Formulir Penelusuran Minat dan Bakat
Isilah formulir ini dengan benar</p>
<form method='post' enctype='multipart/form-data' id='gform_12' action='/wp-admin/admin-ajax.php#gf_12' >
<p>Step 1 of 3
33%
<h3>I. Identitas</h3><label class='gfield_label' for='input_12_3' >a. Nama Mahasiswa(Required)</label><input name='input_3' id='input_12_3' type='text' value='' class='large' aria-required="true" aria-invalid="false" /> <label class='gfield_label' for='input_12_5' >b. Program Studi(Required)</label><select name='input_5' id='input_12_5' class='large gfield_select' aria-required="true" aria-invalid="false" ><option value='Arsitektur' >Arsitektur</option></select><label class='gfield_label' for='input_12_18' >Tempat(Required)</label><input name='input_18' id='input_12_18' type='text' value='' class='large' aria-required="true" aria-invalid="false" /> <label class='gfield_label' for='input_12_19' >Tanggal Lahir(Required)</label>
<input name='input_19' id='input_12_19' type='text' value='' class='datepicker dmy datepicker_no_icon gdatepicker-no-icon' placeholder='dd/mm/yyyy' aria-describedby="input_12_19_date_format" aria-invalid="false" aria-required="true"/>
DD slash MM slash YYYY
<input type='hidden' id='gforms_calendar_icon_input_12_19' class='gform_hidden' value='https://teknik.undwi.ac.id/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg'/><fieldset id="field_12_7" data-js-reload="field_12_7"><legend class='gfield_label' >d. Agama(Required)</legend>
<input class='gfield-choice-input' name='input_7' type='radio' value='Hindu' id='choice_12_7_0' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_0' id='label_12_7_0'>Hindu</label>
<input class='gfield-choice-input' name='input_7' type='radio' value='Islam' id='choice_12_7_1' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_1' id='label_12_7_1'>Islam</label>
<input class='gfield-choice-input' name='input_7' type='radio' value='Kristen' id='choice_12_7_2' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_2' id='label_12_7_2'>Kristen</label>
<input class='gfield-choice-input' name='input_7' type='radio' value='Katolik' id='choice_12_7_3' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_3' id='label_12_7_3'>Katolik</label>
<input class='gfield-choice-input' name='input_7' type='radio' value='Budha' id='choice_12_7_4' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_4' id='label_12_7_4'>Budha</label>
<input class='gfield-choice-input' name='input_7' type='radio' value='Konghucu' id='choice_12_7_5' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_5' id='label_12_7_5'>Konghucu</label>
<input class='gfield-choice-input' name='input_7' type='radio' value='gf_other_choice' id='choice_12_7_6' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_7_6' id='label_12_7_6'>Other</label><br /><input id='input_12_7_other' name='input_7_other' type='text' value='Other' aria-label='Other Choice, please specify' disabled='disabled' />
</fieldset><fieldset id="field_12_8" data-js-reload="field_12_8"><legend class='gfield_label' >e. Jenis Kelamin(Required)</legend>
<input class='gfield-choice-input' name='input_8' type='radio' value='Laki-laki' id='choice_12_8_0' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_8_0' id='label_12_8_0'>Laki-laki</label>
<input class='gfield-choice-input' name='input_8' type='radio' value='Perempuan' id='choice_12_8_1' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_8_1' id='label_12_8_1'>Perempuan</label>
</fieldset><label class='gfield_label' for='input_12_9' >f. Alamat Asal(Required)</label><input name='input_9' id='input_12_9' type='text' value='' class='large' aria-required="true" aria-invalid="false" /> <label class='gfield_label' for='input_12_10' >g. Alamat Sekarang(Required)</label><input name='input_10' id='input_12_10' type='text' value='' class='large' aria-required="true" aria-invalid="false" /> <label class='gfield_label' for='input_12_12' >h. Email</label>
<input name='input_12' id='input_12_12' type='text' value='' class='large' aria-invalid="false" />
<label class='gfield_label' for='input_12_13' >i. No. HP/WhatsApp(Required)</label><input name='input_13' id='input_12_13' type='text' value='' class='large' aria-describedby="gfield_description_12_13" aria-required="true" aria-invalid="false" /> format: 081234567890
<input type='button' id='gform_next_button_12_15' class='gform_next_button button' value='Next' onclick='jQuery("#gform_target_page_number_12").val("2"); jQuery("#gform_12").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_12").val("2"); jQuery("#gform_12").trigger("submit",[true]); } ' />
<h3>II. Bidang Akademik</h3><fieldset id="field_12_21" data-js-reload="field_12_21"><legend class='gfield_label' >a. Prestasi Lomba Akademik yang pernah diperoleh</legend><input aria-invalid='false' aria-label='a. Prestasi Lomba Akademik yang pernah diperoleh, Row 1' data-aria-label-template='a. Prestasi Lomba Akademik yang pernah diperoleh, Row {0}' type='text' name='input_21[]' value='' /> <button type="button" class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 5)'>Add</button> <button type="button" class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 5)' style="visibility:hidden;">Remove</button></fieldset><fieldset id="field_12_22" data-js-reload="field_12_22"><legend class='gfield_label' >b. Minat dalam mengikuti lomba akademik(Required)</legend>
<input class='gfield-choice-input' name='input_22' type='radio' value='Debat' id='choice_12_22_0' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_22_0' id='label_12_22_0'>Debat</label>
<input class='gfield-choice-input' name='input_22' type='radio' value='Karya Tulis Ilmiah/Essay' id='choice_12_22_1' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_22_1' id='label_12_22_1'>Karya Tulis Ilmiah/Essay</label>
<input class='gfield-choice-input' name='input_22' type='radio' value='Cerdas Cermat' id='choice_12_22_2' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_22_2' id='label_12_22_2'>Cerdas Cermat</label>
<input class='gfield-choice-input' name='input_22' type='radio' value='gf_other_choice' id='choice_12_22_3' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_22_3' id='label_12_22_3'>Other</label><br /><input id='input_12_22_other' name='input_22_other' type='text' value='Other' aria-label='Other Choice, please specify' disabled='disabled' />
