == true"
name="shdategraduated" oninput="this.value=this.value.replace(/[^0-9]/g,'');" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding"
ng-style="studentData.shdategraduated == null && seniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.shprogram.$invalid && !profileform.shprogram.$pristine && seniorhighinfo == true }">
<b style="color:red;" ng-show="seniorhighinfo == true" class="ng-hide">*</b> <b style="font-size:smaller">Course/Program:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid ng-valid-required" style="text-transform:uppercase;" ng-model="studentData.shprogram" ng-disabled="seniorhighinfo == false" ng-required="seniorhighinfo == true"
name="shprogram" autocomplete="off" disabled="disabled">
<span class="help-block note ng-binding"
ng-style="studentData.shprogram == null && seniorhighinfo == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
<div>
<div class="form-group" ng-class="{ 'has-error' : profileform.lastattendedschool.$invalid && !profileform.lastattendedschool.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Last School Attended:</b>
<div>
<i>(Please input full school name (E.g. University of Baguio))</i>
</div>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.lastattendedschool" required="" name="lastattendedschool" autocomplete="off">
<span class="help-block note" ng-style="studentData.lastattendedschool == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<!--<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control" style="text-transform:uppercase;" ng-model="studentData.lastattendedschooladdr" required name="lastattendedschooladdr" autocomplete="off" />
<span class="help-block note" ng-style="studentData.lastattendedschooladdr == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>-->
<div class="col-lg-12">
<div><b style="font-size:smaller">Last School Attended Address:</b></div>
<div class="form-group" ng-class="{ 'has-error' : profileform.schAd_Street.$invalid && !profileform.schAd_Street.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Street:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control input state-error ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.schAd_Street" required="" name="schAd_Street" id="schAd_Street"
autocomplete="off">
<span class="help-block note" ng-style="studentData.schAd_Street == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.schAd_Barangay.$invalid && !profileform.schAd_Barangay.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Barangay</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.schAd_Barangay" required="" name="schAd_Barangay" autocomplete="off">
<span class="help-block note" ng-style="studentData.schAd_Barangay == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.schAd_City.$invalid && !profileform.schAd_City.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">City/Municipality</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.schAd_City" required="" name="schAd_City" autocomplete="off">
<span class="help-block note" ng-style="studentData.schAd_City == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field </span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.schAd_Province.$invalid && !profileform.schAd_Province.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Province</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.schAd_Province" required="" name="schAd_Province" autocomplete="off">
<span class="help-block note" ng-style="studentData.schAd_Province == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.schAd_ZipCode.$invalid && !profileform.schAd_ZipCode.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">ZIP Code</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.schAd_ZipCode" required="" name="schAd_ZipCode" autocomplete="off">
<span class="help-block note" ng-style="studentData.schAd_ZipCode == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
</div>
<div class="col-lg-12 ng-hide" ng-hide="!studentData.courseid">
<div ng-hide="coursetyperegistration == 'College'" class="ng-hide">
<div style="margin-bottom:5px"> :5 <b style="color:#c12e2a">III-A. ACADEMIC INFORMATION</b>
</div>
<div class="form-group">
<b style="font-size:smaller">Learner's Reference Number:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.learnerReferenceNo" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">Education Service Contracting (ESC) No.:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.esc" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">Qualified Voucher Recipents (QVR):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.qvr" autocomplete="off">
<span class="help-block note">
<i class="fa fa-exclamation-circle"></i> Fill out if applicable </span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">Public:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.public" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
</div>
</div>
<div ng-hide="!studentData.courseid" class="ng-hide">
