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<span style="font-size:16px;font-weight:bold;margin-top:10px;">APPLY - SEN COURSE International</span><br>

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	<div class="form-group"> <!-- Name field -->

		<label class="control-label " for="txtname">Name <span class="asteriskField" style="color:#F00">*</span></label>

		<input class="form-control" id="txtname" name="txtname" type="text" required/>

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		<label class="control-label" for="subject">Phone Number <span class="asteriskField" style="color:#F00">*</span></label>

		<input class="form-control" id="contact" name="contact" type="text" required/>

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		<label class="control-label requiredField" for="email">Email <span class="asteriskField" style="color:#F00">*</span></label>

		<input class="form-control" id="email" name="email" type="email" required/>

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		<label class="control-label" for="country">Country<span class="asteriskField" style="color:#F00">*</span> </label>

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		<label class="control-label" for="location">City<span class="asteriskField" style="color:#F00">*</span> </label>

		<input class="form-control" id="location" name="location" type="text" required/>

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		<label class="control-label " for="cmbCourse">Please select your course<span class="asteriskField" style="color:#F00">*</span></label>

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            <option value="">Select Course</option>

      		<option value="Special Education">Special Education</option>

            <option value="Special Educationl Needs (SEN) Courses - Online">Special Educationl Needs (SEN) Courses - Online </option>

            <option value="Learning Disabilities (LD) Courses - Online">Learning Disabilities (LD) Courses - Online</option>

            <option value="Autism Courses - Online">Autism Courses - Online</option>

            <option value="ADHD Courses - Online">ADHD Courses - Online</option>
            
            <option value="SEN Course for Parents">SEN Course for Parents</option>
             
            <option value="Live Online Workshop on SEN">Live Online Workshop on SEN</option>

         <!--   <option value="1 Year Diploma in SEN (Blended)">1 Year Diploma in SEN (Blended)</option>-->

            

             <option value="SEN Seminar">SEN Seminar</option>

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		<label class="control-label" for="comment" >Why are you interested in this course? <span class="asteriskField" style="color:#F00">*</span> </label>

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