<!doctype html>
<html  {$html_attrs}>
	<head>
				<meta http-equiv="X-UA-Compatible" content="IE=Edge">
	<meta name="viewport" content="width=device-width, initial-scale=1.0">
	<title>{$pagetitle}</title>
	<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
	<base href="{$projectPath}">
		<link REL="stylesheet" href="styles/default.css?{$wizardBuildKey}" type="text/css">
	{BEGIN rtlCSS}
	<link REL="stylesheet" href="styles/defaultRTL.css?{$wizardBuildKey}" type="text/css">
	{END rtlCSS}
	{BEGIN styleCSSFiles}
	<link REL="stylesheet" href="{$stylepath}" type="text/css">
	{END styleCSSFiles}
	</head>

	<body class="{$stylename} function-add" {$bodyattrs}>
	{BEGIN body}
		{$header}
		<style>
			{$containerCss}
		</style>
		{$locking}
		<div class="r-small-page" 
			data-body-align="center"
			data-body-width="standard"
		>
							{BEGIN top_block}
<div class="r-form" data-location="top" id="form_top_{$pageid}" data-makeup="small" {$form_top} data-pageid="{$pageid}"
		data-v-width="2"
	data-v-margin="0"
	
>		
	 
		<div class="row">
			 
				<div 
	data-cellId="top_c1" data-pageid="{$pageid}"	{$cell_top_c1}
	class=" r-ori-vert			col-md-12
	">
	 
		<h2 data-itemtype="add_header" data-itemid="add_header" {$item_add_header} data-pageid="{$pageid}" >{$pagetitlelabel OnlineApplicationFormSBS add}</h2>
	</div>					</div>
	</div>		
{END top_block}
									{BEGIN above-grid_block}
<div class="r-form" data-location="above-grid" id="form_above-grid_{$pageid}" data-makeup="small" {$form_above-grid} data-pageid="{$pageid}"
		data-v-width="2"
	data-v-margin="0"
	
>		
	 
		<div class="row">
			 
				<div 
	data-cellId="above-grid_c1" data-pageid="{$pageid}"	{$cell_above-grid_c1}
	class=" r-ori-vert			col-md-12
	">
	 
		{BEGIN message_block}
<div data-itemtype="add_message" data-itemid="add_message" {$item_add_message} data-pageid="{$pageid}" class="alert {$message_class}" role="alert">
<h5>{$message}</h5>
<div>
{BEGIN back_button}
		<button class="btn btn-sm btn-default" {$backbutton_attrs}>Back to menu</button>
	{END back_button}
{BEGIN view_page_button}
	<button class="btn btn-sm btn-default" {$view_page_button_attrs}>View</button>
{END view_page_button}
{BEGIN edit_page_button}
	<button class="btn btn-sm btn-default" {$edit_page_button_attrs}>Edit</button>
{END edit_page_button}
</div>
</div>
{END message_block}	</div>					</div>
	</div>		
{END above-grid_block}
									{BEGIN grid_block}




 
	 
												<div class="panel with-tabs panel-default form-tabs" data-itemtype="tabs" data-itemid="tabs" {$item_tabs} data-pageid="{$pageid}">
	<div class="panel-heading">
		<ul class="nav nav-tabs" role="tablist">
									<li role="presentation" class="active">
				<a aria-controls="settings" role="tab" data-toggle="tab" href="#tab_section{$pageid}">
					Step1 - Basic Application Details				</a>
			</li>
										<li role="presentation" class="">
				<a aria-controls="settings" role="tab" data-toggle="tab" href="#tab_section1{$pageid}">
					Step3 - Education Details				</a>
			</li>
										<li role="presentation" class="">
				<a aria-controls="settings" role="tab" data-toggle="tab" href="#tab_section2{$pageid}">
					Step2				</a>
			</li>
										<li role="presentation" class="">
				<a aria-controls="settings" role="tab" data-toggle="tab" href="#tab_section3{$pageid}">
					Fathers Details				</a>
			</li>
										<li role="presentation" class="">
				<a aria-controls="settings" role="tab" data-toggle="tab" href="#tab_section4{$pageid}">
					Mothers Details				</a>
			</li>
										<li role="presentation" class="">
				<a aria-controls="settings" role="tab" data-toggle="tab" href="#tab_section5{$pageid}">
					Step5 - Documents				</a>
			</li>
									</ul>
	</div>
	<div class="panel-body">
		<div class="tab-content">
							<div role="tabpanel" class="tab-pane active" id="tab_section{$pageid}"> 
			{BEGIN section_block}