<div class="col-lg-12" ng-show="coursetyperegistration == 'College'">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">IV. ALTERNATIVE LEARNING SYSTEM (ALS) - IF ALS GRADUATE, FILL OUT FIELDS UNDER THIS SECTION</b>
</div>
<div class="form-group">
<b style="font-size:smaller">PEPT (Serial/Reference Number):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.pept" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
<div class="form-group">
<b style="font-size:smaller">ALS (Serial/Reference Number):</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" ng-model="studentData.als" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
</div>
<div class="col-lg-12 ng-hide" ng-hide="coursetyperegistration == 'College'">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">IV-A. GOVERNMENT BENIFICIARY</b>
</div>
<div class="form-group">
<b style="font-size:smaller">If yes, please specify:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-valid" style="text-transform:uppercase;" ng-model="studentData.governmentBeneficiary" autocomplete="off">
<span class="help-block note"><i class="fa fa-exclamation-circle"></i> Fill out if applicable</span>
</div>
</div>
</div>
<div class="col-lg-12">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">V. GUARDIAN INFORMATION</b>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.gLastname.$invalid && !profileform.gLastname.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Last Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.gLastname" name="gLastname" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.gLastname == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.gFirstname.$invalid && !profileform.gFirstname.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">First Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.gFirstname" name="gFirstname" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.gFirstname == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.gMiddlename.$invalid && !profileform.gMiddlename.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Middle Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.gMiddlename" name="gMiddlename" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.gMiddlename == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.guardiancontact.$invalid && !profileform.guardiancontact.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Contact Number:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.guardiancontact" required="" name="guardiancontact" autocomplete="off"
oninput="this.value=this.value.replace(/[^0-9]/g,'');">
<span class="help-block note" ng-style="studentData.guardiancontact == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.guardianoccupation.$invalid && !profileform.guardianoccupation.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Occupation:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.guardianoccupation" required="" name="guardianoccupation" autocomplete="off">
<span class="help-block note" ng-style="studentData.guardianoccupation == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.guardianaddress.$invalid && !profileform.guardianaddress.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Guardian Address:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.guardianaddress" required="" name="guardianaddress" autocomplete="off">
<span class="help-block note" ng-style="studentData.guardianaddress == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.guardianrelationship.$invalid && !profileform.guardianrelationship.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Relationship:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.relationshipToStudent" required="" name="guardianrelationship" autocomplete="off">
<span class="help-block note" ng-style="studentData.relationshipToStudent == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
</div>
<div class="col-lg-12">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">VI. PARENTS INFORMATION</b>
</div>
<div style="margin-bottom:10px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a"> MOTHER'S INFORMATION </b> <b style="color:red; font-size:8px;"> ** Note: if no middle name please put </b>. (dot)
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mLastname.$invalid && !profileform.mLastname.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Last Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mLastname" name="mLastname" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.mLastname == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mFirstname.$invalid && !profileform.mFirstname.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">First Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mFirstname" name="mFirstname" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.mFirstname == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mMiddlename.$invalid && !profileform.mMiddlename.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Middle Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mMiddlename" name="mMiddlename" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.mMiddlename == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mContact.$invalid && !profileform.mContact.$pristine && profileform.mContact.$error.pattern }">
