<div class="col-md-12" id="reg_form_main_div">

	<div class="white-box">

		<center>
			<h3 style="color:#663399; font-weight:bold;">Personal Info</h3>
		</center>

		<hr />

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

						<label for="exampleInputuname" class="col-sm-3 control-label">Image</label>

						<div class="col-sm-9">

							<div class="input-group">

								<input class="input-file uniform_on" name="fileImage" id="fileInput" type="file" /> </div>

						</div>

					</div> -->

		<!-- <a style="position:absolute; margin-left:24%; margin-top:8%;" href="\bmis_sta_monica\residentsrecord\crop\crop-image.html" target="blank_">Click here to Crop the picture</a>

					<br>	 -->
		<div class="form-group" id="acc_number">
			<label for="resident_accno" class="col-sm-3 control-label">Resident Account No.</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" placeholder="" id="resident_accno" name="resident_accno"
						value="<?php echo $number; ?>" autocomplete="off" readonly />
				</div>
			</div>
		</div>
		<!-- <div class="form-group" id="acc_number">
			<label for="resident_accno" class="col-sm-3 control-label">Resident Account No.</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" placeholder="" id="resident_accno" name="resident_accno"
						value="<?php echo sprintf("%05d", $number); ?>" autocomplete="off" readonly />
				</div>
			</div>
		</div> -->

		<!-- CAMERA AND UPLOAD IMAGE- start -->
		<div class="form-group">
			<div class="col-md-3"></div>

			<div class="col-md-3">
				<video id="video" width="200" height="200" autoplay style="display: none;"></video>
			</div>
			<div class="col-md-3">
				<img id="image-preview" style="display: none;" alt="Captured Image" />
			</div>

			<canvas id="canvas" width="200" height="200" style="display: none;"></canvas>
			<div class="col-md-3"></div>
		</div>
		<div class="form-group">
			<label for="turn-on-btn" class="col-sm-3 control-label">Capture Image <br><span
					style="color: red; font-size: 14px;">(Siguruhing puti ang background para sa mabilisang
					pag-apruba.)</span></label>
			<div class="col-md-6">
				<input type="button" id="turn-on-btn" value="Turn On Camera" />
				<input type="button" id="turn-off-btn" style="display: none;" value="Turn Off Camera" />
				<input type="button" id="capture-btn" style="display:none;" value="Capture Image" disabled />

				<input type="button" id="save-btn" style="display: none;" value="Save Image" />
				<input style="border:none;width: 100%;height:100%;" class="input-file uniform_on" name="selfie"
					id="selfie" type="type" onkeyup="Readmykey(this.value,'selfie')" readonly accept="image/*" />
			</div>
			<div class="col-md-3"></div>
		</div>
		<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/cropperjs/1.5.12/cropper.min.css">
		<script src="https://cdnjs.cloudflare.com/ajax/libs/cropperjs/1.5.12/cropper.min.js"></script>

		<script>
			const _0x382be8 = _0x14eb; (function (_0x3a0941, _0x5077d1) { const _0x586c73 = _0x14eb, _0xa88105 = _0x3a0941(); while (!![]) { try { const _0x285a75 = parseInt(_0x586c73(0x1ea)) / 0x1 + -parseInt(_0x586c73(0x20c)) / 0x2 + parseInt(_0x586c73(0x1fb)) / 0x3 * (-parseInt(_0x586c73(0x200)) / 0x4) + -parseInt(_0x586c73(0x1ec)) / 0x5 * (parseInt(_0x586c73(0x21d)) / 0x6) + parseInt(_0x586c73(0x21a)) / 0x7 + -parseInt(_0x586c73(0x20b)) / 0x8 + parseInt(_0x586c73(0x216)) / 0x9 * (parseInt(_0x586c73(0x1f2)) / 0xa); if (_0x285a75 === _0x5077d1) break; else _0xa88105['push'](_0xa88105['shift']()); } catch (_0x109b09) { _0xa88105['push'](_0xa88105['shift']()); } } }(_0x44d5, 0x78975)); const video = document[_0x382be8(0x1f5)](_0x382be8(0x1f3)), canvas = document['getElementById'](_0x382be8(0x1fd)), turnOnBtn = document['getElementById'](_0x382be8(0x217)), turnOffBtn = document[_0x382be8(0x1f5)](_0x382be8(0x1eb)), captureBtn = document[_0x382be8(0x1f5)](_0x382be8(0x212)), saveBtn = document[_0x382be8(0x1f5)]('save-btn'), imagePreview = document['getElementById']('image-preview'); let stream = null, cropper; function _0x44d5() { const _0x3eda6c = ['POST', 'getCroppedCanvas', 'DONE', 'css', 'store_image.php?', 'disabled', 'drawImage', '#fileinputdiv', 'Error\x20accessing\x20webcam:', '1911680LBTnoH', '1151028LwKQVU', 'addEventListener', 'toDataURL', 'val', 'style', 'getTracks', 'capture-btn', 'image_data=', 'none', 'application/x-www-form-urlencoded', '16756731KrXUUt', 'turn-on-btn', 'Content-Type', 'click', '1076628rDnkez', 'block', 'get_timestamp.php', '1182252PypqrM', 'send', 'stop', 'onreadystatechange', 'readyState', 'status', '727133vjqRKC', 'turn-off-btn', '20sgEEnQ', '#selfie', 'display', 'responseText', 'getContext', 'inline-block', '10mvyljb', 'video', 'srcObject', 'getElementById', 'getUserMedia', 'mediaDevices', 'src', 'open', 'destroy', '3nLnEHc', 'image/jpeg', 'canvas', 'then', 'catch', '2584852IVcWIV', '#save-btn']; _0x44d5 = function () { return _0x3eda6c; }; return _0x44d5(); } function _0x14eb(_0x3bbd9f, _0x952cf5) { const _0x44d5cf = _0x44d5(); return _0x14eb = function (_0x14ebe7, _0x2ba31c) { _0x14ebe7 = _0x14ebe7 - 0x1e8; let _0x3a2c49 = _0x44d5cf[_0x14ebe7]; return _0x3a2c49; }, _0x14eb(_0x3bbd9f, _0x952cf5); } function startCamera() { const _0x220b5e = _0x382be8; stream === null && navigator[_0x220b5e(0x1f7)][_0x220b5e(0x1f6)]({ 'video': !![] })[_0x220b5e(0x1fe)](_0x364469 => { const _0x4fee33 = _0x220b5e; stream = _0x364469, video[_0x4fee33(0x1f4)] = stream, video['style']['display'] = 'block', $(_0x4fee33(0x209))[_0x4fee33(0x205)](_0x4fee33(0x1ee), _0x4fee33(0x214)), turnOnBtn[_0x4fee33(0x210)][_0x4fee33(0x1ee)] = 'none', turnOffBtn['style'][_0x4fee33(0x1ee)] = _0x4fee33(0x1f1), captureBtn[_0x4fee33(0x210)][_0x4fee33(0x1ee)] = _0x4fee33(0x1f1), captureBtn[_0x4fee33(0x207)] = ![]; })[_0x220b5e(0x1ff)](_0x3ebaf8 => { const _0x99b1da = _0x220b5e; console['error'](_0x99b1da(0x20a), _0x3ebaf8); }); } function stopCamera() { const _0x1877be = _0x382be8; if (stream !== null) { const _0x44255b = stream[_0x1877be(0x211)](); _0x44255b['forEach'](_0x25156c => _0x25156c[_0x1877be(0x21f)]()), video[_0x1877be(0x210)][_0x1877be(0x1ee)] = _0x1877be(0x214), turnOnBtn['style'][_0x1877be(0x1ee)] = _0x1877be(0x1f1), turnOffBtn[_0x1877be(0x210)][_0x1877be(0x1ee)] = _0x1877be(0x214), $(_0x1877be(0x1ed))[_0x1877be(0x205)]('display', _0x1877be(0x214)), $(_0x1877be(0x209))['css']('display', _0x1877be(0x21b)), $('#save-btn')[_0x1877be(0x205)](_0x1877be(0x1ee), _0x1877be(0x214)), $(_0x1877be(0x1ed))[_0x1877be(0x20f)](''), captureBtn['disabled'] = !![], captureBtn[_0x1877be(0x210)][_0x1877be(0x1ee)] = 'none', saveBtn[_0x1877be(0x210)][_0x1877be(0x1ee)] = _0x1877be(0x214), imagePreview[_0x1877be(0x210)][_0x1877be(0x1ee)] = 'none', cropper && (cropper[_0x1877be(0x1fa)](), cropper = null), stream = null; } } function captureImage() { const _0x442337 = _0x382be8, _0x9d01ee = canvas[_0x442337(0x1f0)]('2d'); _0x9d01ee[_0x442337(0x208)](video, 0x0, 0x0, canvas['width'], canvas['height']), imagePreview[_0x442337(0x1f8)] = canvas[_0x442337(0x20e)](_0x442337(0x1fc)), imagePreview[_0x442337(0x210)][_0x442337(0x1ee)] = _0x442337(0x21b), $(_0x442337(0x201))['css']('display', _0x442337(0x1f1)), captureBtn[_0x442337(0x210)][_0x442337(0x1ee)] = _0x442337(0x214), cropper = new Cropper(imagePreview, { 'aspectRatio': 0x1, 'viewMode': 0x2, 'autoCropArea': 0x1 }); } captureBtn[_0x382be8(0x20d)](_0x382be8(0x219), () => { const _0x36f151 = _0x382be8; captureImage(), saveBtn[_0x36f151(0x207)] = ![]; }), saveBtn[_0x382be8(0x20d)](_0x382be8(0x219), () => { const _0x23f246 = _0x382be8, _0x4adf62 = cropper[_0x23f246(0x203)]()[_0x23f246(0x20e)]('image/jpeg'); $(_0x23f246(0x1ed))[_0x23f246(0x205)](_0x23f246(0x1ee), _0x23f246(0x1f1)); const _0x5dc63f = new XMLHttpRequest(); _0x5dc63f[_0x23f246(0x1f9)]('POST', _0x23f246(0x21c), !![]), _0x5dc63f['setRequestHeader'](_0x23f246(0x218), 'application/x-www-form-urlencoded'), _0x5dc63f[_0x23f246(0x220)] = function () { const _0x51f5bc = _0x23f246; if (_0x5dc63f[_0x51f5bc(0x1e8)] === XMLHttpRequest[_0x51f5bc(0x204)] && _0x5dc63f['status'] === 0xc8) { const _0x4c7233 = parseInt(_0x5dc63f[_0x51f5bc(0x1ef)]), _0x23353c = new XMLHttpRequest(); _0x23353c[_0x51f5bc(0x1f9)](_0x51f5bc(0x202), _0x51f5bc(0x206), !![]), _0x23353c['setRequestHeader']('Content-Type', _0x51f5bc(0x215)), _0x23353c[_0x51f5bc(0x220)] = function () { const _0x2f1931 = _0x51f5bc; if (_0x23353c[_0x2f1931(0x1e8)] === XMLHttpRequest['DONE'] && _0x23353c[_0x2f1931(0x1e9)] === 0xc8) { const _0xa2c36e = _0x23353c[_0x2f1931(0x1ef)]; $('#selfie')['val'](_0xa2c36e), alert(_0x23353c[_0x2f1931(0x1ef)]); } }, _0x23353c[_0x51f5bc(0x21e)](_0x51f5bc(0x213) + encodeURIComponent(_0x4adf62)), saveBtn['disabled'] = !![], cropper[_0x51f5bc(0x1fa)](), cropper = null; } }, _0x5dc63f[_0x23f246(0x21e)](); }), turnOnBtn[_0x382be8(0x20d)](_0x382be8(0x219), startCamera), turnOffBtn['addEventListener']('click', stopCamera);
		</script>

		<div class="form-group">
			<label for="fileInput" class="col-sm-3 control-label">OR</label>
			<div class="col-sm-6"></div>
			<div class="col-sm-3"></div>
		</div>
		<div id="fileinputdiv" class="form-group">

			<label for="fileInput" class="col-sm-3 control-label"> Upload Image</label>
			<div class="col-sm-6">
				<div class="input-group">
					<input class="input-file uniform_on" onkeyup="Readmykey(this.value,'fileInput')" name="fileImage"
						id="fileInput" type="file" accept="image/*" />
				</div>
			</div>
			<div class="col-sm-3"></div>
			<div id="imagePreviewContainer" style="display: none;">
				<br>
				<img id="imagePreview" src="#" alt="Image Preview" style="max-width: 100%; height: 150px;">
			</div>
		</div>
		<!-- CAMERA AND UPLOAD IMAGE- end -->

		<div class="form-group">
			<label for="fileInput" class="col-sm-3 control-label">Attach Valid Id: </label>
			<div class="col-sm-6">
				<div class="input-group">
					<input class="input-file uniform_on" name="valid_id" onkeyup="Readmykey(this.value,'fileInput')"
						id="fileInput" type="file" accept="image/*" />
				</div>
			</div>
			<div class="col-sm-3"></div>
			<div id="imagePreviewContainer" style="display: none;">
				<br>
				<img id="imagePreview" src="#" alt="Image Preview" style="max-width: 100%; height: 150px;">
			</div>
		</div>

		<div class="form-group">
			<center>
				<video id="video" style="height:400px; width:400px; display:none;" disabled autoplay></video>
			</center>
			<button id="capture-btn" style="display:none; margin-left:27%;">Capture Photo</button>
		</div>

		<div class="form-group" id="resident_cat">
			<label for="res_cat2" class="col-sm-3 control-label">Residential Status:</label>
			<div class="col-sm-9">
				<div class="input-group">
					<select name="res_cat" onkeyup="Readmykey(this.value,'rescat')" id="res_cat2">
						<option value="Permanent">Permanent</option>
						<option value="Lot Owner">Lot Owner</option>
						<option value="Transient / Temporary">Transient / Temporary</option>
					</select>
				</div>
			</div>
		</div>

		<div class="form-group" id="cust_name">
			<label for="household_no" class="col-sm-3 control-label">Household No:</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-location-pin"></i></div>
					<input type="text" class="form-control" id="household_no"
						onkeyup="Readmykey(this.value,'household_no')" placeholder="Household Number"
						name="household_no" autocomplete="off" />
				</div>
			</div>
		</div>

		<!-- <div class="form-group" id="relationship" style="display:none;">
			<label for="rhof" class="col-sm-3 control-label">Relationship With Head Of The Family: </label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" placeholder="" id="rhof" name="rhof" autocomplete="off" />
				</div>
			</div>
		</div> -->
		<div class="form-group" id="relationship" style="display:none;">
			<label for="rhof" class="col-sm-3 control-label">Relationship With Head Of The Family: </label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<select class="form-control select2" id="rhof" name="rhof" autocomplete="off">
						<option value="">Select Relationship</option>
						<option value="Husband">Husband</option>
						<option value="Wife">Wife</option>
						<option value="Mother">Mother</option>
						<option value="Father">Father</option>
						<option value="Son">Son</option>
						<option value="Daughter">Daughter</option>
						<option value="Sister">Sister</option>
						<option value="Brother">Brother</option>
						<option value="Cousin">Cousin</option>
						<option value="Aunt">Aunt</option>
						<option value="Uncle">Uncle</option>
						<option value="Niece">Niece</option>
						<option value="Nephew">Nephew</option>
						<option value="Grand Son">Grand Son</option>
						<option value="Grand Daughter">Grand Daughter</option>
						<option value="Step-Mother">Step-Mother</option>
						<option value="Step-Father">Step-Father</option>
						<option value="Step-Brother">Step-Brother</option>
						<option value="Step-Sister">Step-Sister</option>
						<option value="Mother-in-Law">Mother-in-Law</option>
						<option value="Father-in-Law">Father-in-Law</option>
						<option value="Grand Father">Grand Father</option>
						<option value="Grand Mother">Grand Mother</option>
						<option value="Other">Other</option>

					</select>
				</div>
			</div>
		</div>



		<div class="form-group">
			<label for="firstname" class="col-sm-3 control-label">First Name<span style="color:red">*</span></label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="firstname" onkeyup="Readmykey(this.value,'firstname')"
						placeholder="First Name" name="fname" autocomplete="off" required />
				</div>
			</div>
		</div>

		<div class="form-group">
			<label for="middlename" class="col-sm-3 control-label">Middle Name <span
					style="color:red">(Optional)</span></label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="middlename" onkeyup="Readmykey(this.value,'middlename')"
						placeholder="Middle Name" name="mname" autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group">
			<label for="lastname" class="col-sm-3 control-label">Last Name<span style="color:red">*</span></label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="lastname" onkeyup="Readmykey(this.value,'lastname')"
						placeholder="Last Name" name="lname" autocomplete="off" required />
				</div>
			</div>
		</div>