 
	 
												<table 
	data-body-align="center"
	data-location="section" id="form_section_{$pageid}" data-makeup="small" {$form_section} data-pageid="{$pageid}" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr>
										

{BEGIN cellblock_section_c3}
<td
	{$cell_section_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="section_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN Surname_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_Surname}  r-vertical-field" 
	data-fieldname="Surname" 
	data-signal-error-for="Surname{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field" {$item_integrated_edit_field} data-pageid="{$pageid}" data-field="Surname" >


	<label class="r-edit-label control-label" for="{$labelfor_Surname}">
		{BEGIN Surname_label}{$label OnlineApplicationFormSBS Surname }{END Surname_label}
	</label>
	<div class="r-edit-field">
		{$Surname_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="Surname">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END Surname_fieldblock}
											
{BEGIN FirstName_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FirstName}  r-vertical-field" 
	data-fieldname="FirstName" 
	data-signal-error-for="FirstName{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field1" {$item_integrated_edit_field1} data-pageid="{$pageid}" data-field="FirstName" >


	<label class="r-edit-label control-label" for="{$labelfor_FirstName}">
		{BEGIN FirstName_label}{$label OnlineApplicationFormSBS FirstName }{END FirstName_label}
	</label>
	<div class="r-edit-field">
		{$FirstName_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FirstName">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FirstName_fieldblock}
											
{BEGIN Photo_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_Photo}  r-vertical-field" 
	data-fieldname="Photo" 
	data-signal-error-for="Photo{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field2" {$item_integrated_edit_field2} data-pageid="{$pageid}" data-field="Photo" >


	<label class="r-edit-label control-label" for="{$labelfor_Photo}">
		{BEGIN Photo_label}{$label OnlineApplicationFormSBS Photo }{END Photo_label}
	</label>
	<div class="r-edit-field">
		{$Photo_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="Photo">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END Photo_fieldblock}
											
{BEGIN Gender_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_Gender}  r-vertical-field" 
	data-fieldname="Gender" 
	data-signal-error-for="Gender{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field3" {$item_integrated_edit_field3} data-pageid="{$pageid}" data-field="Gender" >


	<label class="r-edit-label control-label" for="{$labelfor_Gender}">
		{BEGIN Gender_label}{$label OnlineApplicationFormSBS Gender }{END Gender_label}
	</label>
	<div class="r-edit-field">
		{$Gender_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="Gender">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END Gender_fieldblock}
											
{BEGIN DateofBirth_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_DateofBirth}  r-vertical-field" 
	data-fieldname="DateofBirth" 
	data-signal-error-for="DateofBirth{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field4" {$item_integrated_edit_field4} data-pageid="{$pageid}" data-field="DateofBirth" >


	<label class="r-edit-label control-label" for="{$labelfor_DateofBirth}">
		{BEGIN DateofBirth_label}{$label OnlineApplicationFormSBS DateofBirth }{END DateofBirth_label}
	</label>
	<div class="r-edit-field">
		{$DateofBirth_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="DateofBirth">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END DateofBirth_fieldblock}
											
{BEGIN PlaceofBirth_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_PlaceofBirth}  r-vertical-field" 
	data-fieldname="PlaceofBirth" 
	data-signal-error-for="PlaceofBirth{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field5" {$item_integrated_edit_field5} data-pageid="{$pageid}" data-field="PlaceofBirth" >


	<label class="r-edit-label control-label" for="{$labelfor_PlaceofBirth}">
		{BEGIN PlaceofBirth_label}{$label OnlineApplicationFormSBS PlaceofBirth }{END PlaceofBirth_label}
	</label>
	<div class="r-edit-field">
		{$PlaceofBirth_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="PlaceofBirth">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END PlaceofBirth_fieldblock}
											
{BEGIN TertiaryInstitutionAdmitted_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_TertiaryInstitutionAdmitted}  r-vertical-field" 
	data-fieldname="TertiaryInstitutionAdmitted" 
	data-signal-error-for="TertiaryInstitutionAdmitted{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field6" {$item_integrated_edit_field6} data-pageid="{$pageid}" data-field="TertiaryInstitutionAdmitted" >