<b style="color:red;">*</b> <b style="font-size:smaller">Contact No.:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mContact" name="mContact" required="" autocomplete="off"
oninput="this.value=this.value.replace(/[^0-9]/g,'');">
<span class="help-block note" ng-style="studentData.mContact == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mOccupation.$invalid && !profileform.mOccupation.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Occupation:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mOccupation" name="mOccupation" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.mOccupation == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.mAddress.$invalid && !profileform.mAddress.$pristine}">
<b style="color:red;">*</b> <b style="font-size:smaller">Address:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.mAddress" name="mAddress" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.mAddress == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field. </span>
</div>
</div>
<div style="margin-bottom:10px; font-size:smaller">
<b style="color:#c12e2a"> FATHER'S INFORMATION</b> <b style="color:red; font-size:8px;"> ** Note: if no middle name please put </b>. (dot)
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.fLastname.$invalid && !profileform.fLastname.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Last Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.fLastname" name="fLastname" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.fLastname == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.fFirstname.$invalid && !profileform.fFirstname.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">First Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.fFirstname" name="fFirstname" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.fFirstname == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.fMiddlename.$invalid && !profileform.fMiddlename.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Middle Name:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.fMiddlename" name="fMiddlename" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.fMiddlename == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.fContact.$invalid && !profileform.fContact.$pristine && profileform.fContact.$error.pattern }">
<b style="color:red;">*</b> <b style="font-size:smaller">Contact No.:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.fContact" name="fContact" required="" autocomplete="off"
oninput="this.value=this.value.replace(/[^0-9]/g,'');">
<span class="help-block note" ng-style="studentData.fContact == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.fOccupation.$invalid && !profileform.fOccupation.$pristine }">
<b style="color:red;">*</b> <b style="font-size:smaller">Occupation:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.fOccupation" required="" name="fOccupation" autocomplete="off">
<span class="help-block note" ng-style="studentData.fOccupation == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field</span>
</div>
</div>
<div class="form-group" ng-class="{ 'has-error' : profileform.fAddress.$invalid && !profileform.fAddress.$pristine}">
<b style="color:red;">*</b> <b style="font-size:smaller">Address:</b>
<div style="margin-top:5px; margin-bottom:5px;">
<input class="form-control ng-pristine ng-untouched ng-invalid ng-invalid-required" style="text-transform:uppercase;" ng-model="studentData.fAddress" name="fAddress" required="" autocomplete="off">
<span class="help-block note" ng-style="studentData.fAddress == null && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"
style="background-color: wheat; color: rgb(0, 0, 0);"><i class="fa fa-exclamation-circle"></i> This is a required field. </span>
</div>
</div>
</div>
</div>
<!--<div class="col-sm-8" style="margin-top:5px; margin-bottom:2px;">
<div style="margin-bottom:5px">
<b style="color:#c12e2a">VII. DIGITAL FILE REQUIREMENT UPLOAD </b>
<span class="help-block note"><i class="fa fa-dot-circle-o" style="color:black">NOTE:</i><b>Please convert your digital file to PDF format.</b></span>
</div>
<div class="form-group">
<div style="margin-bottom:10px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a">REPORT CARD/FORM 138: </b>
</div>
<input class="form-control" type="file" ngf-select=""
ng-model="uplodedFile.reportCard" name="file" ngf-pattern="'.pdf'"
accept=".pdf"uplodedFile.reportCard
ngf-max-height="1000"
ngf-max-size="1MB">
</div>
<div class="form-group">
<div style="margin-bottom:10px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a">GOOD MORAL CHARACTER: </b>
</div>
<input class="form-control" type="file" ngf-select=""
ng-model="uplodedFile.gMC" name="file" ngf-pattern="'.pdf'"
accept=".pdf"
ngf-max-height="1000"
ngf-max-size="1MB">
