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School In Year Admissions

Form 5

Your list of schools

In order of preference - number 1 is your first preference and number 6 is your last preference.

1. Name of School Delce Junior School Reason Sibling Change
2. Name of School Parkwood Junior School Reason Distance Change
Date school place is needed
For example, 03 06 2015
Previous
<h1 class="heading-large">Your list of schools</h1>
<p>In order of preference - number <b>1</b> is your first preference and number <b>6</b> is your last preference.</p>

<div class="content-block">

    <table>
        <thead>
            <tr>
                <td colspan="5" class="numeric">
                    <form action="form_1" method="post">
                        <button class="text-button">Start again</button>
                    </form>
                </td>
            </tr>
        </thead>
        <tbody>
            <tr>
                <td><span class="strong">1. Name of School</span></td>
                <td>Delce Junior School</td>
                <td class="numeric"><span class="strong">Reason</span></td>
                <td class="numeric">Sibling</td>
                <td class="numeric"><a href="#">Change</a></td>
            </tr>
            <tr>
                <td><span class="strong">2. Name of School</span></td>
                <td>Parkwood Junior School</td>
                <td class="numeric"><span class="strong">Reason</span></td>
                <td class="numeric">Distance</td>
                <td class="numeric"><a href="#">Change</a></td>
            </tr>
        </tbody>
    </table>

    <form action="form_6" method="post">

        <div class="form-group">
            <fieldset>
                <legend>
                    <span class="form-label-bold">
                        Date school place is needed
                    </span>
                </legend>

                <div class="form-date form-group form-date-group" data-grouped-inputs>

                    <span class="field-validation-error" data-valmsg-for="Child.DateOfBirth.Day" data-valmsg-replace="true"></span>
                    <span class="field-validation-error" data-valmsg-for="Child.DateOfBirth.Month" data-valmsg-replace="true"></span>
                    <span class="field-validation-error" data-valmsg-for="Child.DateOfBirth.Year" data-valmsg-replace="true"></span>

                    <span class="form-hint">For example, 03 06 2015</span>
                    <div class="form-group-day" data-grouped-input>
                        <label for="Child.DateOfBirth.Day">Day</label>
                        <input maxlength="2" class="form-control" data-val="true" data-val-number="The field Day must be a number." data-val-range="Day must be between 1 and 31." data-val-range-max="31" data-val-range-min="1" data-val-required="Day field is required" id="Child_DateOfBirth_Day" name="Child.DateOfBirth.Day" type="text" pattern="[0-9]*" inputmode="numeric">
                    </div>

                    <div class="form-group-month" data-grouped-input>
                        <label for="Child.DateOfBirth.Month">Month</label>
                        <input maxlength="2" class="form-control" data-val="true" data-val-number="The field Month must be a number." data-val-range="Month must be between 1 and 12." data-val-range-max="12" data-val-range-min="1" data-val-required="Month field is required" id="Child_DateOfBirth_Month" name="Child.DateOfBirth.Month" type="text" pattern="[0-9]*" inputmode="numeric">
                    </div>

                    <div class="form-group-year" data-grouped-input>
                        <label for="Child.DateOfBirth.Year">Year</label>
                        <input maxlength="4" class="form-control" data-val="true" data-val-number="The field Year must be a number." data-val-range="Day must be between 1980 and 2014." data-val-range-max="2014" data-val-range-min="1980" data-val-required="Year field is required" id="Child_DateOfBirth_Year" name="Child.DateOfBirth.Year" type="text" pattern="[0-9]*" inputmode="numeric">
                    </div>

                </div>
            </fieldset>

        </div>

        <div class="form-step-buttons">
            <a href="form_4" class="button">Previous</a>
            <button type="submit" class="button">Continue</button>
        </div>

    </form>

</div>