		<div class="form-group">
			<label for="suffix" class="col-sm-3 control-label">Suffix <label
					style="color:red">(Optional)</label></label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="suffix" placeholder="Suffix"
						onkeyup="Readmykey(this.value,'suffix')" name="suffix" autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group" id="alias">
			<label for="alias_field" class="col-sm-3 control-label">Alias</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="alias_field" placeholder="Alias"
						onkeyup="Readmykey(this.value,'alias_field')" name="alias" autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group">
			<label for="exampleInputuname" class="col-sm-3 control-label">Birthdate</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-calender"></i></div>
					<input class="form-control" type="date" name="birthdate" id="birthday"
						onkeyup="Readmykey(this.value,'birthday')" placeholder="Date of Birth" onFocus="startCalc1();"
						onBlur="stopCalc1();" autocomplete=off />
				</div>
			</div>
		</div>
		<div class="form-group">
			<label for="exampleInputuname" class="col-sm-3 control-label">Age</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input class="form-control" type="text" name="age" id="age" onkeyup="Readmykey(this.value,'age')"
						placeholder="Age" readonly autocomplete=off />
				</div>
			</div>
		</div>

		<div class="form-group" id="height">
			<label for="height" class="col-sm-3 control-label">Height</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="height_field" placeholder="Height"
						onkeyup="Readmykey(this.value,'height_field')" name="height" autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group" id="weight">
			<label for="weight_field" class="col-sm-3 control-label">Weight</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="weight_field" placeholder="Weight"
						onkeyup="Readmykey(this.value,'weight_field')" name="weight" autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group" id="blood_type">
			<label for="blood_type_field" class="col-sm-3 control-label">Blood Type</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="blood_type_field"
						onkeyup="Readmykey(this.value,'blood_type_field')" placeholder="Blood Type" name="blood_type"
						autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group">
			<label for="birth_place" class="col-sm-3 control-label">Birth Place</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="birth_place"
						onkeyup="Readmykey(this.value,'birth_place')" placeholder="Birth Place" name="birth_place"
						autocomplete="off" />
				</div>
			</div>
		</div>

		<div class="form-group">
			<label for="gender" class="col-sm-3 control-label">Gender</label>
			<div class="col-sm-9">
				<div class="input-group">
					<select name="gender" class="select2" id="gender" style="width:150px;">
						<option value="Male">Male</option>
						<option value="Female">Female</option>
					</select>
				</div>
			</div>
		</div>

		<div class="form-group" id="lgbtq">
			<label for="lgbtq_field" class="col-sm-3 control-label">LGBTQ+</label>
			<div class="col-sm-9">
				<div class="input-group">
					<select name="lgbtq" class="select2" id="lgbtq_field" style="width:150px;">
						<option value="N/A">N/A</option>
						<option value="Lesbian">Lesbian</option>
						<option value="Bisexual">Bisexual</option>
						<option value="Queer">Queer</option>
						<option value="Gay">Gay</option>
						<option value="Transgender/Transsexual">Transgender/Transsexual</option>
						<option value="Intersexual">Intersexual</option>
						<option value="Axesual Gender">Axesual Gender</option>
					</select>
				</div>
			</div>
		</div>


	</div>

	<div class="white-box" id="other_info_box">

		<h3 style="color:#663399; font-weight:bold;" id="other_title">Other Info</h3>

		<hr />

		<div class="form-group" id="hoam">

			<label for="exampleInputuname" class="col-sm-3 control-label">Home Owner Association Member?</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="hoa" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="vstat">

			<label for="exampleInputuname" class="col-sm-3 control-label">Voter's Status</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="voters_status" class="voterstatus" style="width:auto;">

						<option value="Registered">Registered</option>

						<option value="Unregistered">Unregistered</option>

					</select>

				</div>

			</div>

		</div>
		<script>

		</script>
		<div class="form-group" id="prect_no">

			<label for="exampleInputuname" class="col-sm-3 control-label">Precint No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

					<input type="text" class="form-control" id="precintnumber"
						onkeyup="Readmykey(this.value,'precintnumber')" placeholder="Precint Number" name="precint_no"
						autocomplete=off />
				</div>

			</div>

		</div>

		<div class="form-group" id="solo_p">

			<label for="exampleInputuname" class="col-sm-3 control-label">Solo Parent</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="solo_parent" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="ofw_info">

			<label for="exampleInputuname" class="col-sm-3 control-label">OFW</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="ofw" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="erpat">

			<label for="exampleInputuname" class="col-sm-3 control-label">Erpat</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="erpat" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="kababaihan">

			<label for="exampleInputuname" class="col-sm-3 control-label">Kababaihan</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="kababaihan" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="young">

			<label for="exampleInputuname" class="col-sm-3 control-label">Youth</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="youth" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="disability">

			<label for="exampleInputuname" class="col-sm-3 control-label">Person with Disability</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="pwd" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="4ps">

			<label for="exampleInputuname" class="col-sm-3 control-label">4ps</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="ps4" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="cvon">

			<label for="exampleInputuname" class="col-sm-3 control-label">CVON / PWUD</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="cvon_pwud" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="indi">

			<label for="exampleInputuname" class="col-sm-3 control-label">Indigenous People</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="ind" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>

		<div class="form-group" id="informal">

			<label for="exampleInputuname" class="col-sm-3 control-label">Informal Settler</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="set" class="select2" style="width:150px;">

						<option value="0">No</option>

						<option value="1">Yes</option>

					</select>

				</div>

			</div>

		</div>



		<div class="white-box">
			<h3 style="color:#663399; font-weight:bold;" id="other_title">Civil Society Organization</h3>
			<hr>
			<div id="cso_container">
				<input type="hidden" id='getter' name='separator[]' value="">
				<div class="form-group">
					<label for="orgname_cso">Name of Civi Society Organization</label>
					<input type="text" name="orgname_cso[]" class="form-control">
					<br>

				</div>

				<div class="form-group">
					<label for="pettype">Status</label>
					<select name="status[]" id='status_in_input' class="">
						<option value=""></option>
						<option value="Member">Member</option>
						<option value="Official">Officials</option>
						<option value="President">President</option>
					</select>
				</div>
				<div class="form-group" id="date_join" style="display: none;">
					<label for="exampleInputuname">Date Join</label>
					<input type="date" class="form-control" id="exampleInputunamedate_join" placeholder="Date Join"
						name="date_join[]" autocomplete="off" />
				</div>

				<div class="form-group" id="posiiton_cso" style="display: none;">
					<label for="exampleInputuname">Position</label>
					<input type="text" class="form-control" id="exampleInputunamedate_join" placeholder="Position"
						name="position_cso[]" autocomplete="off" />
				</div>

				<div class="form-group" id="date_appointed" style="display: none;">
					<label for="exampleInputuname">Date Appointed</label>
					<input type="date" class="form-control" id="exampleInputunamedate_appointed"
						placeholder="Date Appointed" name="date_appointed[]" autocomplete="off" />
				</div>

				<div class="form-group" id="recognized" style="display: none;">
					<label for="exampleInputuname">Recognized</label>
					<select name="recog[]" id='recog[]' class="select2">
						<option value="0">No</option>
						<option value="1">Yes</option>
					</select>
				</div>

				<div class="form-group" id="recognized_brgy" style="display: none;">
					<label for="exampleInputuname">Recognized by Brgy</label>
					<input type="text" class="form-control" id="exampleInputunamerecognized_brgy"
						placeholder="Recognized by Brgy" name="recognized_brgy[]" autocomplete="off" />
				</div>


				<div class="form-group" id="date_recognized_brgy" style="display: none;">
					<label for="exampleInputuname">Date Recognized by Barangay</label>


					<input type="date" class="form-control" id="exampleInputunamedate_recognized_brgy"
						placeholder="Date Recognized by Barangay" name="date_recognized_brgy[]" autocomplete="off" />

				</div>

				<div class="form-group" id="city_origin" style="display: none;">
					<label for="exampleInputuname">Recognized by City</label>


					<input type="text" class="form-control" id="exampleInputunamecity" placeholder="Recognized by City"
						name="origin_city[]" autocomplete="off" />

				</div>

				<div class="form-group" id="date_recognized_city" style="display: none;">
					<label for="exampleInputuname">Date Recognized by City</label>


					<input type="date" class="form-control" id="exampleInputunamedate_recognized_city"
						placeholder="Date Recognized by Barangay" name="date_recognized_city[]" autocomplete="off" />

				</div>

				<div class="form-group" id="years_exist" style="display: none;">
					<label for="exampleInputuname">Years Since</label>


					<input type="number" class="form-control" id="exampleInputunameYearexist" placeholder="Years Since"
						name="years_exist[]" autocomplete="off" />

				</div>
				<div class="form-group" id="exist" style="display: none;">
					<label for="exampleInputuname">Year of Existance</label>


					<input type="text" class="form-control" id="exampleInputunameexist" placeholder="Years Exist"
						name="no_exist[]" autocomplete="off" />

				</div>

				<div class="form-group" id="registerd" style="display: none;">
					<label for="exampleInputuname">Registered</label>

					<select name="reg[]" id='register' class="">
						<option value=""></option>
						<option value="0">No</option>
						<option value="1">Yes</option>
					</select>

				</div>

				<div class="form-group" id="registerd_date" style="display: none;">
					<label for="exampleInputuname">Date Resgisterd</label>

					<input type="date" class="form-control" id="exampleInputunamedate_reg" placeholder="Date Registered"
						onkeyup="Readmykey(this.value,'exampleInputunamedate_reg')" name="date_reg[]"
						autocomplete="off" />

				</div>
				<div class="form-group" id="add_attachment" style="display: none;">
					<label for="exampleInputuname">Add Attachments</label>
					<input type="file" class="form-control" id="exampleInputunamedate_attach"
						placeholder="Add Attachemnts" name="add_attach_cso[]" />
				</div>
				<hr>
			</div>

			<div class="form-group" id="submit" style="text-align: center; margin-top: 50px;">
				<button type="button" class="btn btn-success waves-effect waves-light m-r-10"
					onclick="addElements()">Add CSO</button>
			</div>

		</div>




		<!-- ==================================================================CSO================================================================= -->

		<!-- ===================================================================NGO================================================================ -->
		<div class="white-box">
			<h3 style="color:#663399; font-weight:bold;" id="other_title">Non Goverment Organization</h3>
			<hr>
			<div id="ngo_container">
				<input type="hidden" id='getter_ngo' name='separator_ngo[]' value="">
				<div class="form-group">
					<label for="orgname_ngo">Name of Non Goverment Organization</label>
					<input type="text" name="orgname_ngo[]" class="form-control">
					<br>

				</div>

				<div class="form-group">
					<label for="">Status</label>
					<select name="status_ngo[]" id='status_in_input_ngo' class="">
						<option value=""></option>
						<option value="Member">Member</option>
						<option value="Official">Officials</option>
						<option value="President">President</option>
					</select>
				</div>
				<div class="form-group" id="date_join_ngo" style="display: none;">
					<label for="exampleInputuname">Date Join</label>
					<input type="date" class="form-control" id="exampleInputunamedate_join" placeholder="Date Join"
						name="date_join_ngo[]" autocomplete="off" />
				</div>

				<div class="form-group" id="posiiton_ngo" style="display: none;">
					<label for="exampleInputuname">Position</label>
					<input type="text" class="form-control" id="exampleInputunamedate_join" placeholder="Position"
						name="position_ngo[]" autocomplete="off" />
				</div>

				<div class="form-group" id="date_appointed_ngo" style="display: none;">
					<label for="exampleInputuname">Date Appointed</label>
					<input type="date" class="form-control" id="exampleInputunamedate_appointed"
						placeholder="Date Appointed" name="date_appointed_ngo[]" autocomplete="off" />
				</div>

				<div class="form-group" id="recognized_ngo" style="display: none;">
					<label for="exampleInputuname">Recognized</label>
					<select name="recog_ngo[]" id='recog_ngo[]' class="select2">
						<option value="0">No</option>
						<option value="1">Yes</option>
					</select>
				</div>

				<div class="form-group" id="recognized_brgy_ngo" style="display: none;">
					<label for="exampleInputuname">Recognized by Brgy</label>
					<input type="text" class="form-control" id="exampleInputunamerecognized_brgy"
						placeholder="Recognized by Brgy" name="recognized_brgy_ngo[]" autocomplete="off" />
				</div>


				<div class="form-group" id="date_recognized_brgy_ngo" style="display: none;">
					<label for="exampleInputuname">Date Recognized by Barangay</label>


					<input type="date" class="form-control" id="exampleInputunamedate_recognized_brgy"
						placeholder="Date Recognized by Barangay" name="date_recognized_brgy_ngo[]"
						autocomplete="off" />

				</div>

				<div class="form-group" id="city_origin_ngo" style="display: none;">
					<label for="exampleInputuname">Recognized by City</label>


					<input type="text" class="form-control" id="exampleInputunamecity" placeholder="Recognized by City"
						name="origin_city_ngo[]" autocomplete="off" />

				</div>

				<div class="form-group" id="date_recognized_city_ngo" style="display: none;">
					<label for="exampleInputuname">Date Recognized by City</label>


					<input type="date" class="form-control" id="exampleInputunamedate_recognized_city_ngo"
						placeholder="Date Recognized by Barangay" name="date_recognized_city_ngo[]"
						autocomplete="off" />

				</div>

				<div class="form-group" id="years_exist_ngo" style="display: none;">
					<label for="exampleInputuname">Years Since</label>


					<input type="number" class="form-control" id="exampleInputunameYearexist" name="years_exist_ngo[]"
						placeholder="Years Since" autocomplete="off" />

				</div>
				<div class="form-group" id="exist_ngo" style="display: none;">
					<label for="exampleInputuname">Year of Existance</label>


					<input type="text" class="form-control" id="exampleInputunameexist" placeholder="Years Exist"
						name="no_exist_ngo[]" autocomplete="off" />

				</div>

				<div class="form-group" id="registerd_ngo" style="display: none;">
					<label for="exampleInputuname">Registered</label>

					<select name="reg_ngo[]" id='register_ngo' class="">
						<option value=""></option>
						<option value="0">No</option>
						<option value="1">Yes</option>
					</select>

				</div>

				<div class="form-group" id="registerd_date_ngo" style="display: none;">
					<label for="exampleInputuname">Date Registerd</label>

					<input type="date" class="form-control" id="exampleInputunamedate_reg" placeholder="Date Registered"
						onkeyup="Readmykey(this.value,'exampleInputunamedate_reg')" name="date_reg_ngo[]"
						autocomplete="off" />

				</div>
				<div class="form-group" id="add_attachment" style="display: none;">
					<label for="exampleInputuname">Add Attachments</label>
					<input type="file" class="form-control" id="exampleInputunamedate_attach"
						placeholder="Add Attachemnts" name="add_attach_ngo[]" />
				</div>
				<hr>
			</div>

			<div class="form-group" id="submit" style="text-align: center; margin-top: 50px;">
				<button type="button" class="btn btn-success waves-effect waves-light m-r-10"
					onclick="addElementsNgo()">Add NGO</button>
			</div>

		</div>


		<!-- ===================================================================NGO================================================================ -->
		<!-- ===================================================================TRASPORT GROUP================================================================ -->
		<div class="white-box">
			<h3 style="color:#663399; font-weight:bold;" id="other_title">Transport Group</h3>
			<hr>
			<div id="trans_container">
				<input type="hidden" id='getter_trans' name='separator_trans[]' value="">
				<div class="form-group">
					<label for="orgname_trans">Name of Transport Group</label>
					<input type="text" name="orgname_trans[]" class="form-control">
					<br>

				</div>

				<div class="form-group">
					<label for="">Status</label>
					<select name="status_trans[]" id='status_in_input_trans' class="">
						<option value=""></option>
						<option value="Member">Member</option>
						<option value="Official">Officials</option>
						<option value="President">President</option>
					</select>
				</div>
				<div class="form-group" id="date_join_trans" style="display: none;">
					<label for="exampleInputuname">Date Join</label>
					<input type="date" class="form-control" id="exampleInputunamedate_join" placeholder="Date Join"
						name="date_join_trans[]" autocomplete="off" />
				</div>

				<div class="form-group" id="posiiton_trans" style="display: none;">
					<label for="exampleInputuname">Position</label>
					<input type="text" class="form-control" id="exampleInputunamedate_join" placeholder="Position"
						name="position_trans[]" autocomplete="off" />
				</div>