</div>
<div class="form-group">
<div style="margin-bottom:10px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a">PSA/BIRTH CERTIFICATE: </b>
</div>
<input class="form-control" type="file" ngf-select=""
ng-model="uplodedFile.bCert" name="file" ngf-pattern="'.pdf'"
accept=".pdf"
ngf-max-height="1000"
ngf-max-size="1MB">
</div>
<div class="form-group">
<div style="margin-bottom:10px; font-size:smaller; margin-top:10px;">
<b style="color:#c12e2a">WAIVER/CONSENT: (Downloaded from UB Web Site) </b>
</div>
<input class="form-control" type="file" ngf-select=""
ng-model="uplodedFile.waiver" name="file" ngf-pattern="'.pdf'"
accept=".pdf"
ngf-max-height="1000"
ngf-max-size="1MB">
</div>
</div>-->
</div>
<div ng-hide="!studentData.courseid" class="ng-hide">
<p style="margin-bottom:1px; margin-top:1px;"> I am enrolling as a <b class="ng-binding"></b> student of <b>UNIVERSITY OF BAGUIO</b>. I hereby attest that I have complied and completed all the necessary
documents for enrollment. I voluntarily submit these documents for verification and evaluation by the Adimissions and Records Center of the University of Baguio. Upon admission in the University I submit myself to the following </p>
<p style="margin-bottom:1px; margin-top:1px;"> 1.I will obey the rules and regulations of the University of Baguio</p>
<p style="margin-bottom:1px; margin-top:1px;"> 2.I will be serious in my studies</p>
<p style="margin-bottom:1px; margin-top:1px;"> 3.I will attend my class promptly and regularly</p>
<p style="margin-bottom:1px; margin-top:1px;"> 4.If I <b>DROP</b> my subject/s, I will change it officially by accomplishing a <b>DROPPING FORM</b> duly signed by the concerned school personnel. If I do not drop it officially, I
accept that this subject will be given a remark <b>FAILED</b>.</p>
<p style="margin-bottom:1px; margin-top:1px;"> 5.If I get a remark of <b>INC (Incomplete)</b> and /or <b>NFE (No Final Examination)</b>, this means that I have to</p>
<p style="margin-bottom:1px; margin-top:1px;"> <b>COMPLETE</b> the requirements of the course or take the final examination within the prescribed completion period. Failure on my part to do this will mean that I
will have to re- enroll the subject/s. </p>
<p style="margin-bottom:1px; margin-top:1px;"> I understand that any false statement or fraudulent document found hereinafter shall be a ground for non-admittance or dismissal from this institution and all subjects taken by me
shall be considered invalid.</p>
<p style="margin-bottom:1px; margin-top:1px;"> I certify that all the information I have filled up are true and correct and I agree with the above-mentioned statements. I hereby voluntarily affix the captcha code as my
compliance with the rules and regulations of the University of Baguio. </p>
</div>
<div style="font-size:30px; text-align:center;" ng-hide="!studentData.courseid" class="ng-hide">
<label id="captchaname"><b style="font-family:Abagail;" class="ng-binding"></b></label>
<div style=" text-align:center;font-size:12px;font-family:'Arial';">
<input style="text-align:center;" ng-model="ccaptcha" ng-required="ccaptcha == true" name="captcha" onpaste="return false;" autocomplete="off" placeholder="type captcha text here.."
class="ng-pristine ng-untouched ng-valid ng-valid-required">
<!--onpaste="return false;"-->
<!-- <span class="help-block note" ng-style="parentData.fName == null && ccaptcha == true && {'background-color':'wheat' , 'color':'black', 'font-style':'bold'}"><i class="fa fa-exclamation-circle"></i> This is a required field</span>-->
<span>
<button type="button" class="btn btn-default btn-xs" ng-click="reCaptcha()" title="Recaptcha">
<img src="/styles/img/RecaptchaLogo.png" style="width:40px; height:40px">
</button>
</span>
</div>
<div class="col-lg-12 ng-hide" align="right" style="margin-bottom:5px; margin-top:5px;" ng-hide="!studentData.courseid">
<button type="button" class="btn btn-default btn-sm" ng-click="cancelRegistration()" title="Cancel"><i class="fa fa-remove"></i> Cancel</button> <button type="submit" name="paysubmit" class="btn btn-danger btn-sm">Submit</button>
<span id="loginloader" ng-show="src.$$state.pending" style="font-size:10px;" class="ng-hide">
<img class="ajax-loader" width="30" height="30" src="https://portal.ubaguio.edu/styles/img/loading.gif"> Please wait while saving... </span>
</div>
<div>
<!--<button type="button" class="btn btn-danger btn-sm" id="btnSubmit" ng-click="submitNewRegistration(studentData,ccaptcha)"><i class="fa fa-check-circle"></i> Submit</button>-->
<!-- <button type="button" class="btn btn-danger btn-sm" id="btnSubmit" ng-click="submitNewRegistration(studentData,ccaptcha)"><i class="fa fa-check-circle"></i> Submit</button>-->
</div>
</div>
</div>
</article>
</div>
</form><form class="ng-pristine ng-valid">
<table class="table table-bordered" style="background-color:White; color:Black; padding:10px!important;" novalidate="">
<tbody>
<tr>
<td align="left" style="background-color:#333; color:white;" class="alert alert-danger">