	<label class="r-edit-label control-label" for="{$labelfor_TertiaryInstitutionAdmitted}">
		{BEGIN TertiaryInstitutionAdmitted_label}{$label OnlineApplicationFormSBS TertiaryInstitutionAdmitted }{END TertiaryInstitutionAdmitted_label}
	</label>
	<div class="r-edit-field">
		{$TertiaryInstitutionAdmitted_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="TertiaryInstitutionAdmitted">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END TertiaryInstitutionAdmitted_fieldblock}
											
{BEGIN ProgramName_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_ProgramName}  r-vertical-field" 
	data-fieldname="ProgramName" 
	data-signal-error-for="ProgramName{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field7" {$item_integrated_edit_field7} data-pageid="{$pageid}" data-field="ProgramName" >


	<label class="r-edit-label control-label" for="{$labelfor_ProgramName}">
		{BEGIN ProgramName_label}{$label OnlineApplicationFormSBS ProgramName }{END ProgramName_label}
	</label>
	<div class="r-edit-field">
		{$ProgramName_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="ProgramName">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END ProgramName_fieldblock}
											
{BEGIN ProgramCode_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_ProgramCode}  r-vertical-field" 
	data-fieldname="ProgramCode" 
	data-signal-error-for="ProgramCode{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field8" {$item_integrated_edit_field8} data-pageid="{$pageid}" data-field="ProgramCode" >


	<label class="r-edit-label control-label" for="{$labelfor_ProgramCode}">
		{BEGIN ProgramCode_label}{$label OnlineApplicationFormSBS ProgramCode }{END ProgramCode_label}
	</label>
	<div class="r-edit-field">
		{$ProgramCode_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="ProgramCode">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END ProgramCode_fieldblock}
											
{BEGIN EmailAddrssAppl_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_EmailAddrssAppl}  r-vertical-field" 
	data-fieldname="EmailAddrssAppl" 
	data-signal-error-for="EmailAddrssAppl{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field9" {$item_integrated_edit_field9} data-pageid="{$pageid}" data-field="EmailAddrssAppl" >


	<label class="r-edit-label control-label" for="{$labelfor_EmailAddrssAppl}">
		{BEGIN EmailAddrssAppl_label}{$label OnlineApplicationFormSBS EmailAddrssAppl }{END EmailAddrssAppl_label}
	</label>
	<div class="r-edit-field">
		{$EmailAddrssAppl_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="EmailAddrssAppl">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END EmailAddrssAppl_fieldblock}
											
{BEGIN MobileNoAppl_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MobileNoAppl}  r-vertical-field" 
	data-fieldname="MobileNoAppl" 
	data-signal-error-for="MobileNoAppl{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field10" {$item_integrated_edit_field10} data-pageid="{$pageid}" data-field="MobileNoAppl" >


	<label class="r-edit-label control-label" for="{$labelfor_MobileNoAppl}">
		{BEGIN MobileNoAppl_label}{$label OnlineApplicationFormSBS MobileNoAppl }{END MobileNoAppl_label}
	</label>
	<div class="r-edit-field">
		{$MobileNoAppl_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MobileNoAppl">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MobileNoAppl_fieldblock}
	
								</td>
			{END cellblock_section_c3}
								</tr>
			</tbody></table>
{END section_block}
						</div>
					<div role="tabpanel" class="tab-pane " id="tab_section1{$pageid}"> 
			{BEGIN section1_block}




 
	 
												<table 
	data-body-align="center"
	data-location="section1" id="form_section1_{$pageid}" data-makeup="small" {$form_section1} data-pageid="{$pageid}" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr>
										

{BEGIN cellblock_section1_c3}
<td
	{$cell_section1_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="section1_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN LastInstitutuonAttended_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_LastInstitutuonAttended}  r-vertical-field" 
	data-fieldname="LastInstitutuonAttended" 
	data-signal-error-for="LastInstitutuonAttended{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field11" {$item_integrated_edit_field11} data-pageid="{$pageid}" data-field="LastInstitutuonAttended" >


