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This the form:

<div style="border: 0px #000 solid; padding:0px 0 0 5px; width:auto;"><h3 align="center"><b>Job Seeker Application Form:</b></div></h3>
    <div id="container" class="ltr"><form name="cliform" method="post" action="cli_app_check.php"  enctype="multipart/form-data">
<table width="100%" align="center"><tr><td>
<table width="100%" align="center" cellpadding="0" cellspacing="10"><tr><td align="right">Title :</td><td width="16%"><select name="title"><option value="000">Select Title</option><option value="Dr.">Dr.</option><option value="Mr.">Mr.</option><option value="Mrs.">Mrs.</option><option value="Miss.">Miss.</option></select></td><td align="right">Surname :</td><td><input name="sname" type="text" id="sname"></td><td align="right">Other Names :</td><td><input name="onames" type="text" id="onames"></td></tr>

<tr><td align="right">Marital Status :</td><td width="16%"><select name="mstatus"><option value="000">Select Status</option><option value="Single">Single</option><option value="Married">Married</option><option value="Divorced">Divorced</option><option value="Widow">Widow</option><option value="Widower">Widower</option></select></td><td align="right">Sex:</td><td><select name="sex"><option value="000">Select Sex</option><option value="Male">Male</option><option value="Female">Female</option></select></td><td align="right">Date of Birth:</td><td><input name="dob" id="inputField"></td></tr>

<tr><td align="right">Maiden Name:</td><td width="16%"><input name="mname" type="text" id="mname"></td><td align="right">State of Origin:</td><td><select name="stateO">
<option value="000">Select State</option>
<option value="Abia">Abia</option>
<option value="Abuja">Abuja</option>
<option value="Adamawa">Adamawa</option>
<option value="Akwa Ibom">Akwa Ibom</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="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="Nassarawa">Nassarawa</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">Zamfara</option>
</select></td><td align="right">L.G.A.:</td><td><input name="lga" type="text" id="lga"></td></tr>

<tr><td align="right">Contact Address:</td><td colspan="2" align="left"><textarea name="conaddress" cols="30" rows="5"></textarea></td><td align="right">Village Address :</td><td colspan="2" align="left"><textarea name="viladdress" cols="30" rows="5"></textarea></td></tr>

<tr><td align="right">Email Address:</td><td><input name="email" type="text" id="email"></td><td align="right">Telephone:</td><td><input name="phone" type="text" id="phone"></td><td align="right">Religion:</td><td><select name="religion"><option value="000">Select Religion</option><option value="Christian">Christian</option><option value="Muslim">Muslim</option><option value="Traditional">Traditional</option></select></td></tr>

<tr><td align="right">Father's Name :</td><td><input name="fatname" type="text" id="fatname"></td><td align="right">Mother's Name:</td><td><input name="motname" type="text" id="motname"></td><td align="right">Name of Spouse:</td><td><input name="spouse" type="text" id="spouse"></td></tr>

<tr><td align="right">Number of Children :</td><td><input name="numchild" type="text" id="numchild"></td><td align="right">Boy (s):</td><td><input name="boys" type="text" id="boys"></td><td align="right">Girl (s):</td><td><input name="girls" type="text" id="girls"></td></tr>

<tr><td align="right"><label for='uploaded_file'> Upload your CV</label>:</td><td colspan="5" align="left"><input name="uploaded_file" type="file" id="cv"></td></tr>




<tr><td colspan="6" align="left"><hr width="100%"></td></tr>

<tr><td colspan="6" align="center"><table width="100%">

<tr><td colspan="4" align="center"><b>Educational Institutions Attended:</b></td></tr>
<b><tr><td width="10%" align="center"></td><td width="35%" align="center"><b>Levels of Education</b></td><td width="35%" align="center"><b>Name of Institution/Professional Body</b></td><td width="20%" align="center"><b>From ......to ......</b></td></tr></b>
<tr><td align="center">A</td><td align="center">Primary Education</td><td align="center"><input name="priatt" type="text"></td><td><input name="pridate" type="text"></td></tr>
<tr><td align="center">B</td><td align="center">Secondary Education</td><td align="center"><input name="secatt" type="text"></td><td><input name="secdate" type="text"></td></tr>
<tr><td align="center">C</td><td align="center">Tertiary Education</td><td align="center"><input name="taratt" type="text" /></td><td><input name="tardate" type="text" /></td></tr>
<tr><td align="center">D</td><td align="center">Post Graduate</td><td align="center"><input name="pgatt" type="text" /></td><td><input name="pgdate" type="text" /></td></tr>
<tr><td align="center">E</td><td align="center">Doctoral</td><td align="center"><input name="docatt" type="text" /></td><td><input name="docdate" type="text" /></td></tr>
<tr><td align="center">F</td><td align="center">Professional Body 1</td><td align="center"><input name="pbody1" type="text" id="pbody1"></td><td><input name="pbody1date" type="text" /></td></tr>
<tr><td align="center">G</td><td align="center">Professional Body 2</td><td align="center"><input name="pbody2" type="text" id="pbody2"></td><td><input name="pbody2date" type="text" /></td></tr>

</table></td></tr>

<tr><td colspan="6" align="left"><hr width="100%"></td></tr>

<tr><td colspan="6" align="center"><table width="100%">

<tr><td colspan="4" align="center"><b>Qualifications Obtained/Course of Study or Area of Specialisation:</b></td></tr>
<b><tr><td width="10%" align="center"></td><td width="35%" align="center"><b>Levels of Education</b></td><td width="35%" align="center"><b>Qualification</b></td><td width="20%" align="center"><b>Course of Study</b></td></tr></b>
<tr><td align="center">A</td><td align="center">Primary Education</td><td align="center"><input name="priq" type="text"></td><td><input name="priqcourse" type="text" /></td></tr>
<tr><td align="center">B</td><td align="center">Secondary Education</td><td align="center"><input name="secq" type="text"/></td><td><input name="secqcourse" type="text" /></td></tr>
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5 Years
Discussion Span
Last Post by rotten69
2

How would you like us to help you? I'm sorry to say this, but I don't think anyone of us will have the time to go through what you've produced or someone has produced for you... If you're really after some help with the lines you've posted, then you need to be specific about the issues you're facing with the code. Because we don't know what you're trying to achieve.

Good luck

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