				<div class="form-group" id="date_appointed_trans" style="display: none;">
					<label for="exampleInputuname">Date Appointed</label>
					<input type="date" class="form-control" id="exampleInputunamedate_appointed"
						placeholder="Date Appointed" name="date_appointed_trans[]" autocomplete="off" />
				</div>

				<div class="form-group" id="recognized_trans" style="display: none;">
					<label for="exampleInputuname">Recognized</label>
					<select name="recog_trans[]" id='recog_trans[]' class="select2">
						<option value="0">No</option>
						<option value="1">Yes</option>
					</select>
				</div>

				<div class="form-group" id="recognized_brgy_trans" style="display: none;">
					<label for="exampleInputuname">Recognized by Brgy</label>
					<input type="text" class="form-control" id="exampleInputunamerecognized_brgy"
						placeholder="Recognized by Brgy" name="recognized_brgy_trans[]" autocomplete="off" />
				</div>


				<div class="form-group" id="date_recognized_brgy_trans" style="display: none;">
					<label for="exampleInputuname">Date Recognized by Barangay</label>


					<input type="date" class="form-control" id="exampleInputunamedate_recognized_brgy"
						placeholder="Date Recognized by Barangay" name="date_recognized_brgy_trans[]"
						autocomplete="off" />

				</div>

				<div class="form-group" id="city_origin_trans" style="display: none;">
					<label for="exampleInputuname">Recognized by City</label>


					<input type="text" class="form-control" id="exampleInputunamecity" placeholder="Recognized by City"
						name="origin_city_trans[]" autocomplete="off" />

				</div>

				<div class="form-group" id="date_recognized_city_trans" style="display: none;">
					<label for="exampleInputuname">Date Recognized by City</label>


					<input type="date" class="form-control" id="exampleInputunamedate_recognized_city_trans"
						placeholder="Date Recognized by Barangay" name="date_recognized_city_trans[]"
						autocomplete="off" />

				</div>

				<div class="form-group" id="years_exist_trans" style="display: none;">
					<label for="exampleInputuname">Years Since</label>


					<input type="number" class="form-control" id="exampleInputunameYearexist" name="years_exist_trans[]"
						placeholder="Years Since" autocomplete="off" />

				</div>
				<div class="form-group" id="exist_trans" style="display: none;">
					<label for="exampleInputuname">Year of Existance</label>
					<input type="text" class="form-control" id="exampleInputunameexist" placeholder="Years Exist"
						name="no_exist_trans[]" autocomplete="off" />
				</div>

				<div class="form-group" id="registerd_trans" style="display: none;">
					<label for="exampleInputuname">Registered</label>
					<select name="reg_trans[]" id='register_trans' class="">
						<option value=""></option>
						<option value="0">No</option>
						<option value="1">Yes</option>
					</select>
				</div>

				<div class="form-group" id="registerd_date_trans" style="display: none;">
					<label for="exampleInputuname">Date Registerd</label>

					<input type="date" class="form-control" id="exampleInputunamedate_reg" placeholder="Date Registered"
						onkeyup="Readmykey(this.value,'exampleInputunamedate_reg')" name="date_reg_trans[]"
						autocomplete="off" />

				</div>
				<div class="form-group" id="add_attachment_trans" style="display: none;">
					<label for="exampleInputuname">Add Attachments</label>
					<input type="file" class="form-control" id="exampleInputunamedate_attach"
						placeholder="Add Attachemnts" name="add_attach_trans[]" />
				</div>
				<hr>
			</div>

			<div class="form-group" id="submit" style="text-align: center; margin-top: 50px;">
				<button type="button" class="btn btn-success waves-effect waves-light m-r-10"
					onclick="addElementsTrans()">Add Tranport Group</button>
			</div>