	<label class="r-edit-label control-label" for="{$labelfor_LastInstitutuonAttended}">
		{BEGIN LastInstitutuonAttended_label}{$label OnlineApplicationFormSBS LastInstitutuonAttended }{END LastInstitutuonAttended_label}
	</label>
	<div class="r-edit-field">
		{$LastInstitutuonAttended_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="LastInstitutuonAttended">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END LastInstitutuonAttended_fieldblock}
											
{BEGIN HighestGradeCompleted_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_HighestGradeCompleted}  r-vertical-field" 
	data-fieldname="HighestGradeCompleted" 
	data-signal-error-for="HighestGradeCompleted{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field12" {$item_integrated_edit_field12} data-pageid="{$pageid}" data-field="HighestGradeCompleted" >


	<label class="r-edit-label control-label" for="{$labelfor_HighestGradeCompleted}">
		{BEGIN HighestGradeCompleted_label}{$label OnlineApplicationFormSBS HighestGradeCompleted }{END HighestGradeCompleted_label}
	</label>
	<div class="r-edit-field">
		{$HighestGradeCompleted_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="HighestGradeCompleted">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END HighestGradeCompleted_fieldblock}
											
{BEGIN YearHighestGradeCompleted_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_YearHighestGradeCompleted}  r-vertical-field" 
	data-fieldname="YearHighestGradeCompleted" 
	data-signal-error-for="YearHighestGradeCompleted{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field13" {$item_integrated_edit_field13} data-pageid="{$pageid}" data-field="YearHighestGradeCompleted" >


	<label class="r-edit-label control-label" for="{$labelfor_YearHighestGradeCompleted}">
		{BEGIN YearHighestGradeCompleted_label}{$label OnlineApplicationFormSBS YearHighestGradeCompleted }{END YearHighestGradeCompleted_label}
	</label>
	<div class="r-edit-field">
		{$YearHighestGradeCompleted_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="YearHighestGradeCompleted">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END YearHighestGradeCompleted_fieldblock}
											
{BEGIN DistrictOfBirth_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_DistrictOfBirth}  r-vertical-field" 
	data-fieldname="DistrictOfBirth" 
	data-signal-error-for="DistrictOfBirth{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field14" {$item_integrated_edit_field14} data-pageid="{$pageid}" data-field="DistrictOfBirth" >


	<label class="r-edit-label control-label" for="{$labelfor_DistrictOfBirth}">
		{BEGIN DistrictOfBirth_label}{$label OnlineApplicationFormSBS DistrictOfBirth }{END DistrictOfBirth_label}
	</label>
	<div class="r-edit-field">
		{$DistrictOfBirth_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="DistrictOfBirth">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END DistrictOfBirth_fieldblock}
											
{BEGIN ProvinceOfBirth_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_ProvinceOfBirth}  r-vertical-field" 
	data-fieldname="ProvinceOfBirth" 
	data-signal-error-for="ProvinceOfBirth{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field15" {$item_integrated_edit_field15} data-pageid="{$pageid}" data-field="ProvinceOfBirth" >


	<label class="r-edit-label control-label" for="{$labelfor_ProvinceOfBirth}">
		{BEGIN ProvinceOfBirth_label}{$label OnlineApplicationFormSBS ProvinceOfBirth }{END ProvinceOfBirth_label}
	</label>
	<div class="r-edit-field">
		{$ProvinceOfBirth_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="ProvinceOfBirth">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END ProvinceOfBirth_fieldblock}
											
{BEGIN firstyear_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_firstyear}  r-vertical-field" 
	data-fieldname="firstyear" 
	data-signal-error-for="firstyear{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field16" {$item_integrated_edit_field16} data-pageid="{$pageid}" data-field="firstyear" >


	<label class="r-edit-label control-label" for="{$labelfor_firstyear}">
		{BEGIN firstyear_label}{$label OnlineApplicationFormSBS firstyear }{END firstyear_label}
	</label>
	<div class="r-edit-field">
		{$firstyear_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="firstyear">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END firstyear_fieldblock}
											
{BEGIN NewApplicant_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_NewApplicant}  r-vertical-field" 
	data-fieldname="NewApplicant" 
	data-signal-error-for="NewApplicant{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field17" {$item_integrated_edit_field17} data-pageid="{$pageid}" data-field="NewApplicant" >


