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    <title>CBA WAEC FEES SCHOLARSHIP AWARD</title>
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        <div style="text-align: center;">
        <img src="logo.png" />
        </div>
        <header>CBA WAEC FEES SCHOLARSHIP AWARD</header>
        <form action="submit_form.php" method="POST">
            <div class="form first">
                <div class="details personal"><span class="title">A member of Community Builders for Africa  has nominated this school for the WAEC Scholarship Award of the organization for eligible WAEC candidates of the school in the current WAEC enrollment year. Please fill out the form below to complete the scholarship award process. 
. Please fill the form below to continue.</span>
                        <br>
                          <div class="details ID"><span class="title">Nominator Information</span>
                    <div class="fields">
                        <div class="input-field"><label>Name of Sponsor Member</label><input type="text" name="sponsor_name"
                                placeholder="Name of Sponsor Member" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number"
                                name="sponsor_phone" placeholder="Enter phone number"></div>
                        <div class="input-field"><label>Signature</label><input type="file" name="sponsor_signature"
                                placeholder="Upload your Signature"></div>
                        <div class="input-field"><label>Name of Co-ordinator</label><input type="text"
                                name="coordinator_name" placeholder="Enter name of co-ordinator" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number"
                                name="coordinator_phone" placeholder="Enter Phone Number" required></div>
                        <div class="input-field"><label>Co-ordinator Signature</label><input type="file"
                                name="coordinator_signature" placeholder="Co-ordinator Signature" required></div>
                    </div>
                </div>
                        
                    <p>School Information</p>
                    <div class="fields">
                        <div class="input-field"><label>Name of School</label><input type="text" name="school_name"
                                placeholder="Enter school name" required></div>
                        <div class="input-field"><label>State</label>
                       <select onchange="toggleLGA(this);" name="state" id="state" required>
							<option value="" selected="selected">- Select -</option>
							<option value="Abia">Abia</option>
							<option value="Adamawa">Adamawa</option>
							<option value="AkwaIbom">AkwaIbom</option>
							<option value="Anambra">Anambra</option>
							<option value="Bauchi">Bauchi</option>
							<option value="Bayelsa">Bayelsa</option>
							<option value="Benue">Benue</option>
							<option value="Borno">Borno</option>
							<option value="Cross River">Cross River</option>
							<option value="Delta">Delta</option>
							<option value="Ebonyi">Ebonyi</option>
							<option value="Edo">Edo</option>
							<option value="Ekiti">Ekiti</option>
							<option value="Enugu">Enugu</option>
							<option value="FCT">FCT</option>
							<option value="Gombe">Gombe</option>
							<option value="Imo">Imo</option>
							<option value="Jigawa">Jigawa</option>
							<option value="Kaduna">Kaduna</option>
							<option value="Kano">Kano</option>
							<option value="Katsina">Katsina</option>
							<option value="Kebbi">Kebbi</option>
							<option value="Kogi">Kogi</option>
							<option value="Kwara">Kwara</option>
							<option value="Lagos">Lagos</option>
							<option value="Nasarawa">Nasarawa</option>
							<option value="Niger">Niger</option>
							<option value="Ogun">Ogun</option>
							<option value="Ondo">Ondo</option>
							<option value="Osun">Osun</option>
							<option value="Oyo">Oyo</option>
							<option value="Plateau">Plateau</option>
							<option value="Rivers">Rivers</option>
							<option value="Sokoto">Sokoto</option>
							<option value="Taraba">Taraba</option>
							<option value="Yobe">Yobe</option>
							<option value="Zamfara">Zamafara</option>
						</select></div>
                        <div class="input-field"><label>Local Government</label>
                       <select name="lga" id="lga" class=" select-lga" required>
						</select></div>
                        <div class="input-field"><label>City/Location</label><input type="text" name="location"
                                placeholder="Enter school location" required></div>
                    </div>
                </div>
                <div class="details ID"><span class="title">Other Details</span>
                    <div class="fields">
                        <div class="input-field"><label>Name of Principal</label><input type="text" name="principal_name"
                                placeholder="Enter name of Principal" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number"
                                name="principal_phone" placeholder="Enter Phone number" required></div>
                        <div class="input-field"><label>Signature</label><input type="file" name="principal_signature"
                                placeholder="Upload your Signature" required></div>
                        
                    </div><button class="nextBtn"><span class="btnText">Next</span><i
                            class="uil uil-navigator"></i></button>
                </div>
            </div>
            <div class="form second">
                <div class="details address"><span class="title">Applicant 1</span>
                    <div class="fields">
                        <div class="input-field"><label>Name of Applicant</label><input type="text" name="applicant1_name"
                                placeholder="Enter name of applicant" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number" name="applicant1_phone"
                                placeholder="Phone Number" required></div>
                        <div class="input-field"><label>Signature</label><input type="file" name="applicant1_signature"
                                placeholder="Signature" required></div>
                        <div class="input-field"><label>Name of Parent</label><input type="text"
                                name="applicant1_parent_name" placeholder="Enter name of parent" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number"
                                name="applicant1_parent_phone" placeholder="Enter Phone Number" required></div>
                        <div class="input-field"><label>Parent Signature</label><input type="file"
                                name="applicant1_parent_signature" placeholder="Signature" required></div>
                    </div>
                </div>
                <div class="details address"><span class="title">Applicant 2</span>
                    <div class="fields">
                        <div class="input-field"><label>Name of Applicant</label><input type="text" name="applicant2_name"
                                placeholder="Enter name of Applicant" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number" name="applicant2_phone"
                                placeholder="Enter Phone Number" required></div>
                        <div class="input-field"><label>Signature</label><input type="file" name="applicant2_signature"
                                placeholder="Signature" required></div>
                        <div class="input-field"><label>Name of Parent</label><input type="text"
                                name="applicant2_parent_name" placeholder="Enter name of parent" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number"
                                name="applicant2_parent_phone" placeholder="Enter Phone Number" required></div>
                        <div class="input-field"><label>Signature</label><input type="file"
                                name="applicant2_parent_signature" placeholder="Signature" required></div>
                    </div>
                </div>
                <div class="details address"><span class="title">Applicant 3</span>
                    <div class="fields">
                        <div class="input-field"><label>Name of Applicant</label><input type="text" name="applicant3_name"
                                placeholder="Enter name of applicant" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number" name="applicant3_phone"
                                placeholder="Enter Phone Number" required></div>
                        <div class="input-field"><label>Signature</label><input type="file" name="applicant3_signature"
                                placeholder="Signature" required></div>
                        <div class="input-field"><label>Name of Parent</label><input type="text"
                                name="applicant3_parent_name" placeholder="Enter name of parent" required></div>
                        <div class="input-field"><label>Phone Number</label><input type="number"
                                name="applicant3_parent_phone" placeholder="Enter Phone Number" required></div>
                        <div class="input-field"><label>Signature</label><input type="file"
                                name="applicant3_parent_signature" placeholder="Signature" required></div>
                    </div>
                </div>
                <div class="buttons">
                    <div class="backBtn"><i class="uil uil-navigator"></i><span class="btnText">Back</span></div><button
                        type="submit" class="submit"><span class="btnText">Submit</span><i
                            class="uil uil-navigator"></i></button>
                </div>
            </div>
        </form>
    </div>
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