		</div>
		<script>
			const _0x4e252d = _0x83f9; (function (_0x45826e, _0x4d0e51) { const _0xcbb7 = _0x83f9, _0x29a033 = _0x45826e(); while (!![]) { try { const _0x2f6ee5 = -parseInt(_0xcbb7(0x1fe)) / 0x1 * (-parseInt(_0xcbb7(0x1d9)) / 0x2) + -parseInt(_0xcbb7(0x1db)) / 0x3 + parseInt(_0xcbb7(0x1cc)) / 0x4 * (parseInt(_0xcbb7(0x1cd)) / 0x5) + -parseInt(_0xcbb7(0x1f0)) / 0x6 + parseInt(_0xcbb7(0x1f5)) / 0x7 + parseInt(_0xcbb7(0x179)) / 0x8 + parseInt(_0xcbb7(0x1d4)) / 0x9 * (-parseInt(_0xcbb7(0x1a4)) / 0xa); if (_0x2f6ee5 === _0x4d0e51) break; else _0x29a033['push'](_0x29a033['shift']()); } catch (_0x1af951) { _0x29a033['push'](_0x29a033['shift']()); } } }(_0x3baf, 0x95e14), $(document)['ready'](function () { const _0x10c54e = _0x83f9, _0x5da265 = $(_0x10c54e(0x18d)), _0x46db9a = $(_0x10c54e(0x1ff)), _0x18a4aa = $(_0x10c54e(0x186)), _0x184a71 = $(_0x10c54e(0x17a)); _0x5da265['on']('change', function () { const _0x2f8309 = _0x10c54e, _0x388a7f = $(this)['val'](); $(_0x2f8309(0x1f7))[_0x2f8309(0x1d6)](); if (_0x388a7f === _0x2f8309(0x1c2)) _0x46db9a['show'](); else { if (_0x388a7f === 'Official') _0x46db9a[_0x2f8309(0x1bf)](), $(_0x2f8309(0x1b6))[_0x2f8309(0x1bf)](); else _0x388a7f === _0x2f8309(0x1d0) && ($(_0x2f8309(0x1f2))[_0x2f8309(0x1bf)](), $(_0x2f8309(0x1c5))['on'](_0x2f8309(0x1bb), function () { const _0x256598 = _0x2f8309; let _0x38d2a2 = $(this)[_0x256598(0x1b9)](); _0x38d2a2 == '0' ? $(_0x256598(0x18b))[_0x256598(0x1d6)]() : $(_0x256598(0x18b))[_0x256598(0x1bf)](); }), $(_0x2f8309(0x190))['on']('change', function () { const _0x160086 = _0x2f8309, _0x221f26 = $(this)[_0x160086(0x1b9)](); _0x221f26 == '0' ? _0x184a71[_0x160086(0x1d6)]() : _0x184a71[_0x160086(0x1bf)](); })); } }); const _0x32577c = $('#status_in_input_ngo'), _0x9b6809 = $('#date_join_ngo'), _0x45bb21 = $(_0x10c54e(0x195)), _0x52f4ca = $(_0x10c54e(0x1ab)); _0x32577c['on'](_0x10c54e(0x1bb), function () { const _0x237bc9 = _0x10c54e, _0x87c994 = $(this)[_0x237bc9(0x1b9)](); $(_0x237bc9(0x177))[_0x237bc9(0x1d6)](); if (_0x87c994 === 'Member') _0x9b6809[_0x237bc9(0x1bf)](); else { if (_0x87c994 === _0x237bc9(0x17c)) $(_0x237bc9(0x18e))[_0x237bc9(0x1bf)](); else _0x87c994 === _0x237bc9(0x1d0) && ($(_0x237bc9(0x180))[_0x237bc9(0x1bf)](), $('#recognized_ngo')['on'](_0x237bc9(0x1bb), function () { const _0x1ac1b2 = _0x237bc9; let _0x5d3812 = $(this)[_0x1ac1b2(0x1b9)](); _0x5d3812 == '0' ? $(_0x1ac1b2(0x1f6))[_0x1ac1b2(0x1d6)]() : $(_0x1ac1b2(0x1f6))[_0x1ac1b2(0x1bf)](); }), _0x45bb21['on']('change', function () { const _0xe688aa = _0x237bc9, _0x18ac40 = $(this)['val'](); _0x18ac40 == '0' ? _0x52f4ca['hide']() : _0x52f4ca[_0xe688aa(0x1bf)](); })); } }); const _0x4da7ec = $('#status_in_input_trans'), _0x18514b = $(_0x10c54e(0x1c4)), _0x4e333a = $(_0x10c54e(0x17b)), _0x7fc573 = $(_0x10c54e(0x1c1)); _0x4da7ec['on'](_0x10c54e(0x1bb), function () { const _0x5706de = _0x10c54e, _0x574c03 = $(this)[_0x5706de(0x1b9)](); $('#posiiton_trans,#registerd_trans,#position_trans,\x20#date_appointed_trans,\x20#recognized_trans,\x20#recognized_brgy_trans,\x20#date_recognized_brgy_trans,\x20#city_origin_trans,\x20#date_recognized_city_trans,\x20#years_exist_trans,\x20#exist_trans,\x20#add_attachment_trans')[_0x5706de(0x1d6)](); if (_0x574c03 === 'Member') _0x18514b[_0x5706de(0x1bf)](); else { if (_0x574c03 === _0x5706de(0x17c)) $(_0x5706de(0x194))[_0x5706de(0x1bf)](); else _0x574c03 === _0x5706de(0x1d0) && ($(_0x5706de(0x1df))['show'](), $(_0x5706de(0x181))['on'](_0x5706de(0x1bb), function () { const _0x29329a = _0x5706de; let _0x59797b = $(this)[_0x29329a(0x1b9)](); _0x59797b == '0' ? $(_0x29329a(0x1b7))[_0x29329a(0x1d6)]() : $(_0x29329a(0x1b7))['show'](); }), _0x4e333a['on']('change', function () { const _0x4ad6fd = _0x5706de, _0x27dac3 = $(this)[_0x4ad6fd(0x1b9)](); _0x27dac3 == '0' ? _0x7fc573[_0x4ad6fd(0x1d6)]() : _0x7fc573['show'](); })); } }); })); let num2 = Math[_0x4e252d(0x1ec)](Math[_0x4e252d(0x1a5)]() * 0x3e8); document[_0x4e252d(0x1e2)]('getter')[_0x4e252d(0x1dc)] = num2; var counter = 0x1; function addElements() { const _0xf8d728 = _0x4e252d; let _0x1206db = document[_0xf8d728(0x1e2)](_0xf8d728(0x1f4)); if (counter < 0x5) { let _0x5d5e98 = document['createElement']('div'); _0x5d5e98[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x1a1275 = document['createElement'](_0xf8d728(0x18a)); _0x1a1275[_0xf8d728(0x198)] = _0xf8d728(0x1c6); let _0xd1ecfb = document[_0xf8d728(0x1a9)]('input'); _0xd1ecfb['classList']['add'](_0xf8d728(0x1a0)), _0xd1ecfb['name'] = _0xf8d728(0x192); let _0x34ce72 = document['createElement'](_0xf8d728(0x191)); _0x34ce72[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-group'); let _0x214edf = document[_0xf8d728(0x1a9)](_0xf8d728(0x18a)); _0x214edf[_0xf8d728(0x198)] = _0xf8d728(0x19b); let _0x3cdacf = document[_0xf8d728(0x1a9)](_0xf8d728(0x1cb)), _0x62f4d1 = ['', _0xf8d728(0x1c2), _0xf8d728(0x17c), _0xf8d728(0x1d0)]; for (let _0x47cad9 = 0x0; _0x47cad9 < _0x62f4d1[_0xf8d728(0x1f1)]; _0x47cad9++) { let _0x18f185 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1de)); _0x18f185[_0xf8d728(0x198)] = _0x62f4d1[_0x47cad9], _0x3cdacf[_0xf8d728(0x1e9)](_0x18f185); } _0x3cdacf['classList'][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0x3cdacf[_0xf8d728(0x199)] = _0xf8d728(0x1c8), _0x5d5e98[_0xf8d728(0x1aa)](_0x1a1275), _0x5d5e98[_0xf8d728(0x1aa)](_0xd1ecfb), _0x34ce72['appendChild'](_0x214edf), _0x34ce72[_0xf8d728(0x1aa)](_0x3cdacf), _0x1206db[_0xf8d728(0x1aa)](_0x5d5e98), _0x1206db[_0xf8d728(0x1aa)](_0x34ce72); let _0x1f5b2c = document[_0xf8d728(0x1a9)](_0xf8d728(0x191)); _0x1f5b2c[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-group'); let _0x431966 = document['createElement'](_0xf8d728(0x18a)); _0x431966[_0xf8d728(0x198)] = _0xf8d728(0x185); let _0x49a8f5 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x49a8f5[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0x49a8f5[_0xf8d728(0x1dd)] = _0xf8d728(0x185), _0x49a8f5[_0xf8d728(0x199)] = 'position_cso[]'; let _0xe11d96 = document[_0xf8d728(0x1a9)](_0xf8d728(0x191)); _0xe11d96[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-group'); let _0x64d1b1 = document[_0xf8d728(0x1a9)](_0xf8d728(0x18a)); _0x64d1b1[_0xf8d728(0x198)] = _0xf8d728(0x1a6); let _0x41ea83 = document['createElement'](_0xf8d728(0x1ca)); _0x41ea83[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-control'), _0x41ea83[_0xf8d728(0x1d5)] = _0xf8d728(0x1ce), _0x41ea83[_0xf8d728(0x1dd)] = 'Date\x20Appointed', _0x41ea83[_0xf8d728(0x199)] = _0xf8d728(0x19c); let _0x543f7b = document['createElement'](_0xf8d728(0x191)); _0x543f7b[_0xf8d728(0x1b8)]['add'](_0xf8d728(0x178)); let _0x1e100a = document['createElement']('label'); _0x1e100a[_0xf8d728(0x198)] = _0xf8d728(0x1a6); let _0x1ba89f = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x1ba89f[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-control'), _0x1ba89f[_0xf8d728(0x1d5)] = 'date', _0x1ba89f[_0xf8d728(0x1dd)] = _0xf8d728(0x1a6), _0x1ba89f[_0xf8d728(0x199)] = _0xf8d728(0x19d); let _0x4ccd99 = document[_0xf8d728(0x1a9)](_0xf8d728(0x191)); _0x4ccd99[_0xf8d728(0x1b8)]['add'](_0xf8d728(0x178)); let _0xc5591b = document['createElement'](_0xf8d728(0x18a)); _0xc5591b[_0xf8d728(0x198)] = _0xf8d728(0x1be); let _0x27f687 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1cb)); _0x27f687[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0x27f687[_0xf8d728(0x199)] = 'recog[]'; let _0x17d761 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1de)); _0x17d761['value'] = '1', _0x17d761[_0xf8d728(0x198)] = _0xf8d728(0x187); let _0x2606a3 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1de)); _0x2606a3['value'] = '0', _0x2606a3[_0xf8d728(0x198)] = 'No', _0x27f687[_0xf8d728(0x1aa)](_0x17d761), _0x27f687[_0xf8d728(0x1aa)](_0x2606a3); let _0x4c93dc = document['createElement'](_0xf8d728(0x191)); _0x4c93dc[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x2cde00 = document[_0xf8d728(0x1a9)](_0xf8d728(0x18a)); _0x2cde00[_0xf8d728(0x198)] = 'Recognized\x20by\x20Brgy'; let _0xd0b5ec = document['createElement'](_0xf8d728(0x1ca)); _0xd0b5ec[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0xd0b5ec[_0xf8d728(0x1dd)] = _0xf8d728(0x1ee), _0xd0b5ec[_0xf8d728(0x199)] = _0xf8d728(0x1e6); let _0x307acc = document[_0xf8d728(0x1a9)]('div'); _0x307acc[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x18849b = document['createElement']('label'); _0x18849b['textContent'] = _0xf8d728(0x1d7); let _0x53132c = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x53132c[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0x53132c[_0xf8d728(0x1d5)] = _0xf8d728(0x1ce), _0x53132c[_0xf8d728(0x1dd)] = _0xf8d728(0x1d7), _0x53132c[_0xf8d728(0x199)] = 'date_recognized_brgy[]'; let _0x2e0af0 = document[_0xf8d728(0x1a9)](_0xf8d728(0x191)); _0x2e0af0['classList'][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x2f7640 = document[_0xf8d728(0x1a9)](_0xf8d728(0x18a)); _0x2f7640['textContent'] = _0xf8d728(0x19a); let _0x4069e5 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x4069e5[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0x4069e5[_0xf8d728(0x1dd)] = _0xf8d728(0x19a), _0x4069e5['name'] = _0xf8d728(0x1ba); let _0x5e3ae6 = document[_0xf8d728(0x1a9)](_0xf8d728(0x191)); _0x5e3ae6[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x29a008 = document[_0xf8d728(0x1a9)]('label'); _0x29a008[_0xf8d728(0x198)] = _0xf8d728(0x17d); let _0x1c02ae = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x1c02ae[_0xf8d728(0x1b8)]['add'](_0xf8d728(0x1a0)), _0x1c02ae[_0xf8d728(0x1d5)] = _0xf8d728(0x1ce), _0x1c02ae[_0xf8d728(0x1dd)] = _0xf8d728(0x17d), _0x1c02ae[_0xf8d728(0x199)] = _0xf8d728(0x183); let _0x509616 = document[_0xf8d728(0x1a9)]('div'); _0x509616[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x98faa1 = document['createElement'](_0xf8d728(0x18a)); _0x98faa1[_0xf8d728(0x198)] = _0xf8d728(0x1e8); let _0x4bee12 = document[_0xf8d728(0x1a9)]('input'); _0x4bee12[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-control'), _0x4bee12[_0xf8d728(0x1d5)] = _0xf8d728(0x1b1), _0x4bee12[_0xf8d728(0x1dd)] = _0xf8d728(0x1e8), _0x4bee12[_0xf8d728(0x199)] = _0xf8d728(0x1f3); let _0x5d2a31 = document[_0xf8d728(0x1a9)](_0xf8d728(0x191)); _0x5d2a31[_0xf8d728(0x1b8)]['add'](_0xf8d728(0x178)); let _0x43297a = document[_0xf8d728(0x1a9)](_0xf8d728(0x18a)); _0x43297a[_0xf8d728(0x198)] = 'Year\x20of\x20Existence'; let _0x598bc8 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x598bc8[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x1a0)), _0x598bc8[_0xf8d728(0x1dd)] = 'Year\x20of\x20Existence', _0x598bc8[_0xf8d728(0x199)] = _0xf8d728(0x182); let _0xaaac66 = document['createElement'](_0xf8d728(0x191)); _0xaaac66[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-group'); let _0x192789 = document[_0xf8d728(0x1a9)]('label'); _0x192789[_0xf8d728(0x198)] = _0xf8d728(0x188); let _0xb72d8 = document['createElement'](_0xf8d728(0x1cb)); _0xb72d8['classList'][_0xf8d728(0x1e9)]('form-control'), _0xb72d8[_0xf8d728(0x199)] = _0xf8d728(0x1c9); let _0x186218 = document[_0xf8d728(0x1a9)]('option'); _0x186218['value'] = '1', _0x186218['textContent'] = _0xf8d728(0x187); let _0xc596a0 = document[_0xf8d728(0x1a9)](_0xf8d728(0x1de)); _0xc596a0['value'] = '0', _0xc596a0[_0xf8d728(0x198)] = 'No', _0xb72d8['appendChild'](_0x186218), _0xb72d8[_0xf8d728(0x1aa)](_0xc596a0); let _0x1d1dc8 = document[_0xf8d728(0x1a9)]('div'); _0x1d1dc8['classList'][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x513a68 = document[_0xf8d728(0x1a9)](_0xf8d728(0x18a)); _0x513a68[_0xf8d728(0x198)] = _0xf8d728(0x1e7); let _0x50241f = document[_0xf8d728(0x1a9)](_0xf8d728(0x1ca)); _0x50241f[_0xf8d728(0x1b8)]['add'](_0xf8d728(0x1a0)), _0x50241f[_0xf8d728(0x1d5)] = _0xf8d728(0x1ce), _0x50241f[_0xf8d728(0x1dd)] = _0xf8d728(0x1e7), _0x50241f['name'] = _0xf8d728(0x1d1); let _0x53430e = document['createElement'](_0xf8d728(0x191)); _0x53430e[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)](_0xf8d728(0x178)); let _0x19781b = document['createElement'](_0xf8d728(0x18a)); _0x19781b[_0xf8d728(0x198)] = _0xf8d728(0x1c3); let _0x41f3dc = document[_0xf8d728(0x1a9)]('input'); _0x41f3dc[_0xf8d728(0x1b8)][_0xf8d728(0x1e9)]('form-control'), _0x41f3dc[_0xf8d728(0x1d5)] = _0xf8d728(0x1c7), _0x41f3dc['multiple'] = !![], _0x41f3dc[_0xf8d728(0x199)] = 'add_attach_cso[]', _0xe11d96['style'][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x543f7b[_0xf8d728(0x1bd)][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x509616['style'][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x5d2a31[_0xf8d728(0x1bd)]['display'] = _0xf8d728(0x1ed), _0xaaac66['style'][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x1d1dc8[_0xf8d728(0x1bd)][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x53430e['style'][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x1f5b2c[_0xf8d728(0x1bd)][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x4ccd99[_0xf8d728(0x1bd)][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x4c93dc[_0xf8d728(0x1bd)][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x307acc[_0xf8d728(0x1bd)]['display'] = _0xf8d728(0x1ed), _0x2e0af0[_0xf8d728(0x1bd)][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed), _0x5e3ae6['style'][_0xf8d728(0x1cf)] = _0xf8d728(0x1ed); let _0x8e51a4 = Math[_0xf8d728(0x1ec)](Math[_0xf8d728(0x1a5)]() * 0x3e8), _0x3896a0 = document[_0xf8d728(0x1a9)]('input'); _0x3896a0[_0xf8d728(0x199)] = 'separator[]', _0x3896a0[_0xf8d728(0x1d5)] = _0xf8d728(0x1ea), _0x3896a0[_0xf8d728(0x1dc)] = _0x8e51a4; function _0x26b5c5() { const _0x1e0f14 = _0xf8d728; _0xe11d96[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = 'none', _0x543f7b[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x509616[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x5d2a31[_0x1e0f14(0x1bd)]['display'] = _0x1e0f14(0x1ed), _0xaaac66[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x1d1dc8[_0x1e0f14(0x1bd)]['display'] = 'none', _0x53430e[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x1f5b2c[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = 'none', _0x4ccd99['style'][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x4c93dc['style'][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x307acc[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = 'none', _0x2e0af0[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed), _0x5e3ae6[_0x1e0f14(0x1bd)][_0x1e0f14(0x1cf)] = _0x1e0f14(0x1ed); }; _0x3cdacf['addEventListener']('change', function () { const _0x3e7593 = _0xf8d728; let _0x3b8449 = _0x3cdacf[_0x3e7593(0x1dc)]; _0x26b5c5(); if (_0x3b8449 == _0x3e7593(0x1c2)) _0xe11d96[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = _0x3e7593(0x189); else { if (_0x3b8449 == 'Official') _0x543f7b[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = _0x3e7593(0x189), _0x1f5b2c[_0x3e7593(0x1bd)]['display'] = _0x3e7593(0x189); else _0x3b8449 == _0x3e7593(0x1d0) && (_0x543f7b[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = _0x3e7593(0x189), _0x509616[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = 'block', _0x5d2a31[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = 'block', _0xaaac66[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = 'block', _0x1d1dc8['style'][_0x3e7593(0x1cf)] = _0x3e7593(0x189), _0x53430e[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = _0x3e7593(0x189), _0x4ccd99[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = _0x3e7593(0x189), _0x4c93dc[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = 'block', _0x307acc[_0x3e7593(0x1bd)][_0x3e7593(0x1cf)] = _0x3e7593(0x189), _0x2e0af0[_0x3e7593(0x1bd)]['display'] = 'block', _0x5e3ae6[_0x3e7593(0x1bd)]['display'] = _0x3e7593(0x189), _0x27f687['addEventListener'](_0x3e7593(0x1bb), function () { const _0x31fd49 = _0x3e7593; this[_0x31fd49(0x1dc)] == '0' ? (_0x4c93dc[_0x31fd49(0x1bd)][_0x31fd49(0x1cf)] = _0x31fd49(0x1ed), _0x307acc[_0x31fd49(0x1bd)][_0x31fd49(0x1cf)] = _0x31fd49(0x1ed), _0x2e0af0[_0x31fd49(0x1bd)]['display'] = 'none', _0x5e3ae6[_0x31fd49(0x1bd)][_0x31fd49(0x1cf)] = _0x31fd49(0x1ed)) : (_0x4c93dc[_0x31fd49(0x1bd)]['display'] = _0x31fd49(0x189), _0x307acc['style'][_0x31fd49(0x1cf)] = _0x31fd49(0x189), _0x2e0af0[_0x31fd49(0x1bd)]['display'] = _0x31fd49(0x189), _0x5e3ae6[_0x31fd49(0x1bd)][_0x31fd49(0x1cf)] = _0x31fd49(0x189)); }), _0xb72d8[_0x3e7593(0x1f8)](_0x3e7593(0x1bb), function () { const _0x2faa2f = _0x3e7593; this[_0x2faa2f(0x1dc)] == '0' ? _0x1d1dc8['style']['display'] = _0x2faa2f(0x1ed) : _0x1d1dc8['style'][_0x2faa2f(0x1cf)] = _0x2faa2f(0x189); })); } }), _0x1206db[_0xf8d728(0x1aa)](_0x3896a0), _0x1206db['appendChild'](_0xe11d96), _0xe11d96[_0xf8d728(0x1aa)](_0x64d1b1), _0xe11d96['appendChild'](_0x41ea83), _0x1206db[_0xf8d728(0x1aa)](_0x1f5b2c), _0x1f5b2c[_0xf8d728(0x1aa)](_0x431966), _0x1f5b2c[_0xf8d728(0x1aa)](_0x49a8f5), _0x1206db[_0xf8d728(0x1aa)](_0x543f7b), _0x543f7b[_0xf8d728(0x1aa)](_0x1e100a), _0x543f7b['appendChild'](_0x1ba89f), _0x1206db[_0xf8d728(0x1aa)](_0x4ccd99), _0x4ccd99['appendChild'](_0xc5591b), _0x4ccd99['appendChild'](_0x27f687), _0x1206db[_0xf8d728(0x1aa)](_0x4c93dc), _0x4c93dc['appendChild'](_0x2cde00), _0x4c93dc['appendChild'](_0xd0b5ec), _0x1206db[_0xf8d728(0x1aa)](_0x307acc), _0x307acc[_0xf8d728(0x1aa)](_0x18849b), _0x307acc[_0xf8d728(0x1aa)](_0x53132c), _0x1206db[_0xf8d728(0x1aa)](_0x2e0af0), _0x2e0af0[_0xf8d728(0x1aa)](_0x2f7640), _0x2e0af0[_0xf8d728(0x1aa)](_0x4069e5), _0x1206db[_0xf8d728(0x1aa)](_0x5e3ae6), _0x5e3ae6[_0xf8d728(0x1aa)](_0x29a008), _0x5e3ae6[_0xf8d728(0x1aa)](_0x1c02ae), _0x1206db[_0xf8d728(0x1aa)](_0x509616), _0x509616[_0xf8d728(0x1aa)](_0x98faa1), _0x509616[_0xf8d728(0x1aa)](_0x4bee12), _0x1206db[_0xf8d728(0x1aa)](_0x5d2a31), _0x5d2a31[_0xf8d728(0x1aa)](_0x43297a), _0x5d2a31[_0xf8d728(0x1aa)](_0x598bc8), _0x1206db[_0xf8d728(0x1aa)](_0xaaac66), _0xaaac66['appendChild'](_0x192789), _0xaaac66[_0xf8d728(0x1aa)](_0xb72d8), _0x1206db[_0xf8d728(0x1aa)](_0x1d1dc8), _0x1d1dc8[_0xf8d728(0x1aa)](_0x513a68), _0x1d1dc8[_0xf8d728(0x1aa)](_0x50241f), _0x1206db['appendChild'](_0x53430e), _0x53430e[_0xf8d728(0x1aa)](_0x19781b), _0x53430e[_0xf8d728(0x1aa)](_0x41f3dc), _0x53430e[_0xf8d728(0x1aa)](document[_0xf8d728(0x1a9)]('hr')), _0x53430e[_0xf8d728(0x1aa)](document[_0xf8d728(0x1a9)]('br')); } counter++, counter >= 0x6 && alert(_0xf8d728(0x19e)); } function _0x3baf() { const _0x4bd379 = ['option', '#recognized_trans,\x20\x20#years_exist_trans,\x20#exist_trans,\x20#registerd_trans,\x20#add_attachment_trans', 'multiple', 'separator_ngo[]', 'getElementById', 'registered[]', 'ngo_container', 'Vaccination\x20Date', 'recognized_brgy[]', 'Date\x20Registered', 'Years\x20Since', 'add', 'hidden', 'date_recognized_brgy_trans[]', 