</fieldset>
<input type='button' id='gform_previous_button_12_24' class='gform_previous_button button' value='Previous' onclick='jQuery("#gform_target_page_number_12").val("1"); jQuery("#gform_12").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_12").val("1"); jQuery("#gform_12").trigger("submit",[true]); } ' /> <input type='button' id='gform_next_button_12_24' class='gform_next_button button' value='Next' onclick='jQuery("#gform_target_page_number_12").val("3"); jQuery("#gform_12").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_12").val("3"); jQuery("#gform_12").trigger("submit",[true]); } ' />
<h3>III. Bidang Non Akademik</h3><fieldset id="field_12_27" data-js-reload="field_12_27"><legend class='gfield_label' >1) Kegiatan olahraga yang diminati(Required)</legend>
<input class='gfield-choice-input' name='input_27' type='radio' value='Basket' id='choice_12_27_0' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_27_0' id='label_12_27_0'>Basket</label>
<input class='gfield-choice-input' name='input_27' type='radio' value='Futsal' id='choice_12_27_1' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_27_1' id='label_12_27_1'>Futsal</label>
<input class='gfield-choice-input' name='input_27' type='radio' value='Sepak Bola' id='choice_12_27_2' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_27_2' id='label_12_27_2'>Sepak Bola</label>
<input class='gfield-choice-input' name='input_27' type='radio' value='Voli' id='choice_12_27_3' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_27_3' id='label_12_27_3'>Voli</label>
<input class='gfield-choice-input' name='input_27' type='radio' value='Bulu Tangkis' id='choice_12_27_4' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_27_4' id='label_12_27_4'>Bulu Tangkis</label>
<input class='gfield-choice-input' name='input_27' type='radio' value='gf_other_choice' id='choice_12_27_5' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_27_5' id='label_12_27_5'>Other</label><br /><input id='input_12_27_other' name='input_27_other' type='text' value='Other' aria-label='Other Choice, please specify' disabled='disabled' />
</fieldset><fieldset id="field_12_28" data-js-reload="field_12_28"><legend class='gfield_label' >2) Prestasi yang diperoleh dalam bidang olahraga</legend><input aria-invalid='false' aria-label='2) Prestasi yang diperoleh dalam bidang olahraga, Row 1' data-aria-label-template='2) Prestasi yang diperoleh dalam bidang olahraga, Row {0}' type='text' name='input_28[]' value='' /> <button type="button" class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 5)'>Add</button> <button type="button" class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 5)' style="visibility:hidden;">Remove</button></fieldset><fieldset id="field_12_32" data-js-reload="field_12_32"><legend class='gfield_label' >1) Kegiatan seni budaya yang diminati(Required)</legend>
<input class='gfield-choice-input' name='input_32' type='radio' value='Teater' id='choice_12_32_0' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_0' id='label_12_32_0'>Teater</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='Tari' id='choice_12_32_1' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_1' id='label_12_32_1'>Tari</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='Musik Tradisional' id='choice_12_32_2' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_2' id='label_12_32_2'>Musik Tradisional</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='Musik Modern' id='choice_12_32_3' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_3' id='label_12_32_3'>Musik Modern</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='Menggambar' id='choice_12_32_4' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_4' id='label_12_32_4'>Menggambar</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='Mendesain' id='choice_12_32_5' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_5' id='label_12_32_5'>Mendesain</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='Paduan Suara' id='choice_12_32_6' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_6' id='label_12_32_6'>Paduan Suara</label>
<input class='gfield-choice-input' name='input_32' type='radio' value='gf_other_choice' id='choice_12_32_7' onchange='gformToggleRadioOther( this )' />
<label for='choice_12_32_7' id='label_12_32_7'>Other</label><br /><input id='input_12_32_other' name='input_32_other' type='text' value='Other' aria-label='Other Choice, please specify' disabled='disabled' />
</fieldset><fieldset id="field_12_33" data-js-reload="field_12_33"><legend class='gfield_label' >2) Prestasi yang diperoleh dalam bidang seni & budaya</legend><input aria-invalid='false' aria-label='2) Prestasi yang diperoleh dalam bidang seni & budaya, Row 1' data-aria-label-template='2) Prestasi yang diperoleh dalam bidang seni & budaya, Row {0}' type='text' name='input_33[]' value='' /> <button type="button" class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 5)'>Add</button> <button type="button" class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 5)' style="visibility:hidden;">Remove</button></fieldset><fieldset id="field_12_36" data-js-reload="field_12_36"><legend class='gfield_label gfield_label_before_complex' >Pernyataan(Required)</legend>
<input class='gfield-choice-input' name='input_36.1' type='checkbox' value='Dengan ini saya menyatakan bahwa data yang sampaikan adalah benar' id='choice_12_36_1' />
<label for='choice_12_36_1' id='label_12_36_1'>Dengan ini saya menyatakan bahwa data yang sampaikan adalah benar</label>
</fieldset><label class='gfield_label' for='input_12_35' >Tanda tangan</label><input type='hidden' class='gform_hidden' name='input_12_35_valid' id='input_12_35_valid' /><canvas id='input_12_35' width='300' height='180'></canvas>
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<input type='hidden' class='gform_hidden' name='is_submit_12' value='1' />
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<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
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