	<label class="r-edit-label control-label" for="{$labelfor_NewApplicant}">
		{BEGIN NewApplicant_label}{$label OnlineApplicationFormSBS NewApplicant }{END NewApplicant_label}
	</label>
	<div class="r-edit-field">
		{$NewApplicant_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="NewApplicant">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END NewApplicant_fieldblock}
											
{BEGIN Reapply_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_Reapply}  r-vertical-field" 
	data-fieldname="Reapply" 
	data-signal-error-for="Reapply{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field18" {$item_integrated_edit_field18} data-pageid="{$pageid}" data-field="Reapply" >


	<label class="r-edit-label control-label" for="{$labelfor_Reapply}">
		{BEGIN Reapply_label}{$label OnlineApplicationFormSBS Reapply }{END Reapply_label}
	</label>
	<div class="r-edit-field">
		{$Reapply_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="Reapply">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END Reapply_fieldblock}
	
								</td>
			{END cellblock_section1_c3}
								</tr>
			</tbody></table>
{END section1_block}
						</div>
					<div role="tabpanel" class="tab-pane " id="tab_section2{$pageid}"> 
			{BEGIN section2_block}




 
	 
												<table 
	data-body-align="center"
	data-location="section2" id="form_section2_{$pageid}" data-makeup="small" {$form_section2} data-pageid="{$pageid}" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr>
										

{BEGIN cellblock_section2_c3}
<td
	{$cell_section2_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="section2_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN WitnessAddress_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_WitnessAddress}  r-vertical-field" 
	data-fieldname="WitnessAddress" 
	data-signal-error-for="WitnessAddress{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field19" {$item_integrated_edit_field19} data-pageid="{$pageid}" data-field="WitnessAddress" >


	<label class="r-edit-label control-label" for="{$labelfor_WitnessAddress}">
		{BEGIN WitnessAddress_label}{$label OnlineApplicationFormSBS WitnessAddress }{END WitnessAddress_label}
	</label>
	<div class="r-edit-field">
		{$WitnessAddress_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="WitnessAddress">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END WitnessAddress_fieldblock}
											
{BEGIN WitnessName_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_WitnessName}  r-vertical-field" 
	data-fieldname="WitnessName" 
	data-signal-error-for="WitnessName{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field20" {$item_integrated_edit_field20} data-pageid="{$pageid}" data-field="WitnessName" >


	<label class="r-edit-label control-label" for="{$labelfor_WitnessName}">
		{BEGIN WitnessName_label}{$label OnlineApplicationFormSBS WitnessName }{END WitnessName_label}
	</label>
	<div class="r-edit-field">
		{$WitnessName_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="WitnessName">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END WitnessName_fieldblock}
											
{BEGIN WitnessOccupation_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_WitnessOccupation}  r-vertical-field" 
	data-fieldname="WitnessOccupation" 
	data-signal-error-for="WitnessOccupation{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field21" {$item_integrated_edit_field21} data-pageid="{$pageid}" data-field="WitnessOccupation" >


	<label class="r-edit-label control-label" for="{$labelfor_WitnessOccupation}">
		{BEGIN WitnessOccupation_label}{$label OnlineApplicationFormSBS WitnessOccupation }{END WitnessOccupation_label}
	</label>
	<div class="r-edit-field">
		{$WitnessOccupation_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="WitnessOccupation">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END WitnessOccupation_fieldblock}
	
								</td>
			{END cellblock_section2_c3}
								</tr>
			</tbody></table>
{END section2_block}
						</div>
					<div role="tabpanel" class="tab-pane " id="tab_section3{$pageid}"> 
			{BEGIN section3_block}




 
	 
												<table 
	data-body-align="center"
	data-location="section3" id="form_section3_{$pageid}" data-makeup="small" {$form_section3} data-pageid="{$pageid}" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr>
										

{BEGIN cellblock_section3_c3}
<td
	{$cell_section3_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="section3_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN FATHERSNAME_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERSNAME}  r-vertical-field" 
	data-fieldname="FATHERSNAME" 
	data-signal-error-for="FATHERSNAME{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field22" {$item_integrated_edit_field22} data-pageid="{$pageid}" data-field="FATHERSNAME" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERSNAME}">
		{BEGIN FATHERSNAME_label}{$label OnlineApplicationFormSBS FATHERSNAME }{END FATHERSNAME_label}
	</label>
	<div class="r-edit-field">
		{$FATHERSNAME_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERSNAME">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERSNAME_fieldblock}
											