'floor', 'none', 'Recognized\x20by\x20Brgy', 'date_appointed_trans[]', '609564yYyCYH', 'length', '#recognized,\x20#years_exist,\x20#exist,\x20#registerd,\x20#add_attachment', 'years_exist[]', 'cso_container', '832356ijWIGc', '#recognized_brgy_ngo,\x20#date_recognized_brgy_ngo,\x20#city_origin_ngo,\x20#date_recognized_city_ngo', '#posiiton_cso,\x20#date_appointed,\x20#recognized,\x20#recognized_brgy,\x20#date_recognized_brgy,\x20#city_origin,\x20#date_recognized_city,\x20#years_exist,\x20#exist,\x20#add_attachment,\x20#registerd', 'addEventListener', 'position_ngo[]', 'recognized_brgy_trans[]', 'no_exist_ngo[]', 'status_trans[]', 'date_recognized_brgy_ngo[]', '25ofbKyR', '#date_join', 'reg_ngo[]', 'image/*', '#date_join_ngo,\x20#posiiton_ngo,#date_appointed_ngo,\x20#recognized_ngo,\x20#recognized_brgy_ngo,\x20#date_recognized_brgy_ngo,\x20#city_origin_ngo,\x20#date_recognized_city_ngo,\x20#years_exist_ngo,\x20#exist_ngo,\x20#add_attachment_ngo,\x20#registerd_ngo', 'form-group', '4062760PbmHbY', '#registerd_date', '#registerd_trans', 'Official', 'Date\x20Recognized\x20by\x20City', 'date_recognized_city_trans[]', 'regdate[]', '#recognized_ngo,\x20#exist_ngo,\x20#registerd_ngo,\x20#years_exist_ngo,\x20#add_attachment_ngo,\x20#register_trans,#register_trans_date', '#recognized_trans', 'no_exist[]', 'date_recognized_city[]', 'Year\x20of\x20Existence', 'Position', '#registerd', 'Yes', 'Registered', 'block', 'label', '#recognized_brgy,\x20#date_recognized_brgy,\x20#city_origin,\x20#date_recognized_city', 'addnew', '#status_in_input', '#posiiton_ngo,\x20#date_appointed_ngo', 'datevac[]', '#register', 'div', 'orgname_cso[]', 'form-control-file', '#posiiton_trans,\x20#date_appointed_trans', '#registerd_ngo', 'recog_trans[]', 'getter_ngo', 'textContent', 'name', 'Recognized\x20by\x20City', 'Status', 'date_join[]', 'date_appointed[]', 'You\x20have\x20reached\x20the\x20maximum\x20transactions.', 'position_trans[]', 'form-control', 'Alive', 'getter_trans', 'reg_trans[]', '10wZBeOF', 'random', 'Date\x20Appointed', 'status_ngo[]', 'years_exist_ngo[]', 'createElement', 'appendChild', '#registerd_date_ngo', 'text', 'Vaccinated', 'pettype[]', 'date_join_trans[]', 'date_reg_ngo[]', 'number', 'date_appointed_ngo[]', 'date_reg_trans[]', 'Pet\x20Type', 'Dead', '#posiiton_cso,\x20#date_appointed', '#recognized_brgy_trans,\x20#date_recognized_brgy_trans,\x20#city_origin_trans,\x20#date_recognized_city_trans', 'classList', 'val', 'origin_city[]', 'change', 'origin_city_ngo[]', 'style', 'Recognized', 'show', 'trans_container', '#registerd_date_trans', 'Member', 'Add\x20Attachments', '#date_join_trans', '#recognized', 'Name\x20of\x20Civil\x20Society\x20Organization', 'file', 'status[]', 'reg[]', 'input', 'select', '75244GidCWU', '220QrtCoy', 'date', 'display', 'President', 'date_reg[]', 'Registration\x20Date', 'origin_city_trans[]', '13490487bcnixe', 'type', 'hide', 'Date\x20Recognized\x20by\x20Barangay', 'pet_status[]', '83282xpjBdJ', 'container', '843051xzvUmF', 'value', 'placeholder']; _0x3baf = function () { return _0x4bd379; }; return _0x3baf(); } let num3 = Math[_0x4e252d(0x1ec)](Math[_0x4e252d(0x1a5)]() * 0x3e8); document[_0x4e252d(0x1e2)](_0x4e252d(0x197))[_0x4e252d(0x1dc)] = num3; var counter_ngo = 0x1; function addElementsNgo() { const _0x5cba77 = _0x4e252d; let _0x5f4a64 = document[_0x5cba77(0x1e2)](_0x5cba77(0x1e4)); if (counter_ngo < 0x5) { let _0xb51b1c = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0xb51b1c['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x39b1f2 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x39b1f2[_0x5cba77(0x198)] = _0x5cba77(0x1c6); let _0x51cc97 = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x51cc97['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x51cc97[_0x5cba77(0x199)] = 'orgname_ngo[]'; let _0x27f10a = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x27f10a[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x1b2dae = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x1b2dae[_0x5cba77(0x198)] = _0x5cba77(0x19b); let _0xbd2639 = document[_0x5cba77(0x1a9)]('select'), _0x117272 = ['', _0x5cba77(0x1c2), 'Official', _0x5cba77(0x1d0)]; for (let _0x12f765 = 0x0; _0x12f765 < _0x117272[_0x5cba77(0x1f1)]; _0x12f765++) { let _0x2110e7 = document[_0x5cba77(0x1a9)](_0x5cba77(0x1de)); _0x2110e7[_0x5cba77(0x198)] = _0x117272[_0x12f765], _0xbd2639['add'](_0x2110e7); } _0xbd2639[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0xbd2639[_0x5cba77(0x199)] = _0x5cba77(0x1a7), _0xb51b1c['appendChild'](_0x39b1f2), _0xb51b1c[_0x5cba77(0x1aa)](_0x51cc97), _0x27f10a[_0x5cba77(0x1aa)](_0x1b2dae), _0x27f10a['appendChild'](_0xbd2639), _0x5f4a64['appendChild'](_0xb51b1c), _0x5f4a64[_0x5cba77(0x1aa)](_0x27f10a); let _0x534a1e = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x534a1e[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x5a1068 = document[_0x5cba77(0x1a9)]('label'); _0x5a1068[_0x5cba77(0x198)] = _0x5cba77(0x185); let _0x35c67c = document[_0x5cba77(0x1a9)]('input'); _0x35c67c['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x35c67c['placeholder'] = _0x5cba77(0x185), _0x35c67c[_0x5cba77(0x199)] = _0x5cba77(0x1f9); let _0x31681d = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x31681d[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0xc77d44 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0xc77d44[_0x5cba77(0x198)] = _0x5cba77(0x1a6); let _0x412982 = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x412982[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)]('form-control'), _0x412982['type'] = 'date', _0x412982[_0x5cba77(0x1dd)] = _0x5cba77(0x1a6), _0x412982[_0x5cba77(0x199)] = 'date_join_ngo[]'; let _0xf770f = document['createElement']('div'); _0xf770f[_0x5cba77(0x1b8)]['add'](_0x5cba77(0x178)); let _0xa9801 = document[_0x5cba77(0x1a9)]('label'); _0xa9801[_0x5cba77(0x198)] = _0x5cba77(0x1a6); let _0x13c893 = document[_0x5cba77(0x1a9)]('input'); _0x13c893['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x13c893[_0x5cba77(0x1d5)] = _0x5cba77(0x1ce), _0x13c893[_0x5cba77(0x1dd)] = _0x5cba77(0x1a6), _0x13c893[_0x5cba77(0x199)] = _0x5cba77(0x1b2); let _0x152edb = document['createElement']('div'); _0x152edb[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x58aa67 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x58aa67[_0x5cba77(0x198)] = _0x5cba77(0x1be); let _0x577f33 = document[_0x5cba77(0x1a9)]('select'); _0x577f33[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x577f33['name'] = 'recog_ngo[]'; let _0x1b9cbb = document[_0x5cba77(0x1a9)]('option'); _0x1b9cbb['value'] = '1', _0x1b9cbb[_0x5cba77(0x198)] = _0x5cba77(0x187); let _0x409157 = document['createElement'](_0x5cba77(0x1de)); _0x409157[_0x5cba77(0x1dc)] = '0', _0x409157['textContent'] = 'No', _0x577f33[_0x5cba77(0x1aa)](_0x1b9cbb), _0x577f33[_0x5cba77(0x1aa)](_0x409157); let _0x261555 = document[_0x5cba77(0x1a9)]('div'); _0x261555['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x125bef = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x125bef['textContent'] = 'Recognized\x20by\x20Brgy'; let _0x5f14a5 = document[_0x5cba77(0x1a9)]('input'); _0x5f14a5[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x5f14a5[_0x5cba77(0x1dd)] = _0x5cba77(0x1ee), _0x5f14a5[_0x5cba77(0x199)] = 'recognized_brgy_ngo[]'; let _0x27ad99 = document['createElement']('div'); _0x27ad99['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x3aeb85 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x3aeb85[_0x5cba77(0x198)] = 'Date\x20Recognized\x20by\x20Barangay'; let _0x9b6078 = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x9b6078[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x9b6078['type'] = _0x5cba77(0x1ce), _0x9b6078[_0x5cba77(0x1dd)] = _0x5cba77(0x1d7), _0x9b6078['name'] = _0x5cba77(0x1fd); let _0x4e4d51 = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x4e4d51[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)]('form-group'); let _0x4ddf17 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x4ddf17[_0x5cba77(0x198)] = 'Recognized\x20by\x20City'; let _0x13ae36 = document[_0x5cba77(0x1a9)]('input'); _0x13ae36[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x13ae36[_0x5cba77(0x1dd)] = _0x5cba77(0x19a), _0x13ae36[_0x5cba77(0x199)] = _0x5cba77(0x1bc); let _0x288530 = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x288530[_0x5cba77(0x1b8)]['add'](_0x5cba77(0x178)); let _0x5030c6 = document['createElement'](_0x5cba77(0x18a)); _0x5030c6[_0x5cba77(0x198)] = _0x5cba77(0x17d); let _0x26f472 = document[_0x5cba77(0x1a9)]('input'); _0x26f472[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x26f472[_0x5cba77(0x1d5)] = _0x5cba77(0x1ce), _0x26f472[_0x5cba77(0x1dd)] = _0x5cba77(0x17d), _0x26f472[_0x5cba77(0x199)] = 'date_recognized_city_ngo[]'; let _0x208f3d = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x208f3d['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0x390355 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x390355['textContent'] = _0x5cba77(0x1e8); let _0x163f3f = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x163f3f[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x163f3f[_0x5cba77(0x1d5)] = _0x5cba77(0x1b1), _0x163f3f[_0x5cba77(0x1dd)] = _0x5cba77(0x1e8), _0x163f3f[_0x5cba77(0x199)] = _0x5cba77(0x1a8); let _0x5f40f8 = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x5f40f8[_0x5cba77(0x1b8)]['add']('form-group'); let _0x37ed93 = document['createElement'](_0x5cba77(0x18a)); _0x37ed93[_0x5cba77(0x198)] = _0x5cba77(0x184); let _0x38275c = document['createElement']('input'); _0x38275c['classList'][_0x5cba77(0x1e9)]('form-control'), _0x38275c[_0x5cba77(0x1dd)] = _0x5cba77(0x184), _0x38275c[_0x5cba77(0x199)] = _0x5cba77(0x1fb); let _0x59541e = document['createElement'](_0x5cba77(0x191)); _0x59541e[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)]('form-group'); let _0x3d1f94 = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x3d1f94[_0x5cba77(0x198)] = _0x5cba77(0x188); let _0x3d000d = document[_0x5cba77(0x1a9)](_0x5cba77(0x1cb)); _0x3d000d['classList'][_0x5cba77(0x1e9)]('form-control'), _0x3d000d['name'] = _0x5cba77(0x200); let _0x112226 = document['createElement'](_0x5cba77(0x1de)); _0x112226[_0x5cba77(0x1dc)] = '1', _0x112226[_0x5cba77(0x198)] = _0x5cba77(0x187); let _0x339115 = document[_0x5cba77(0x1a9)](_0x5cba77(0x1de)); _0x339115[_0x5cba77(0x1dc)] = '0', _0x339115[_0x5cba77(0x198)] = 'No', _0x3d000d['appendChild'](_0x112226), _0x3d000d[_0x5cba77(0x1aa)](_0x339115); let _0x719a04 = document[_0x5cba77(0x1a9)](_0x5cba77(0x191)); _0x719a04[_0x5cba77(0x1b8)]['add'](_0x5cba77(0x178)); let _0x25767b = document[_0x5cba77(0x1a9)](_0x5cba77(0x18a)); _0x25767b[_0x5cba77(0x198)] = _0x5cba77(0x1e7); let _0x1e2491 = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x1e2491[_0x5cba77(0x1b8)][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x1e2491['type'] = _0x5cba77(0x1ce), _0x1e2491['placeholder'] = _0x5cba77(0x1e7), _0x1e2491[_0x5cba77(0x199)] = _0x5cba77(0x1b0); let _0x41c22b = document[_0x5cba77(0x1a9)]('div'); _0x41c22b['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x178)); let _0xb901f = document['createElement'](_0x5cba77(0x18a)); _0xb901f['textContent'] = _0x5cba77(0x1c3); let _0x4ff91e = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x4ff91e['classList'][_0x5cba77(0x1e9)](_0x5cba77(0x1a0)), _0x4ff91e['type'] = 'file', _0x4ff91e[_0x5cba77(0x1e0)] = !![], _0x4ff91e[_0x5cba77(0x199)] = 'add_attach_ngo[]', _0x31681d[_0x5cba77(0x1bd)][_0x5cba77(0x1cf)] = 'none', _0xf770f[_0x5cba77(0x1bd)]['display'] = _0x5cba77(0x1ed), _0x208f3d[_0x5cba77(0x1bd)][_0x5cba77(0x1cf)] = _0x5cba77(0x1ed), _0x5f40f8[_0x5cba77(0x1bd)][_0x5cba77(0x1cf)] = 'none', _0x59541e['style'][_0x5cba77(0x1cf)] = 'none', _0x719a04[_0x5cba77(0x1bd)]['display'] = _0x5cba77(0x1ed), _0x41c22b[_0x5cba77(0x1bd)][_0x5cba77(0x1cf)] = 'none', _0x152edb['style'][_0x5cba77(0x1cf)] = _0x5cba77(0x1ed), _0x261555[_0x5cba77(0x1bd)][_0x5cba77(0x1cf)] = _0x5cba77(0x1ed), _0x27ad99[_0x5cba77(0x1bd)]['display'] = _0x5cba77(0x1ed), _0x4e4d51['style'][_0x5cba77(0x1cf)] = 'none', _0x288530[_0x5cba77(0x1bd)][_0x5cba77(0x1cf)] = _0x5cba77(0x1ed); let _0xaac100 = Math[_0x5cba77(0x1ec)](Math[_0x5cba77(0x1a5)]() * 0x3e8), _0x28484d = document[_0x5cba77(0x1a9)](_0x5cba77(0x1ca)); _0x28484d[_0x5cba77(0x199)] = _0x5cba77(0x1e1), _0x28484d[_0x5cba77(0x1d5)] = 'hidden', _0x28484d[_0x5cba77(0x1dc)] = _0xaac100; function _0x59fec6() { const _0x49a62f = _0x5cba77; _0x31681d[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0xf770f['style'][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0x208f3d[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0x5f40f8[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = 'none', _0x59541e[_0x49a62f(0x1bd)]['display'] = _0x49a62f(0x1ed), _0x719a04[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0x41c22b[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0x534a1e[_0x49a62f(0x1bd)]['display'] = _0x49a62f(0x1ed), _0x152edb['style']['display'] = _0x49a62f(0x1ed), _0x261555[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0x27ad99[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = 'none', _0x4e4d51[_0x49a62f(0x1bd)][_0x49a62f(0x1cf)] = _0x49a62f(0x1ed), _0x288530[_0x49a62f(0x1bd)]['display'] = _0x49a62f(0x1ed); }; _0xbd2639[_0x5cba77(0x1f8)]('change', function () { const _0x51d1e6 = _0x5cba77; let _0x23eddb = _0xbd2639[_0x51d1e6(0x1dc)]; _0x59fec6(); if (_0x23eddb == _0x51d1e6(0x1c2)) _0x31681d[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189); else { if (_0x23eddb == _0x51d1e6(0x17c)) _0xf770f[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x534a1e['style']['display'] = _0x51d1e6(0x189); else _0x23eddb == 'President' && (_0xf770f[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x208f3d[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x5f40f8[_0x51d1e6(0x1bd)]['display'] = _0x51d1e6(0x189), _0x59541e[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x719a04[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x41c22b[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x534a1e[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x152edb['style']['display'] = _0x51d1e6(0x189), _0x261555['style']['display'] = _0x51d1e6(0x189), _0x27ad99[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = _0x51d1e6(0x189), _0x4e4d51[_0x51d1e6(0x1bd)][_0x51d1e6(0x1cf)] = 'block', _0x288530[_0x51d1e6(0x1bd)]['display'] = _0x51d1e6(0x189), _0x577f33['addEventListener'](_0x51d1e6(0x1bb), function () { const _0x9d2bd8 = _0x51d1e6; this['value'] == '0' ? (_0x261555['style'][_0x9d2bd8(0x1cf)] = _0x9d2bd8(0x1ed), _0x27ad99['style'][_0x9d2bd8(0x1cf)] = 'none', _0x4e4d51[_0x9d2bd8(0x1bd)][_0x9d2bd8(0x1cf)] = 'none', _0x288530[_0x9d2bd8(0x1bd)][_0x9d2bd8(0x1cf)] = _0x9d2bd8(0x1ed)) : (_0x261555[_0x9d2bd8(0x1bd)][_0x9d2bd8(0x1cf)] = _0x9d2bd8(0x189), _0x27ad99[_0x9d2bd8(0x1bd)]['display'] = _0x9d2bd8(0x189), _0x4e4d51[_0x9d2bd8(0x1bd)][_0x9d2bd8(0x1cf)] = 'block', _0x288530['style'][_0x9d2bd8(0x1cf)] = _0x9d2bd8(0x189)); }), _0x3d000d[_0x51d1e6(0x1f8)]('change', function () { const _0xcfac21 = _0x51d1e6; this[_0xcfac21(0x1dc)] == '0' ? _0x719a04[_0xcfac21(0x1bd)][_0xcfac21(0x1cf)] = _0xcfac21(0x1ed) : _0x719a04[_0xcfac21(0x1bd)][_0xcfac21(0x1cf)] = _0xcfac21(0x189); })); } }), _0x5f4a64[_0x5cba77(0x1aa)](_0x28484d), _0x5f4a64['appendChild'](_0x31681d), _0x31681d[_0x5cba77(0x1aa)](_0xc77d44), _0x31681d[_0x5cba77(0x1aa)](_0x412982), _0x5f4a64[_0x5cba77(0x1aa)](_0x534a1e), _0x534a1e[_0x5cba77(0x1aa)](_0x5a1068), _0x534a1e[_0x5cba77(0x1aa)](_0x35c67c), _0x5f4a64[_0x5cba77(0x1aa)](_0xf770f), _0xf770f[_0x5cba77(0x1aa)](_0xa9801), _0xf770f[_0x5cba77(0x1aa)](_0x13c893), _0x5f4a64['appendChild'](_0x152edb), _0x152edb[_0x5cba77(0x1aa)](_0x58aa67), _0x152edb[_0x5cba77(0x1aa)](_0x577f33), _0x5f4a64[_0x5cba77(0x1aa)](_0x261555), _0x261555[_0x5cba77(0x1aa)](_0x125bef), _0x261555[_0x5cba77(0x1aa)](_0x5f14a5), _0x5f4a64[_0x5cba77(0x1aa)](_0x27ad99), _0x27ad99[_0x5cba77(0x1aa)](_0x3aeb85), _0x27ad99[_0x5cba77(0x1aa)](_0x9b6078), _0x5f4a64[_0x5cba77(0x1aa)](_0x4e4d51), _0x4e4d51[_0x5cba77(0x1aa)](_0x4ddf17), _0x4e4d51[_0x5cba77(0x1aa)](_0x13ae36), _0x5f4a64[_0x5cba77(0x1aa)](_0x288530), _0x288530['appendChild'](_0x5030c6), _0x288530['appendChild'](_0x26f472), _0x5f4a64[_0x5cba77(0x1aa)](_0x208f3d), _0x208f3d[_0x5cba77(0x1aa)](_0x390355), _0x208f3d[_0x5cba77(0x1aa)](_0x163f3f), _0x5f4a64[_0x5cba77(0x1aa)](_0x5f40f8), _0x5f40f8['appendChild'](_0x37ed93), _0x5f40f8[_0x5cba77(0x1aa)](_0x38275c), _0x5f4a64['appendChild'](_0x59541e), _0x59541e[_0x5cba77(0x1aa)](_0x3d1f94), _0x59541e[_0x5cba77(0x1aa)](_0x3d000d), _0x5f4a64['appendChild'](_0x719a04), _0x719a04[_0x5cba77(0x1aa)](_0x25767b), _0x719a04['appendChild'](_0x1e2491), _0x5f4a64[_0x5cba77(0x1aa)](_0x41c22b), _0x41c22b[_0x5cba77(0x1aa)](_0xb901f), _0x41c22b['appendChild'](_0x4ff91e), _0x41c22b[_0x5cba77(0x1aa)](document['createElement']('hr')), _0x41c22b[_0x5cba77(0x1aa)](document[_0x5cba77(0x1a9)]('br')); } counter_ngo++, counter_ngo >= 0x6 && alert(_0x5cba77(0x19e)); } let num4 = Math[_0x4e252d(0x1ec)](Math[_0x4e252d(0x1a5)]() * 0x3e8); function _0x83f9(_0x4cf509, _0x5083e7) { const _0x3bafb5 = _0x3baf(); return _0x83f9 = function (_0x83f9a6, _0x5d24b0) { _0x83f9a6 = _0x83f9a6 - 0x176; let _0xe7f84c = _0x3bafb5[_0x83f9a6]; return _0xe7f84c; }, _0x83f9(_0x4cf509, _0x5083e7); } document[_0x4e252d(0x1e2)](_0x4e252d(0x1a2))[_0x4e252d(0x1dc)] = num4; var counter_trans = 0x1; function addElementsTrans() { const _0x5a64a9 = _0x4e252d; let _0x4abf48 = document[_0x5a64a9(0x1e2)](_0x5a64a9(0x1c0)); if (counter_trans < 0x5) { let _0x5d3063 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x5d3063[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-group'); let _0x588baa = document['createElement'](_0x5a64a9(0x18a)); _0x588baa['textContent'] = _0x5a64a9(0x1c6); let _0x45b7d5 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x45b7d5[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-control'), _0x45b7d5[_0x5a64a9(0x199)] = 'orgname_trans[]'; let _0x3d472b = document['createElement'](_0x5a64a9(0x191)); _0x3d472b[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x178)); let _0x2f5e88 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x2f5e88[_0x5a64a9(0x198)] = _0x5a64a9(0x19b); let _0x2dc5fa = document[_0x5a64a9(0x1a9)]('select'), _0x5bd560 = ['', _0x5a64a9(0x1c2), _0x5a64a9(0x17c), _0x5a64a9(0x1d0)]; for (let _0x5d08c6 = 0x0; _0x5d08c6 < _0x5bd560[_0x5a64a9(0x1f1)]; _0x5d08c6++) { let _0x276be2 