<div style="float:right">
<label data-dismiss="modal" style="border:lightgray 1px solid; padding:2px;"><i class="fa fa-remove"></i></label>
</div>
</td>
</tr>
<tr>
<td>
<div style="margin-top:10px; font-style:normal;">
<b style="padding:10px;"><i class="fa fa-microphone"></i> CHANGE PASSWORD:</b>
</div>
</td>
</tr>
<tr>
<td>
<div style="margin-bottom:5px;">
<b style="color:red;">*</b> <b>New Password:</b>
<div>
<i>(Minimum of 6 alphanumeric characters)</i>
</div>
</div>
<input class="form-control ng-pristine ng-untouched ng-valid" type="password" ng-model="newpassword">
</td>
</tr>
<tr>
<td>
<div style="margin-bottom:5px;">
<b style="color:red;">*</b> <b>Confirm Password:</b>
<div>
<i>(Minimum of 6 alphanumeric characters)</i>
</div>
</div>
<input class="form-control ng-pristine ng-untouched ng-valid" type="password" ng-model="confirmpassword">
</td>
</tr>
<tr>
<td style="vertical-align:middle;" align="center">
<label class="btn btn-danger btn-xs btn-block" ng-click="SubmitPassword();"><i class="fa fa-save"></i> Update Password</label>
</td>
</tr>
</tbody>
</table>
</form>Text Content
Log In Academic Management System Select User : Academic Faculty / Instructor Current Student Applicant : Apply as a new Student Module Change Access ATTENTION TO ALL ENROLLED STUDENTS! (REQUIRED) ** The following survey is to determine your mode of learning this Second Semester 2020-2021. You are required to fill-up this form. Failure to fill-up this form means that you are opting for the "ONLINE MODE" of learning. This survey is available from January 11-22, 2021 Thank you. Survey Link Email Address : Username : ID Number : Please enter username Birthdate : (E.g 12/25/1990) Enter your birthdate Password : Enter your password Forgot Password? Proceed to Management Information Systems (MIS) or to your respected department / school to reset your password Forgot Password? Request password reset using Job Requests Ticketing System (JRETS) Forgot Password? Request a new OTP code Apply as Student Retrieve via OTP Log In STUDENT DIRECTORY (Applicants are advised to read briefly read the Consent Agreement) CONSENT AGREEMENT I have read and understood the University of Baguio Privacy Policy which is posted at www.ubaguio.edu and in a conspicuous place in this office. I understand that the personal data being collected by this office will be devoted only for the identified primary and secondary purposes posted in a conspicuous place within the office. I also understand that personal data will be handled by the authorized personnel of this office strictly in accordance with the University of Baguio Privacy Manual. By clicking the agree button, I am hereby giving my consent for the processing of my personal data by the authorized personnel of this office for the identified primary and secondary purposes. The processing of my personal data may include any, several or all of the following: (1) collection, (2) use, (3) retention, (4) storage, (5) disposal, (6) disclosure, (7) sharing, and (8) other similar acts. I am hereby giving my written consent for disclosure of my personal and sensitive data to my Parents (Father and Mother), including my Guardian stated in my Directory This is without prejudice to my right to withdraw my consent at a later date or to object to the further processing of my personal data in accordance with the Data Privacy Act and its Implementing Rules and Regulations, the University of Baguio Privacy Policy, and the University of Baguio Privacy Manual. Disagree Agree STUDENT DIRECTORY Baccalaureate / College / Graduate School Kinder /Elementary / High School * Department: * Course/Grade Level/Strand: FRESHMAN TRANSFEREE CROSS ENROLEE REFRESHER I. PERSONAL INFORMATION ** Note: if no middle name please put . (dot) * Family Name: This is a required field * First Name: This is a required field * Middle Name: This is a required field Suffix (eg. Jr, I): Fill out if applicable * Birthdate: (Format: MM/DD/YYYY) This is a required field * Birthplace: This is a required field * Religion: This is a required field * Civil Status: Single Married Legally Separated Widowed This is a required field * Mother Tongue (eg. English): This is a required field * Nationality: This is a required field PWD ID : Fill out if applicable * Gender: Cisgender (Cis)- Someone whose gender identity corresponds with sex they have at birth. Cis Transgender This is a required field * SEX: Personal identification of one's own gender Male Female This is a required field * Are you a first generation student: if you are the first person in your immediate familty to attend a university at any level No Yes This is a required field * ETHNICITY: Based on youf family language, please specify the ethnic group that you belong to. This is a required field *MONTHLY FAMILY INCOME: Less than 10,957 Greater then or equal to 10,957 but less than 21,194 Greater then or equal to 21,194 but less than 43,828 Greater then or equal to 43,828 