<?php $title="Eligibility Check | Versura";
include("include/header.php"); ?>
<div class="page-header">
  <div class="container">
    <div class="row">
      <div class="col-md-12">
        <div class="page-breadcrumb">
          <ol class="breadcrumb">
            <li><a href="index.php">Home</a></li>
            <li class="active">Eligibility Check</li>
          </ol>
        </div>
      </div>
      <div class="col-md-12 col-sm-12 col-xs-12">
        <div class="bg-white pinside30">
          <div class="row">
            <div class="col-md-12">
              <h1 class="page-title">Eligibility</h1>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
</div>
<div class=" ">
  <!-- content start -->
  <div class="container">
    <div class="row">
      <div class="col-md-12">
        <div class="wrapper-content bg-white">
        <figure><img src="images/eligibility.jpg" alt=""/ class="img-responsive"></figure>
          <div class="contact-form mb60">
            <div class=" pinside40">
              <div class="col-md-offset-2 col-md-8 col-sm-12 col-xs-12">
                <div class="mb60  section-title text-center  ">
                  <!-- section title start-->
                  <h1>Check your eligibility</h1>
                 <!-- <p>Reach out to us &amp; we will respond as soon as we can.</p>-->
                </div>
              </div>
              <div class="row">
              
              <div class="col-md-12"><br>
<p> If you meet all of the above criteria, please share the following details to enable one of our representative to reach out to you:</p><br>
</div>
              
              
                <form class="contact-us" method="post" action="#">
                  <div class=" ">
                    <!-- Text input-->
                    <div class="col-md-4 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="name">name<span class=" "> </span></label>
                        <input id="name" type="text" placeholder="Name" class="form-control input-md">
                      </div>
                    </div>
                    <!-- Text input-->
                    <div class="col-md-4 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="email">Email<span class=" "> </span></label>
                        <input id="email" type="email" placeholder="Email" class="form-control input-md">
                      </div>
                    </div>
                    <!-- Text input-->
                    <div class="col-md-4 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Phone<span class=" "> </span></label>
                        <input id="phone" type="text" placeholder="Phone" class="form-control input-md">
                      </div>
                    </div>
                    <!-- Select Basic -->
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Name of the Society or Trust or Company<span class=" "> </span></label>
                        <input id="society" type="text" placeholder="Name of the Society or Trust or Company" class="form-control input-md">
                      </div>
                    </div>
                     <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Brand Name of the School(s)<span class=" "> </span></label>
                        <input id="brand" type="text" placeholder="Brand Name of the School(s)" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Location<span class=" "> </span></label>
                        <input id="location" type="text" placeholder="Location" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                       <p>Affiliation of School(s)</p>
                        <select name="select" id="affiliation">
 <option selected="selected" value="-1">Select School</option>

  <option>CBSE</option>
  <option>ICSE</option>
  <option>State Board</option>
   <option>IB</option>
    <option>Multiple</option>
     <option>None of the above</option>
</select>

                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Number of Affiliated Schools/ Institutions/ Branches<span class=" "> </span></label>
                        <input id="number" type="text" placeholder="Number of Affiliated Schools/ Institutions/ Branches" class="form-control input-md">
                      </div>
                    </div>
                    
                    
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <p>Type of School</p>
                      <select name="select" id="type">
 <option selected="selected" value="-1">Select School</option>

  <option>Private</option>
  <option>Government</option>
  <option>Govt-Aided</option>
</select>
                        
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                       <p>Constitution of School</p>
                      <select name="select" id="constitution">
 <option selected="selected" value="-1">Select School</option>

  <option>Trust</option>
  <option>Society</option>
  <option>Section 25 Company</option>
  <option>Private Limited Company</option>
  <option>Other</option>
</select>
                       
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">No. of students<span class=" "> </span></label>
                        <input id="students" type="text" placeholder="No. of students" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                      <p>Grades Coverage</p>
                          <select name="select" id="grades">
 <option selected="selected" value="-1">Select Grade</option>

  <option>< Grade 5</option>
  <option>Upto Grade 10</option>
  <option>Upto Grade 12</option>
</select>
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                      <p>Fee Receipts (Rs. Crores):</p>
                        <label class="sr-only control-label" for="phone">Fee receipts expected in current financial year (2017-18)<span class=" "> </span></label>
                        <input id="current" type="text" placeholder="Fee receipts expected in current financial year (2017-18)" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Fee Receipts in last financial year (2016-17)<span class=" "> </span></label>
                        <input id="last" type="text" placeholder="Fee Receipts in last financial year (2016-17)" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Fee Receipts in previous financial year (2015-16) <span class=" "> </span></label>
                        <input id="previous" type="text" placeholder="Fee Receipts in previous financial year (2015-16) " class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">How old is the School - no. of years<span class=" "> </span></label>
                        <input id="old" type="text" placeholder="How old is the School - no. of years" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                      <p>Banking Arrangements:</p>
                        <label class="sr-only control-label" for="phone">Any existing loans (insert amount in INR lacs)<span class=" "> </span></label>
                        <input id="existing" type="text" placeholder="Any existing loans (insert amount in INR lacs)" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Who have you taken a loan from currently<span class=" "> </span></label>
                        <input id="who" type="text" placeholder="Who have you taken a loan from currently" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12">
                    <hr>
                    <h3>Funding Requirements:</h3>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Purpose<span class=" "> </span></label>
                        <input id="purpose" type="text" placeholder="Purpose" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Amount Sought by Institution (Rs. Lacs):<span class=" "> </span></label>
                        <input id="institution" type="text" placeholder="Amount Sought by Institution (Rs. Lacs):" class="form-control input-md">
                      </div>
                    </div>
                    <div class="col-md-12 col-sm-12 col-xs-12">
                      <div class="form-group">
                        <label class="sr-only control-label" for="phone">Tenure Sought (in Years):<span class=" "> </span></label>
                        <input id="tenure" type="text" placeholder="Tenure Sought (in Years):" class="form-control input-md">
                      </div>
                    </div>
                   
                    
                    
                    <!-- Button -->
                    <div class="col-md-12 col-xs-12">
                      <button type="submit" class="btn btn-default" onclick="return sendmail();">Submit</button>
                    </div>
                  </div>
                </form>
              </div>
            </div>
            <!-- /.section title start-->
          </div>

        </div>
      </div>
    </div>
  </div>
</div>
<?php include("include/footer.php"); ?>