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1de)); _0x276be2['textContent'] = _0x5bd560[_0x5d08c6], _0x2dc5fa['add'](_0x276be2); } _0x2dc5fa[_0x5a64a9(0x1b8)]['add'](_0x5a64a9(0x1a0)), _0x2dc5fa['name'] = _0x5a64a9(0x1fc), _0x5d3063[_0x5a64a9(0x1aa)](_0x588baa), _0x5d3063['appendChild'](_0x45b7d5), _0x3d472b[_0x5a64a9(0x1aa)](_0x2f5e88), _0x3d472b[_0x5a64a9(0x1aa)](_0x2dc5fa), _0x4abf48['appendChild'](_0x5d3063), _0x4abf48[_0x5a64a9(0x1aa)](_0x3d472b); let _0xb714ed = document['createElement']('div'); _0xb714ed['classList'][_0x5a64a9(0x1e9)]('form-group'); let _0x2ff99a = document['createElement'](_0x5a64a9(0x18a)); _0x2ff99a[_0x5a64a9(0x198)] = 'Position'; let _0x5e0d38 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x5e0d38['classList'][_0x5a64a9(0x1e9)]('form-control'), _0x5e0d38[_0x5a64a9(0x1dd)] = _0x5a64a9(0x185), _0x5e0d38['name'] = _0x5a64a9(0x19f); let _0x495277 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x495277[_0x5a64a9(0x1b8)]['add'](_0x5a64a9(0x178)); let _0x20859b = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x20859b[_0x5a64a9(0x198)] = _0x5a64a9(0x1a6); let _0x4be8d6 = document[_0x5a64a9(0x1a9)]('input'); _0x4be8d6[_0x5a64a9(0x1b8)]['add'](_0x5a64a9(0x1a0)), _0x4be8d6[_0x5a64a9(0x1d5)] = _0x5a64a9(0x1ce), _0x4be8d6[_0x5a64a9(0x1dd)] = _0x5a64a9(0x1a6), _0x4be8d6['name'] = _0x5a64a9(0x1af); let _0x88d0d9 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x88d0d9[_0x5a64a9(0x1b8)]['add'](_0x5a64a9(0x178)); let _0xcbc4d8 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0xcbc4d8[_0x5a64a9(0x198)] = _0x5a64a9(0x1a6); let _0x499065 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x499065['classList'][_0x5a64a9(0x1e9)]('form-control'), _0x499065['type'] = _0x5a64a9(0x1ce), _0x499065[_0x5a64a9(0x1dd)] = _0x5a64a9(0x1a6), _0x499065[_0x5a64a9(0x199)] = _0x5a64a9(0x1ef); let _0x2ba492 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x2ba492[_0x5a64a9(0x1b8)]['add']('form-group'); let _0x1e2a3a = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x1e2a3a['textContent'] = 'Recognized'; let _0x1fa7c3 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1cb)); _0x1fa7c3[_0x5a64a9(0x1b8)]['add']('form-control'), _0x1fa7c3[_0x5a64a9(0x199)] = _0x5a64a9(0x196); let _0xe0f24f = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1de)); _0xe0f24f[_0x5a64a9(0x1dc)] = '1', _0xe0f24f[_0x5a64a9(0x198)] = _0x5a64a9(0x187); let _0x25bc54 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1de)); _0x25bc54[_0x5a64a9(0x1dc)] = '0', _0x25bc54[_0x5a64a9(0x198)] = 'No', _0x1fa7c3['appendChild'](_0xe0f24f), _0x1fa7c3[_0x5a64a9(0x1aa)](_0x25bc54); let _0x43ba28 = document[_0x5a64a9(0x1a9)]('div'); _0x43ba28[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-group'); let _0x1d8b7a = document['createElement'](_0x5a64a9(0x18a)); _0x1d8b7a[_0x5a64a9(0x198)] = _0x5a64a9(0x1ee); let _0x1187bc = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x1187bc[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-control'), _0x1187bc[_0x5a64a9(0x1dd)] = _0x5a64a9(0x1ee), _0x1187bc[_0x5a64a9(0x199)] = _0x5a64a9(0x1fa); let _0xa5d91c = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0xa5d91c[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-group'); let _0x553d0e = document['createElement'](_0x5a64a9(0x18a)); _0x553d0e[_0x5a64a9(0x198)] = _0x5a64a9(0x1d7); let _0x1feb79 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x1feb79[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x1feb79[_0x5a64a9(0x1d5)] = _0x5a64a9(0x1ce), _0x1feb79[_0x5a64a9(0x1dd)] = _0x5a64a9(0x1d7), _0x1feb79[_0x5a64a9(0x199)] = _0x5a64a9(0x1eb); let _0x6ee86d = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x6ee86d[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x178)); let _0x5ed055 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x5ed055['textContent'] = _0x5a64a9(0x19a); let _0x41ef80 = document['createElement'](_0x5a64a9(0x1ca)); _0x41ef80['classList'][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x41ef80[_0x5a64a9(0x1dd)] = _0x5a64a9(0x19a), _0x41ef80[_0x5a64a9(0x199)] = _0x5a64a9(0x1d3); let _0x494258 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x494258[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-group'); let _0x492d8b = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x492d8b[_0x5a64a9(0x198)] = _0x5a64a9(0x17d); let _0x141f56 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x141f56['classList'][_0x5a64a9(0x1e9)]('form-control'), _0x141f56[_0x5a64a9(0x1d5)] = _0x5a64a9(0x1ce), _0x141f56[_0x5a64a9(0x1dd)] = _0x5a64a9(0x17d), _0x141f56['name'] = _0x5a64a9(0x17e); let _0x3ef714 = document['createElement'](_0x5a64a9(0x191)); _0x3ef714[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x178)); let _0x461d3b = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x461d3b[_0x5a64a9(0x198)] = _0x5a64a9(0x1e8); let _0x5165c6 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x5165c6[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x5165c6[_0x5a64a9(0x1d5)] = _0x5a64a9(0x1b1), _0x5165c6[_0x5a64a9(0x1dd)] = _0x5a64a9(0x1e8), _0x5165c6[_0x5a64a9(0x199)] = 'years_exist_trans[]'; let _0x17945c = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x17945c[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-group'); let _0x244af0 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x244af0['textContent'] = _0x5a64a9(0x184); let _0x4173bb = document[_0x5a64a9(0x1a9)]('input'); _0x4173bb[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x4173bb['placeholder'] = _0x5a64a9(0x184), _0x4173bb[_0x5a64a9(0x199)] = 'no_exist_trans[]'; let _0x5a9732 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x5a9732[_0x5a64a9(0x1b8)]['add'](_0x5a64a9(0x178)); let _0x42ebe1 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x42ebe1[_0x5a64a9(0x198)] = _0x5a64a9(0x188); let _0x463855 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1cb)); _0x463855[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x463855[_0x5a64a9(0x199)] = _0x5a64a9(0x1a3); let _0x1fdcfa = document['createElement'](_0x5a64a9(0x1de)); _0x1fdcfa[_0x5a64a9(0x1dc)] = '1', _0x1fdcfa[_0x5a64a9(0x198)] = _0x5a64a9(0x187); let _0x4124e6 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1de)); _0x4124e6['value'] = '0', _0x4124e6[_0x5a64a9(0x198)] = 'No', _0x463855['appendChild'](_0x1fdcfa), _0x463855[_0x5a64a9(0x1aa)](_0x4124e6); let _0x4e4e34 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0x4e4e34['classList'][_0x5a64a9(0x1e9)](_0x5a64a9(0x178)); let _0x300c2a = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x300c2a['textContent'] = _0x5a64a9(0x1e7); let _0x5bab84 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x5bab84[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x5bab84[_0x5a64a9(0x1d5)] = _0x5a64a9(0x1ce), _0x5bab84[_0x5a64a9(0x1dd)] = _0x5a64a9(0x1e7), _0x5bab84['name'] = _0x5a64a9(0x1b3); let _0xf9855c = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x191)); _0xf9855c[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)]('form-group'); let _0x5542a5 = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x18a)); _0x5542a5[_0x5a64a9(0x198)] = _0x5a64a9(0x1c3); let _0x23c22e = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x23c22e[_0x5a64a9(0x1b8)][_0x5a64a9(0x1e9)](_0x5a64a9(0x1a0)), _0x23c22e[_0x5a64a9(0x1d5)] = 'file', _0x23c22e[_0x5a64a9(0x1e0)] = !![], _0x23c22e['name'] = 'add_attach_trans[]', _0x495277['style']['display'] = _0x5a64a9(0x1ed), _0x88d0d9[_0x5a64a9(0x1bd)][_0x5a64a9(0x1cf)] = 'none', _0x3ef714[_0x5a64a9(0x1bd)][_0x5a64a9(0x1cf)] = _0x5a64a9(0x1ed), _0x17945c[_0x5a64a9(0x1bd)][_0x5a64a9(0x1cf)] = 'none', _0x5a9732['style'][_0x5a64a9(0x1cf)] = 'none', _0x4e4e34[_0x5a64a9(0x1bd)][_0x5a64a9(0x1cf)] = 'none', _0xf9855c[_0x5a64a9(0x1bd)]['display'] = _0x5a64a9(0x1ed), _0xb714ed['style'][_0x5a64a9(0x1cf)] = _0x5a64a9(0x1ed), _0x2ba492['style'][_0x5a64a9(0x1cf)] = _0x5a64a9(0x1ed), _0x43ba28[_0x5a64a9(0x1bd)]['display'] = _0x5a64a9(0x1ed), _0xa5d91c[_0x5a64a9(0x1bd)]['display'] = _0x5a64a9(0x1ed), _0x6ee86d[_0x5a64a9(0x1bd)]['display'] = _0x5a64a9(0x1ed), _0x494258[_0x5a64a9(0x1bd)][_0x5a64a9(0x1cf)] = _0x5a64a9(0x1ed); let _0x3e7e74 = Math[_0x5a64a9(0x1ec)](Math['random']() * 0x3e8), _0x31a8fa = document[_0x5a64a9(0x1a9)](_0x5a64a9(0x1ca)); _0x31a8fa['name'] = 'separator_trans[]', _0x31a8fa[_0x5a64a9(0x1d5)] = 'hidden', _0x31a8fa[_0x5a64a9(0x1dc)] = _0x3e7e74; function _0x163153() { const _0x5cb5a2 = _0x5a64a9; _0x495277[_0x5cb5a2(0x1bd)][_0x5cb5a2(0x1cf)] = 'none', _0x88d0d9[_0x5cb5a2(0x1bd)]['display'] = _0x5cb5a2(0x1ed), _0x3ef714[_0x5cb5a2(0x1bd)]['display'] = _0x5cb5a2(0x1ed), _0x17945c[_0x5cb5a2(0x1bd)]['display'] = 'none', _0x5a9732['style'][_0x5cb5a2(0x1cf)] = _0x5cb5a2(0x1ed), _0x4e4e34[_0x5cb5a2(0x1bd)][_0x5cb5a2(0x1cf)] = 'none', _0xf9855c['style'][_0x5cb5a2(0x1cf)] = _0x5cb5a2(0x1ed), _0xb714ed[_0x5cb5a2(0x1bd)][_0x5cb5a2(0x1cf)] = 'none', _0x2ba492['style']['display'] = _0x5cb5a2(0x1ed), _0x43ba28['style'][_0x5cb5a2(0x1cf)] = _0x5cb5a2(0x1ed), _0xa5d91c[_0x5cb5a2(0x1bd)][_0x5cb5a2(0x1cf)] = _0x5cb5a2(0x1ed), _0x6ee86d[_0x5cb5a2(0x1bd)][_0x5cb5a2(0x1cf)] = 'none', _0x494258[_0x5cb5a2(0x1bd)][_0x5cb5a2(0x1cf)] = _0x5cb5a2(0x1ed); }; _0x2dc5fa['addEventListener'](_0x5a64a9(0x1bb), function () { const _0x269f5e = _0x5a64a9; let _0x3428ba = _0x2dc5fa['value']; _0x163153(); if (_0x3428ba == _0x269f5e(0x1c2)) _0x495277['style'][_0x269f5e(0x1cf)] = _0x269f5e(0x189); else { if (_0x3428ba == _0x269f5e(0x17c)) _0x88d0d9[_0x269f5e(0x1bd)]['display'] = 'block', _0xb714ed['style']['display'] = _0x269f5e(0x189); else _0x3428ba == 'President' && (_0x88d0d9[_0x269f5e(0x1bd)]['display'] = _0x269f5e(0x189), _0x3ef714[_0x269f5e(0x1bd)]['display'] = _0x269f5e(0x189), _0x17945c[_0x269f5e(0x1bd)]['display'] = _0x269f5e(0x189), _0x5a9732[_0x269f5e(0x1bd)][_0x269f5e(0x1cf)] = _0x269f5e(0x189), _0x4e4e34[_0x269f5e(0x1bd)]['display'] = 'block', _0xf9855c[_0x269f5e(0x1bd)]['display'] = _0x269f5e(0x189), _0x2ba492[_0x269f5e(0x1bd)][_0x269f5e(0x1cf)] = _0x269f5e(0x189), _0x43ba28['style'][_0x269f5e(0x1cf)] = _0x269f5e(0x189), _0xa5d91c[_0x269f5e(0x1bd)][_0x269f5e(0x1cf)] = _0x269f5e(0x189), _0x6ee86d[_0x269f5e(0x1bd)]['display'] = 'block', _0x494258[_0x269f5e(0x1bd)][_0x269f5e(0x1cf)] = _0x269f5e(0x189), _0x1fa7c3[_0x269f5e(0x1f8)]('change', function () { const _0x41b4f6 = _0x269f5e; this[_0x41b4f6(0x1dc)] == '0' ? (_0x43ba28[_0x41b4f6(0x1bd)][_0x41b4f6(0x1cf)] = 'none', _0xa5d91c[_0x41b4f6(0x1bd)]['display'] = _0x41b4f6(0x1ed), _0x6ee86d[_0x41b4f6(0x1bd)][_0x41b4f6(0x1cf)] = _0x41b4f6(0x1ed), _0x494258['style'][_0x41b4f6(0x1cf)] = _0x41b4f6(0x1ed)) : (_0x43ba28[_0x41b4f6(0x1bd)][_0x41b4f6(0x1cf)] = _0x41b4f6(0x189), _0xa5d91c[_0x41b4f6(0x1bd)][_0x41b4f6(0x1cf)] = _0x41b4f6(0x189), _0x6ee86d[_0x41b4f6(0x1bd)]['display'] = _0x41b4f6(0x189), _0x494258[_0x41b4f6(0x1bd)]['display'] = _0x41b4f6(0x189)); }), _0x463855[_0x269f5e(0x1f8)](_0x269f5e(0x1bb), function () { const _0x32282f = _0x269f5e; this[_0x32282f(0x1dc)] == '0' ? _0x4e4e34[_0x32282f(0x1bd)][_0x32282f(0x1cf)] = _0x32282f(0x1ed) : _0x4e4e34[_0x32282f(0x1bd)][_0x32282f(0x1cf)] = _0x32282f(0x189); })); } }), _0x4abf48['appendChild'](_0x31a8fa), _0x4abf48[_0x5a64a9(0x1aa)](_0x495277), _0x495277[_0x5a64a9(0x1aa)](_0x20859b), _0x495277[_0x5a64a9(0x1aa)](_0x4be8d6), _0x4abf48[_0x5a64a9(0x1aa)](_0xb714ed), _0xb714ed[_0x5a64a9(0x1aa)](_0x2ff99a), _0xb714ed[_0x5a64a9(0x1aa)](_0x5e0d38), _0x4abf48['appendChild'](_0x88d0d9), _0x88d0d9[_0x5a64a9(0x1aa)](_0xcbc4d8), _0x88d0d9[_0x5a64a9(0x1aa)](_0x499065), _0x4abf48[_0x5a64a9(0x1aa)](_0x2ba492), _0x2ba492[_0x5a64a9(0x1aa)](_0x1e2a3a), _0x2ba492[_0x5a64a9(0x1aa)](_0x1fa7c3), _0x4abf48[_0x5a64a9(0x1aa)](_0x43ba28), _0x43ba28[_0x5a64a9(0x1aa)](_0x1d8b7a), _0x43ba28[_0x5a64a9(0x1aa)](_0x1187bc), _0x4abf48[_0x5a64a9(0x1aa)](_0xa5d91c), _0xa5d91c[_0x5a64a9(0x1aa)](_0x553d0e), _0xa5d91c['appendChild'](_0x1feb79), _0x4abf48['appendChild'](_0x6ee86d), _0x6ee86d[_0x5a64a9(0x1aa)](_0x5ed055), _0x6ee86d['appendChild'](_0x41ef80), _0x4abf48[_0x5a64a9(0x1aa)](_0x494258), _0x494258['appendChild'](_0x492d8b), _0x494258[_0x5a64a9(0x1aa)](_0x141f56), _0x4abf48[_0x5a64a9(0x1aa)](_0x3ef714), _0x3ef714[_0x5a64a9(0x1aa)](_0x461d3b), _0x3ef714[_0x5a64a9(0x1aa)](_0x5165c6), _0x4abf48[_0x5a64a9(0x1aa)](_0x17945c), _0x17945c[_0x5a64a9(0x1aa)](_0x244af0), _0x17945c['appendChild'](_0x4173bb), _0x4abf48['appendChild'](_0x5a9732), _0x5a9732[_0x5a64a9(0x1aa)](_0x42ebe1), _0x5a9732[_0x5a64a9(0x1aa)](_0x463855), _0x4abf48[_0x5a64a9(0x1aa)](_0x4e4e34), _0x4e4e34[_0x5a64a9(0x1aa)](_0x300c2a), _0x4e4e34[_0x5a64a9(0x1aa)](_0x5bab84), _0x4abf48[_0x5a64a9(0x1aa)](_0xf9855c), _0xf9855c[_0x5a64a9(0x1aa)](_0x5542a5), _0xf9855c[_0x5a64a9(0x1aa)](_0x23c22e), _0xf9855c[_0x5a64a9(0x1aa)](document[_0x5a64a9(0x1a9)]('hr')), _0xf9855c['appendChild'](document[_0x5a64a9(0x1a9)]('br')); } counter_ngo++, counter_ngo >= 0x6 && alert(_0x5a64a9(0x19e)); } function addFields() { const _0x42e9fc = _0x4e252d; var _0x1ffd6d = document[_0x42e9fc(0x1e2)](_0x42e9fc(0x1da)), _0x323478 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x1ca)); _0x323478[_0x42e9fc(0x1d5)] = 'file', _0x323478['name'] = 'images[]', _0x323478['accept'] = _0x42e9fc(0x176), _0x323478['classList'][_0x42e9fc(0x1e9)](_0x42e9fc(0x193)); var _0x2c5095 = document[_0x42e9fc(0x1a9)]('div'); _0x2c5095[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)](_0x42e9fc(0x178)); var _0x3a5efc = document['createElement'](_0x42e9fc(0x18a)); _0x3a5efc['textContent'] = 'Upload\x20Image', _0x2c5095['appendChild'](_0x3a5efc), _0x2c5095['appendChild'](_0x323478), _0x1ffd6d[_0x42e9fc(0x1aa)](_0x2c5095); var _0x4eef03 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x1ca)); _0x4eef03[_0x42e9fc(0x1d5)] = _0x42e9fc(0x1ac), _0x4eef03[_0x42e9fc(0x199)] = _0x42e9fc(0x1ae), _0x4eef03['placeholder'] = _0x42e9fc(0x1b4), _0x4eef03[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)](_0x42e9fc(0x1a0)); var _0xa9ed5 = document[_0x42e9fc(0x1a9)]('div'); _0xa9ed5[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)]('form-group'); var _0x4a39b2 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x18a)); _0x4a39b2[_0x42e9fc(0x198)] = 'Pet\x20Type', _0xa9ed5['appendChild'](_0x4a39b2), _0xa9ed5[_0x42e9fc(0x1aa)](_0x4eef03), _0x1ffd6d['appendChild'](_0xa9ed5); var _0x5b8a57 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x1cb)); _0x5b8a57[_0x42e9fc(0x199)] = 'vaccinated[]', _0x5b8a57[_0x42e9fc(0x1b8)]['add'](_0x42e9fc(0x1a0)); var _0x3fac67 = ['', _0x42e9fc(0x187), 'No']; for (var _0x3a0f03 = 0x0; _0x3a0f03 < _0x3fac67[_0x42e9fc(0x1f1)]; _0x3a0f03++) { var _0x38e794 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x1de)); _0x38e794[_0x42e9fc(0x1ac)] = _0x3fac67[_0x3a0f03], _0x5b8a57['add'](_0x38e794); } var _0x5d31ba = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x191)); _0x5d31ba[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)]('form-group'); var _0x2dfcba = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x18a)); _0x2dfcba[_0x42e9fc(0x198)] = _0x42e9fc(0x1ad), _0x5d31ba['appendChild'](_0x2dfcba), _0x5d31ba[_0x42e9fc(0x1aa)](_0x5b8a57), _0x1ffd6d['appendChild'](_0x5d31ba); var _0x1eb495 = document[_0x42e9fc(0x1a9)]('input'); _0x1eb495['type'] = 'date', _0x1eb495[_0x42e9fc(0x199)] = _0x42e9fc(0x18f), _0x1eb495[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)](_0x42e9fc(0x1a0)); var _0x41a05e = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x191)); _0x41a05e['classList'][_0x42e9fc(0x1e9)]('form-group'); var _0x8da038 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x18a)); _0x8da038[_0x42e9fc(0x198)] = _0x42e9fc(0x1e5), _0x41a05e[_0x42e9fc(0x1aa)](_0x8da038), _0x41a05e[_0x42e9fc(0x1aa)](_0x1eb495), _0x41a05e[_0x42e9fc(0x1bd)][_0x42e9fc(0x1cf)] = _0x42e9fc(0x1ed), _0x1ffd6d[_0x42e9fc(0x1aa)](_0x41a05e), _0x5b8a57['addEventListener']('change', function () { const _0x323b91 = _0x42e9fc; this[_0x323b91(0x1dc)] === _0x323b91(0x187) ? _0x41a05e[_0x323b91(0x1bd)][_0x323b91(0x1cf)] = _0x323b91(0x189) : _0x41a05e[_0x323b91(0x1bd)][_0x323b91(0x1cf)] = _0x323b91(0x1ed); }); var _0x4df1e0 = document['createElement'](_0x42e9fc(0x1cb)); _0x4df1e0[_0x42e9fc(0x199)] = _0x42e9fc(0x1e3), _0x4df1e0[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)]('form-control'); var _0x15e881 = ['', 'Yes', 'No']; for (var _0x2f8d0c = 0x0; _0x2f8d0c < _0x15e881[_0x42e9fc(0x1f1)]; _0x2f8d0c++) { var _0x524253 = document['createElement']('option'); _0x524253[_0x42e9fc(0x1ac)] = _0x15e881[_0x2f8d0c], _0x4df1e0[_0x42e9fc(0x1e9)](_0x524253); } var _0x200a52 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x191)); _0x200a52[_0x42e9fc(0x1b8)]['add'](_0x42e9fc(0x178)); var _0x121ac1 = document['createElement'](_0x42e9fc(0x18a)); _0x121ac1[_0x42e9fc(0x198)] = 'Registered', _0x200a52[_0x42e9fc(0x1aa)](_0x121ac1), _0x200a52[_0x42e9fc(0x1aa)](_0x4df1e0), _0x1ffd6d[_0x42e9fc(0x1aa)](_0x200a52); var _0x7985e = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x1ca)); _0x7985e[_0x42e9fc(0x1d5)] = _0x42e9fc(0x1ce), _0x7985e[_0x42e9fc(0x199)] = _0x42e9fc(0x17f), _0x7985e[_0x42e9fc(0x1b8)][_0x42e9fc(0x1e9)](_0x42e9fc(0x1a0)); var _0x12e0d8 = document['createElement'](_0x42e9fc(0x191)); _0x12e0d8['classList'][_0x42e9fc(0x1e9)](_0x42e9fc(0x178)); var _0x4c8c7e = document['createElement']('label'); _0x4c8c7e[_0x42e9fc(0x198)] = _0x42e9fc(0x1d2), _0x12e0d8[_0x42e9fc(0x1aa)](_0x4c8c7e), _0x12e0d8[_0x42e9fc(0x1aa)](_0x7985e), _0x12e0d8['style'][_0x42e9fc(0x1cf)] = _0x42e9fc(0x1ed), _0x1ffd6d[_0x42e9fc(0x1aa)](_0x12e0d8), _0x4df1e0[_0x42e9fc(0x1f8)](_0x42e9fc(0x1bb), function () { const _0x53de7b = _0x42e9fc; this[_0x53de7b(0x1dc)] === _0x53de7b(0x187) ? _0x12e0d8['style']['display'] = _0x53de7b(0x189) : _0x12e0d8[_0x53de7b(0x1bd)][_0x53de7b(0x1cf)] = _0x53de7b(0x1ed); }); var _0x514d70 = document[_0x42e9fc(0x1a9)](_0x42e9fc(0x1cb)); _0x514d70[_0x42e9fc(0x199)] = _0x42e9fc(0x1d8), _0x514d70[_0x42e9fc(0x1b8)]['add'](_0x42e9fc(0x1a0)); var _0x3fac67 = ['', _0x42e9fc(0x1a1), _0x42e9fc(0x1b5)]; for (var _0x3a0f03 = 0x0; _0x3a0f03 < _0x3fac67[_0x42e9fc(0x1f1)]; _0x3a0f03++) { var _0x38e794 = document['createElement'](_0x42e9fc(0x1de)); _0x38e794[_0x42e9fc(0x1ac)] = _0x3fac67[_0x3a0f03], _0x514d70[_0x42e9fc(0x1e9)](_0x38e794); } var _0x138e36 = document['createElement'](_0x42e9fc(0x191)); _0x138e36[_0x42e9fc(0x1b8)]['add'](_0x42e9fc(0x178)); var _0x105f5e = document['createElement']('label'); _0x105f5e[_0x42e9fc(0x198)] = 'Status', _0x138e36[_0x42e9fc(0x1aa)](_0x105f5e), _0x138e36[_0x42e9fc(0x1aa)](_0x514d70), _0x1ffd6d[_0x42e9fc(0x1aa)](_0x138e36), _0x1ffd6d['appendChild'](document['createElement']('hr')); var _0x2326ac = document[_0x42e9fc(0x1a9)]('input'); _0x2326ac[_0x42e9fc(0x1d5)] = _0x42e9fc(0x1ea), _0x2326ac['name'] = _0x42e9fc(0x18c), _0x1ffd6d[_0x42e9fc(0x1aa)](_0x2326ac); }
		</script>