but less than 76,669 Greater then or equal to 76,669 but less than 131,484 Greater then or equal to 131,484 but less than 219,140 Greater then or equal to 219,140 This is a required field I-A. PHYSICAL INFORMATION * Height (cm): This is a required field. (If you are not aware in this field, just type 0) * Weight (k): This is a required field. (If you are not aware in this field, just type 0) Body Mass Index: Fill out if applicable II. CONTACT INFORMATION * Mobile No: This is a required field mobile not valid * E-mail Address: This is a required field Email not valid Current Address: * House Number and Street: This is a required field * Barangay This is a required field * City/Municipality This is a required field * Province This is a required field * ZIP Code This is a required field Permanent Address: Same (Residential) * House Number and Street: This is a required field * Barangay This is a required field * City/Municipality This is a required field * Province This is a required field * ZIP Code This is a required field III. EDUCATIONAL BACKGROUND ELEMENTARY SCHOOL * Name of School: Fill out if applicable * Address of School: Fill out if applicable * Year Graduated: Fill out if applicable JUNIOR HIGH SCHOOL * Name of School: Fill out if applicable * Address of School: Fill out if applicable * Year Graduated: Fill out if applicable SENIOR HIGH SCHOOL * Name of School: This is a required field * Address of School: This is a required field * Year Graduated: This is a required field * Course/Program: This is a required field * Last School Attended: (Please input full school name (E.g. University of Baguio)) This is a required field Last School Attended Address: * Street: This is a required field * Barangay This is a required field * City/Municipality This is a required field * Province This is a required field * ZIP Code This is a required field :5 III-A. ACADEMIC INFORMATION Learner's Reference Number: This is a required field Education Service Contracting (ESC) No.: Fill out if applicable Qualified Voucher Recipents (QVR): Fill out if applicable Public: Fill out if applicable IV. ALTERNATIVE LEARNING SYSTEM (ALS) - IF ALS GRADUATE, FILL OUT FIELDS UNDER THIS SECTION PEPT (Serial/Reference Number): Fill out if applicable ALS (Serial/Reference Number): Fill out if applicable IV-A. GOVERNMENT BENIFICIARY If yes, please specify: Fill out if applicable V. GUARDIAN INFORMATION * Last Name: This is a required field * First Name: This is a required field * Middle Name: This is a required field * Contact Number: This is a required field * Occupation: This is a required field * Guardian Address: This is a required field * Relationship: This is a required field VI. PARENTS INFORMATION MOTHER'S INFORMATION ** Note: if no middle name please put . (dot) * Last Name: This is a required field * First Name: This is a required field * Middle Name: This is a required field * Contact No.: This is a required field * Occupation: This is a required field * Address: This is a required field. FATHER'S INFORMATION ** Note: if no middle name please put . (dot) * Last Name: This is a required field * First Name: This is a required field * Middle Name: This is a required field * Contact No.: This is a required field * Occupation: This is a required field * Address: This is a required field. I am enrolling as a student of UNIVERSITY OF BAGUIO. I hereby attest that I have complied and completed all the necessary documents for enrollment. I voluntarily submit these documents for verification and evaluation by the Adimissions and Records Center of the University of Baguio. Upon admission in the University I submit myself to the following 1.I will obey the rules and regulations of the University of Baguio 2.I will be serious in my studies 3.I will attend my class promptly and regularly 4.If I DROP my subject/s, I will change it officially by accomplishing a DROPPING FORM duly signed by the concerned school personnel. If I do not drop it officially, I accept that this subject will be given a remark FAILED. 5.If I get a remark of INC (Incomplete) and /or NFE (No Final Examination), this means that I have to COMPLETE the requirements of the course or take the final examination within the prescribed completion period. Failure on my part to do this will mean that I will have to re- enroll the subject/s. I understand that any false statement or fraudulent document found hereinafter shall be a ground for non-admittance or dismissal from this institution and all subjects taken by me shall be considered invalid. I certify that all the information I have filled up are true and correct and I agree with the above-mentioned statements. I hereby voluntarily affix the captcha code as my compliance with the rules and regulations of the University of Baguio. Cancel Submit Please wait while saving... CHANGE PASSWORD: * New Password: (Minimum of 6 alphanumeric characters) * Confirm Password: (Minimum of 6 alphanumeric characters) Update Password