<?php require_once('webform_pre.php');?>

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<head>

    <meta http-equiv="X-UA-Compatible" content="IE=edge">

    <meta name="author" content="">



    <title>Apply to SEN Courses – Asian College of Teachers</title>

    <meta name="description" content="Apply to international SEN courses to learn to identify and help the special children in your classroom.">

    



   <?php include('common/script.php');?> 

<script language="javascript">

	function SaveData()

	{

	    form2.txtAction2.value = "save_data";

	    form2.submit();

	}

</script>

</head>



<body>

     <!-- Start header -->

        <?php include('common/header.php');?>

        <!-- end of header -->

<section class="inner-banner-sec">

<div class="inner-overlay">

<div class="container">

<div class="inbanner-text-bx">

<h1>Apply Now</h1>

<p>Learn to create an effective inclusive classroom

</p>

</div>

</div>

</div>

</section>

<!-------------------end inner banner section-------------------->

<div class="breadcrumb-sec">

<div class="container">

<ul class="breadcrumbs-custom">

                <li><a href="./">Home</a></li>

                <li class="active">Apply</li>

              </ul>

</div>

</div>



<!-------------------------------------------------->

<section class="inner-body">

<div class="container">

<div class="inn-title">

<h2 class="title">Apply Now</h2>

</div>

<div class="row">



<div class="col-md-8 col-sm-10">

<div class="top-form">

                              	      

<form name="form2" id="form2" method="POST" style="line-height:0.5;padding:10px;">

<span style="font-size:20px;font-weight:bold;margin-top:10px;">APPLICATION - SEN COURSE International</span><br><br><br>

<span style="font-size:12px;">Asian College of Teachers</span>

<hr style="border-bottom: 1px dotted #ccc;">

	<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/>

	</div>

	 <div class="form-group"> 

		<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/>

	</div>

	<div class="form-group">

		<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/>

	</div>



	<div class="form-group"> 

    <label class="control-label" for="dob">Date of Birth </label>

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



    </div>

   <div class="form-group"> 

		<label class="control-label" for="qualification">Educational Qualification <span class="asteriskField" style="color:#F00">*</span></label>

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

	</div>

    <div class="form-group"> 

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

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

	</div>

    

     <div class="form-group"> 

		<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/>

	</div>

      <div class="form-group">

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

		<select class="form-control" name="cmbCourse" id="cmbCourse" required>

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

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

            <option value="ADHD">ADHD</option>

            <option value="Autism">Autism</option>

            <option value="Learning Disabilities">Learning Disabilities</option>

            <option value="5-Days SEN Workshop">5-Days SEN Workshop</option>

            <option value="1 Year Diploma in SEN (Blended)">1 Year Diploma in SEN (Blended)</option>
            
            <option value="Live Online Workshop">Live Online Workshop</option>

	</select>

	</div>

    <div class="form-group"> 

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

		<textarea class="form-control" name="comment" id="comment" required></textarea>

    </div>

<center>           

    <button type="submit" class="btn btn-primary" name="submit" id="submit" style="font-size:16px;"  onClick="SaveData()">SUBMIT</button>

    <input type="hidden" name="txtAction2" id="txtAction2">

   </center>

</form>

</div>

</div>











</div>





</div>

</section>



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<?php include('common/counter.php');?>



<!-------------------------------------------------->

<?php include('common/testimonial.php');?>



<!-------------------------------------------------->

<?php include('common/client-logo.php');?>



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<?php include('common/footer.php');?>



  

   

</body>



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