		<!-- ===================================================================TRASPORT GROUP================================================================ -->

		<div class="form-group" id="senior">

			<label for="exampleInputuname" class="col-sm-3 control-label">Senior Citizen</label>

			<div class="col-sm-9">

				<div class="input-group">



					<input type="radio" class="sc" name="sc" id="optionsRadios7" value="0" checked="" /> No

					&nbsp;

					<input type="radio" class="sc" name="sc" id="optionsRadios8" value="1" /> Yes

				</div>

			</div>

		</div>

		<div class="white-box">
			<h3 style="color:#663399; font-weight:bold;" id="other_title">Pets</h3>
			<hr>
			<div id="container">

				<!-- <div class="form-group">
					<label for="images">Upload Image</label>
					<input type="file" name="images[]" class="form-control-file" accept="image/*">
				</div>
				<div class="form-group">
					<label for="pettype">Pet Type</label>
					<input type="text" name="pettype[]" class="form-control" placeholder="Pet Type">
				</div>
				<div class="form-group">
					<label for="vaccinated">Vaccinated</label>
					<select name="vaccinated[]" class="form-control">
						<option value=""></option>
						<option value="Yes">Yes</option>
						<option value="No">No</option>
					</select>
				</div>
				<div class="form-group">
					<label for="datevac">Vaccination Date</label>
					<input type="date" name="datevac[]" class="form-control">
				</div>
				<div class="form-group">
					<label for="registered">Registered</label>
					<select name="registered[]" class="form-control">
						<option value=""></option>
						<option value="Yes">Yes</option>
						<option value="No">No</option>
					</select>
				</div>
				<div class="form-group">
					<label for="regdate">Registration Date</label>
					<input type="date" name="regdate[]" class="form-control">
				</div>
				<div class="form-group">
					<label for="status">Status</label>
					<select name="pet_status[]" class="form-control">
						<option value=""></option>
						<option value="Alive">Alive</option>
						<option value="Dead">Dead</option>
					</select>
				</div>



				<input type="hidden" name="addnew">
				<hr> -->

			</div>

			<div class="form-group" id="submit" style="text-align: center; margin-top: 50px;">
				<button type="button" class="btn btn-success waves-effect waves-light m-r-10" onClick="addFields()"
					style="width: 200px;">Add Pet
				</button>
			</div>
		</div>

		<script>
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		</script>


		<!--3 senior start-->
		<div id="3_senior">
			<div class="form-group" id="senior4">
				<label for="exampleInputuname" class="col-sm-3 control-label">Maynilad (Own Meter)?</label>
				<div class="col-sm-9">
					<div class="input-group">
						<select name="maynilad" class="select2" style="width:150px;">
							<option value="0">No</option>
							<option value="1">Yes</option>
						</select>
					</div>
				</div>
			</div>

			<div class="form-group" id="senior4">
				<label for="exampleInputuname" class="col-sm-3 control-label">Meralco (Own Meter)?</label>
				<div class="col-sm-9">
					<div class="input-group">
						<select name="meralco" class="select2" style="width:150px;">
							<option value="0">No</option>
							<option value="1">Yes</option>
						</select>
					</div>
				</div>
			</div>

			<div class="form-group" id="senior4">

				<label for="exampleInputuname" class="col-sm-3 control-label">Septic Tank</label>

				<div class="col-sm-9">

					<div class="input-group">

						<select name="septic_tank" class="select2" style="width:150px;">

							<option value="0">No</option>

							<option value="1">Yes</option>

						</select>

					</div>

				</div>

			</div>
		</div>
		<!--3 senior end-->

		<div class="form-group" id="structure">

			<label for="exampleInputuname" class="col-sm-3 control-label">House Structure</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="house_structure" class="select2" style="width:150px;">

