<div class=”banner-form”>
<div class=”form-header”>
<h3>REGISTER NOW</h3>
<p>All fields are mandatory</p>
</div>
<form autocomplete=”nope” id=”landing2-register” method=”post” action=”https://www.bibs.co.in/save-data?form_name=LANDING2-REGISTER&path=landing-page”>
<input type=”hidden” name=”_token” value=”PKT6Obr4oQ5s1ABWITvaVKEBmUFMZfgRWc3UJVWi”>
<div class=”form-group”>
<input type=”text” autocomplete=”nope” name=”name” required=”” class=”form-control ” placeholder=”Name *” value=””>
</div>
<select class=”form-control d-none” aria-label=”Default select example” id=”land” style=”display:none;”>
<option value=”” disabled=” disabled” selected=””>Do you have a Land?*</option>
</select>
<div class=”form-group”>
<input type=”email” autocomplete=”nope” name=”email” required=”” class=”form-control ” placeholder=”E-mail *” value=””>
</div>
<div class=”form-group”>
<input type=”tel” autocomplete=”nope” maxlength=”10″ pattern=”[6-9]{1}[0-9]{9}” oninvalid=”if (!window.__cfRLUnblockHandlers) return false; setCustomValidity(‘Please Enter A Valid Number’)” oninput=”if (!window.__cfRLUnblockHandlers) return false; setCustomValidity(”)” name=”phone” required=”” class=”form-control ” placeholder=”Phone *” value=””>
</div>
<div class=”form-group”>
<input type=”text” autocomplete=”nope” name=”year” class=”form-control ” placeholder=”Year of Graduation *” value=””>
</div>
<div class=”text text-danger recaptcha-error”></div>
<div class=”form-group”>
<button class=”btn btn-primary btn-block” type=”submit”>Submit</button>
</div>
</form>
</div>