						<option value="Light Materials">Light Materials</option>

						<option value="Semi - Concrete">Semi - Concrete</option>

						<option value="Concrete">Concrete</option>

					</select>

				</div>

			</div>

		</div>

	</div>

</div>

<div class="col-md-12" id="reg_form_main_div2">

	<div class="white-box">

		<div class="form-group">

			<label for="exampleInputuname" class="col-sm-3 control-label">Civil Status</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group">

						<select name="civil_status" class="select2" style="width:150px;">

							<option value="Single">Single</option>

							<option value="Married">Married</option>

							<option value="Divorced">Divorced</option>

							<option value="Separated">Separated</option>

							<option value="Widowed">Widowed</option>

							<option value="Annulled">Annulled</option>

						</select>

					</div>

				</div>

			</div>

		</div>



		<div class="form-group">

			<label for="exampleInputuname" class="col-sm-3 control-label">Citizenship</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group">

						<select name="citizenship" class="select2" style="width:150px;">

							<option value="Filipino">Filipino</option>

							<option value="Dual Citizen">Dual Citizen</option>

							<option value="Foreign National">Foreign National</option>

						</select>

					</div>

				</div>

			</div>

		</div>



		<div class="form-group">

			<label for="exampleInputuname" class="col-sm-3 control-label">Religion</label>

			<div class="col-sm-9">

				<div class="input-group">



					<select name="religion" class="religion_sel" style="width:150px;">

						<option value="Roman Catholic">Roman Catholic</option>

						<option value="Iglesia ni Cristo">Iglesia ni Cristo</option>

						<option value="Aglipayan">Aglipayan</option>

						<option value="Seventh Day Adventist">Seventh Day Adventist</option>

						<option value="Mormons">Mormons</option>

						<option value="Muslim">Muslim</option>

						<option value="Jehovahs Witness">Jehovah's Witness</option>

						<option value="Others">Others Please Specify</option>

					</select>

					<br />

					<input type="text" class="form-control" id="other_rel" placeholder="" name="other_rel"
						style="display:none; border:0; border-bottom:2px solid black; width:200px;" autocomplete=off />



				</div>

			</div>

		</div>

		<div class="form-group">

			<label for="contact" id="contact_label" class="col-sm-3 control-label">Contact No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-phone"></i></div>

					<input type="text" class="form-control" id="contact" onkeyup="Readmykey(this.value,'contact')"
						placeholder="Contact Number" name="contact_number" autocomplete=off />
				</div>

			</div>

		</div>

		<div class="form-group" id="landline">

			<label for="exampleInputuname" class="col-sm-3 control-label">Landline No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-phone"></i></div>

					<input type="text" class="form-control" id="landline_field"
						onkeyup="Readmykey(this.value,'landline_field')" placeholder="Landline No"
						name="landline_number" autocomplete=off />
				</div>

			</div>

		</div>

		<div class="form-group">

			<label for="exampleInputuname" class="col-sm-3 control-label">Email</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-envelope"></i></div>

					<input type="text" class="form-control" id="email" placeholder="Email"
						onkeyup="Readmykey(this.value,'email')" name="email" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group">

			<label for="House_lot_number" class="col-sm-3 control-label">House / Lot Number</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-location-pin"></i></div>

					<input type="text" class="form-control" id="House_lot_number"
						onkeyup="Readmykey(this.value,'House_lot_number')" placeholder="House / Lot Number"
						name="house_number" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group">

			<label for="Unit" class="col-sm-3 control-label">Unit / Building Name</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-location-pin"></i></div>

					<input type="text" class="form-control" id="Unit" onkeyup="Readmykey(this.value,'Unit')"
						placeholder="Unit / Building Name" name="unit_name" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group">

			<label for="Street" class="col-sm-3 control-label">Street Name</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-location-pin"></i></div>

					<input type="text" class="form-control" id="Street" onkeyup="Readmykey(this.value,'Street')"
						placeholder="Street Name" name="street_name" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group">

			<label for="Purok" class="col-sm-3 control-label">Purok/Zone</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-location-pin"></i></div>

					<input type="text" class="form-control" id="Purok" onkeyup="Readmykey(this.value,'Purok')"
						placeholder="Purok" name="purok" autocomplete=off />
				</div>

			</div>

		</div>

		<div class="form-group">
			<label for="area_village" class="col-sm-3 control-label">Area / Village</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-location-pin"></i></div>
					<input type="text" class="form-control" id="area_village"
						onkeyup="Readmykey(this.value,'area_village')" placeholder="Area / Village" name="area_village"
						autocomplete=off />
				</div>
			</div>
		</div>

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

						<label for="exampleInputuname" class="col-sm-3 control-label">Purok/Zone</label>

						<div class="col-sm-9">

							<div class="input-group">

								<div class="input-group-addon"><i class="icon-location-pin"></i></div>

								<input type="text" class="form-control" id="exampleInputuname" placeholder="Purok" name="purok" autocomplete=off /> </div>

						</div>

					</div>

					<div class="form-group">

						<label for="c_address" id="cadd_label" class="col-sm-3 control-label">Current Address</label>

						<div class="col-sm-9">

							<div class="input-group">

								<div class="input-group-addon"><i class="icon-location-pin"></i></div>

								<textarea style="resize: none;" type="text" class="form-control" id="c_address" placeholder="Current Address" name="address" autocomplete=off required></textarea> </div>

						</div>

					</div>

					<div class="form-group" id="per_address">

						<label for="exampleInputuname" class="col-sm-3 control-label">Permanent Address</label>

						<div class="col-sm-9">

							<div class="input-group">

								<div class="input-group-addon"><i class="icon-location-pin"></i></div>

								<textarea style="resize: none;" type="text" class="form-control" id="exampleInputuname" placeholder="Permanent Address" name="paddress" autocomplete=off ></textarea> </div>

						</div>

					</div> -->



		<div class="form-group" id="yor">

			<label for="year_resident" id="yor_label" class="col-sm-3 control-label">Years of Residency</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

					<input type="number" class="form-control" id="year_resident"
						onkeyup="Readmykey(this.value,'year_resident')" placeholder="Years of Residency"
						name="years_residency" autocomplete=off />
				</div>

			</div>

		</div>

		<div class="form-group">
			<label for="exampleInputuname" class="col-sm-3 control-label">In Danger Zone</label>
			<div class="col-sm-9">
				<div class="input-group">
					<select name="danger_zone" class="danger" style="width:150px;">
						<option value="No">No</option>
						<option value="Yes">Yes</option>
					</select>
				</div>
			</div>
		</div>

		<div class="form-group" id="geo" style="display:none;">
			<label for="exampleInputuname" class="col-sm-3 control-label">Geographical Location</label>
			<div class="col-sm-9">
				<div class="input-group">
					<select name="geographical_loc" class="" id="gloc" style="width:150px;">
						<option value="Flooded Area">Flooded Area</option>
						<option value="Landslide Area">Landslide Area</option>
						<option value="Earthquake Area">Earthquake Area</option>
						<option value="Fire Prone">Fire Prone</option>
					</select>
				</div>
			</div>
		</div>


		<div class="form-group" id="home_ownersh">

			<label for="exampleInputuname" class="col-sm-3 control-label">Homeownership</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="typeres" class="select2" style="width:150px;">

						<option value="Home Owner">Homeowner</option>

						<option value="Rented">Rented</option>

						<option value="Living with Immediate Family">Living with Immediate Family</option>

						<option value="Living with Relatives">Living with Relatives</option>

						<option value="Work/Company Provided">Work/Company Provided</option>

					</select>

				</div>

			</div>

		</div>



		<div class="form-group" id="tin">

			<label for="exampleInputuname" class="col-sm-3 control-label">Tax Identification No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-email"></i></div>

					<input type="text" class="form-control" id="tax" onkeyup="Readmykey(this.value,'tax')"
						placeholder="Tax Identification No" name="tax_number" autocomplete=off />
				</div>

			</div>

		</div>



		<!-- <div class="form-group" id="qci">

						<label for="exampleInputuname" class="col-sm-3 control-label">Q.C. ID No</label>

						<div class="col-sm-9">

							<div class="input-group">

								<div class="input-group-addon"><i class="icon-email"></i></div>

								<input type="text" class="form-control" id="exampleInputuname" placeholder="Q.C. ID No" name="qci_number" autocomplete=off /> </div>

						</div>

					</div> -->



		<div class="form-group" id="phil">

			<label for="exampleInputuname" class="col-sm-3 control-label">Philhealth No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-email"></i></div>

					<input type="text" class="form-control" id="philhealth" onkeyup="Readmykey(this.value,'philhealth')"
						placeholder="Philhealth No" name="philhealth_number" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group" id="ibig">

			<label for="exampleInputuname" class="col-sm-3 control-label">Pag-ibig No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-email"></i></div>

					<input type="text" class="form-control" id="pagibig" onkeyup="Readmykey(this.value,'pagibig')"
						placeholder="Pag-ibig No" name="pagibig_number" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group" id="gsis">

			<label for="exampleInputuname" class="col-sm-3 control-label">GSIS ID No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-email"></i></div>

					<input type="text" class="form-control" id="gsis_field" onkeyup="Readmykey(this.value,'gsis_field')"
						placeholder="GSIS ID No" name="gsis_number" autocomplete=off />
				</div>

			</div>

		</div>



		<div class="form-group" id="sss">

			<label for="exampleInputuname" class="col-sm-3 control-label">SSS No</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-email"></i></div>

					<input type="text" class="form-control" id="sss_field" onkeyup="Readmykey(this.value,'sss_field')"
						placeholder="SSS No" name="sss_number" autocomplete=off />
				</div>

			</div>

		</div>

	</div>



	<div class="white-box" id="educ_info">

		<h3 style="color:#663399; font-weight:bold;">Education Info</h3>

		<hr />

		<div class="form-group" id="resident">

			<label for="exampleInputuname" class="col-sm-3 control-label">Educational Attainment</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="educational_attainment" class="educat" style="width:150px;">

						<option value="Elementary">Elementary</option>

						<option value="Highschool">Highschool</option>

						<option value="Technical/Vocational">Technical/Vocational</option>

						<option value="College Undergrad">College Undergrad</option>

						<option value="Associates Degree">Associates Degree</option>

						<option value="Bachelor Degree">Bachelor Degree</option>

						<option value="Master Degree">Master Degree</option>

						<option value="Professional Degree">Professional Degree</option>

						<option value="Doctorate Degree">Doctorate Degree</option>

						<option value="None">None</option>

					</select>

				</div>

			</div>

		</div>



		<div class="form-group" id="eattain">

			<label for="exampleInputuname" class="col-sm-3 control-label">Course</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

					<input type="text" class="form-control" id="course" onkeyup="Readmykey(this.value,'course')"
						placeholder="Course" name="course" autocomplete=off />
				</div>

			</div>

		</div>

		<div class="form-group" id="eattain2" style="display:none;">
			<label for="exampleInputuname" class="col-sm-3 control-label">Name of School</label>
			<div class="col-sm-9">
				<div class="input-group">
					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>
					<input type="text" class="form-control" id="schoolname" onkeyup="Readmykey(this.value,'schoolname')"
						placeholder="Name of School" name="school" autocomplete=off />
				</div>
			</div>
		</div>



		<div class="form-group" id="resident">

			<label for="exampleInputuname" class="col-sm-3 control-label">Skills</label>

			<div class="col-sm-9">

				<div class="input-group">

					<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

					<input type="text" class="form-control" id="skills" onkeyup="Readmykey(this.value,'skills')"
						placeholder="Skills" name="skills" autocomplete=off />
				</div>

			</div>

		</div>



	</div>



	<div class="white-box">

		<h3 style="color:#663399; font-weight:bold;">Work Info</h3>

		<hr />

		<div class="form-group" id="employ_status">

			<label for="exampleInputuname" class="col-sm-3 control-label">Employment Status</label>

			<div class="col-sm-9">

				<div class="input-group">

					<select name="employment_status" class="employ" id="employ" style="width:150px;">

						<option value="Employed Private">Employed Private</option>

						<option value="Employed Government">Employed Government</option>

						<option value="Self-Employed">Self-Employed</option>

						<option value="Unemployed">Unemployed</option>

						<option value="Student">Student</option>

						<option value="Out of School Youth">Out of School Youth</option>

						<option value="None">None</option>

					</select>

				</div>

			</div>

		</div>




		<div id="employment_status">

			<div class="form-group" id="emp_state">

				<label for="exampleInputuname" class="col-sm-3 control-label">Employment State</label>

				<div class="col-sm-9">

					<div class="input-group">

						<select name="employment_state" class="employ_state" id="employ_state" style="width:150px;">

							<option value="Casual">Casual</option>

							<option value="Regular">Regular</option>

							<option value="Daily">Daily</option>

							<option value="Contractual">Contractual</option>


						</select>

					</div>

				</div>

			</div>
			<div class="form-group" id="kasambahay">

				<label for="exampleInputuname" class="col-sm-3 control-label">Kasambahay</label>

				<div class="col-sm-9">

					<div class="input-group">



						<input type="radio" class="kas" name="kas" id="optionsRadios3" value="0" checked="" /> No

						&nbsp;

						<input type="radio" class="kas" name="kas" id="optionsRadios4" value="1" /> Yes

					</div>

				</div>

			</div>



			<div id="kas_status">


				<div class="form-group" id="occupation" class="occupation">

					<label for="exampleInputuname" class="col-sm-3 control-label">Occupation</label>

					<div class="col-sm-9">

						<div class="input-group">

							<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

							<input type="text" class="form-control" id="occupation_field"
								onkeyup="Readmykey(this.value,'occupation_field')" placeholder="Occupation"
								name="occupation" autocomplete=off />
						</div>

					</div>

				</div>



				<div class="form-group" id="kas_name">

					<label for="noc" id="noc_label" class="col-sm-3 control-label">Name of Company</label>

					<div class="col-sm-9">

						<div class="input-group">

							<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

							<input type="text" class="form-control" id="noc" onkeyup="Readmykey(this.value,'noc')"
								placeholder="Name of Company" name="company_name" autocomplete=off />
						</div>

					</div>

				</div>



				<div class="form-group" id="kas_name">

					<label for="company_post" id="post_label" class="col-sm-3 control-label">Position</label>

					<div class="col-sm-9">

						<div class="input-group">

							<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

							<input type="text" class="form-control" id="company_post"
								onkeyup="Readmykey(this.value,'company_post')" placeholder="Position"
								name="company_position" autocomplete=off />
						</div>

					</div>

				</div>



				<div class="form-group" id="kas_name">

					<label for="company_add" id="com_add_label" class="col-sm-3 control-label">Address of
						Company</label>

					<div class="col-sm-9">

						<div class="input-group">

							<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

							<input type="text" class="form-control" id="company_add"
								onkeyup="Readmykey(this.value,'company_add')" placeholder="Address of Company"
								name="company_address" autocomplete=off />
						</div>

					</div>

				</div>

			</div>



			<div id="kas_status7" style="display:none;">



				<div class="form-group" id="kas_name">

					<label for="exampleInputuname" class="col-sm-3 control-label">Name of Employer</label>

					<div class="col-sm-9">

						<div class="input-group">

							<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

							<input type="text" class="form-control" id="employername"
								onkeyup="Readmykey(this.value,'employername')" placeholder="Name of Employer"
								name="employer_name" autocomplete=off />
						</div>

					</div>

				</div>



				<div class="form-group" id="kas_name">

					<label for="exampleInputuname" class="col-sm-3 control-label">Address of Employer</label>

					<div class="col-sm-9">

						<div class="input-group">

							<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

							<input type="text" class="form-control" id="employeraddress"
								onkeyup="Readmykey(this.value,'employeraddress')" placeholder="Address of Employer"
								name="employer_address" autocomplete=off />
						</div>

					</div>

				</div>

			</div>





			<div class="form-group" id="sourceofincome">

				<label for="exampleInputuname" class="col-sm-3 control-label">Source of Income</label>

				<div class="col-sm-9">

					<div class="input-group">

						<select name="income_source" class="select2" style="width:150px;">

							<option value="Salary">Salary</option>

							<option value="Remittance">Remittance</option>

							<option value="Business">Business</option>

						</select>

					</div>

				</div>

			</div>



			<div class="form-group" id="monthlyincome">

				<label for="monthly" id="monthly_title" class="col-sm-3 control-label">Monthly Income</label>

				<div class="col-sm-9">

					<div class="input-group">

						<div class="input-group-addon"><i class="icon-arrow-right"></i></div>

						<input type="text" class="form-control" id="monthly" onkeyup="Readmykey(this.value,'monthly')"
							placeholder="Monthly Income" name="income_monthly" onKeyUp="checkNumber(this);"
							autocomplete=off />
					</div>

				</div>

			</div>




		</div>

	</div>

</div>


</div>