{BEGIN FATHERSURNAME_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERSURNAME}  r-vertical-field" 
	data-fieldname="FATHERSURNAME" 
	data-signal-error-for="FATHERSURNAME{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field23" {$item_integrated_edit_field23} data-pageid="{$pageid}" data-field="FATHERSURNAME" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERSURNAME}">
		{BEGIN FATHERSURNAME_label}{$label OnlineApplicationFormSBS FATHERSURNAME }{END FATHERSURNAME_label}
	</label>
	<div class="r-edit-field">
		{$FATHERSURNAME_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERSURNAME">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERSURNAME_fieldblock}
											
{BEGIN FatherVillage_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FatherVillage}  r-vertical-field" 
	data-fieldname="FatherVillage" 
	data-signal-error-for="FatherVillage{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field24" {$item_integrated_edit_field24} data-pageid="{$pageid}" data-field="FatherVillage" >


	<label class="r-edit-label control-label" for="{$labelfor_FatherVillage}">
		{BEGIN FatherVillage_label}{$label OnlineApplicationFormSBS FatherVillage }{END FatherVillage_label}
	</label>
	<div class="r-edit-field">
		{$FatherVillage_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FatherVillage">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FatherVillage_fieldblock}
											
{BEGIN FatherLLG_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FatherLLG}  r-vertical-field" 
	data-fieldname="FatherLLG" 
	data-signal-error-for="FatherLLG{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field25" {$item_integrated_edit_field25} data-pageid="{$pageid}" data-field="FatherLLG" >


	<label class="r-edit-label control-label" for="{$labelfor_FatherLLG}">
		{BEGIN FatherLLG_label}{$label OnlineApplicationFormSBS FatherLLG }{END FatherLLG_label}
	</label>
	<div class="r-edit-field">
		{$FatherLLG_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FatherLLG">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FatherLLG_fieldblock}
											
{BEGIN FatherDistrict_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FatherDistrict}  r-vertical-field" 
	data-fieldname="FatherDistrict" 
	data-signal-error-for="FatherDistrict{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field26" {$item_integrated_edit_field26} data-pageid="{$pageid}" data-field="FatherDistrict" >


	<label class="r-edit-label control-label" for="{$labelfor_FatherDistrict}">
		{BEGIN FatherDistrict_label}{$label OnlineApplicationFormSBS FatherDistrict }{END FatherDistrict_label}
	</label>
	<div class="r-edit-field">
		{$FatherDistrict_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FatherDistrict">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FatherDistrict_fieldblock}
											
{BEGIN FATHERJOB_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERJOB}  r-vertical-field" 
	data-fieldname="FATHERJOB" 
	data-signal-error-for="FATHERJOB{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field27" {$item_integrated_edit_field27} data-pageid="{$pageid}" data-field="FATHERJOB" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERJOB}">
		{BEGIN FATHERJOB_label}{$label OnlineApplicationFormSBS FATHERJOB }{END FATHERJOB_label}
	</label>
	<div class="r-edit-field">
		{$FATHERJOB_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERJOB">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERJOB_fieldblock}
											
{BEGIN FATHERPROV_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERPROV}  r-vertical-field" 
	data-fieldname="FATHERPROV" 
	data-signal-error-for="FATHERPROV{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field28" {$item_integrated_edit_field28} data-pageid="{$pageid}" data-field="FATHERPROV" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERPROV}">
		{BEGIN FATHERPROV_label}{$label OnlineApplicationFormSBS FATHERPROV }{END FATHERPROV_label}
	</label>
	<div class="r-edit-field">
		{$FATHERPROV_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERPROV">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERPROV_fieldblock}
											
{BEGIN FATHERNATIONAL_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERNATIONAL}  r-vertical-field" 
	data-fieldname="FATHERNATIONAL" 
	data-signal-error-for="FATHERNATIONAL{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field29" {$item_integrated_edit_field29} data-pageid="{$pageid}" data-field="FATHERNATIONAL" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERNATIONAL}">
		{BEGIN FATHERNATIONAL_label}{$label OnlineApplicationFormSBS FATHERNATIONAL }{END FATHERNATIONAL_label}
	</label>
	<div class="r-edit-field">
		{$FATHERNATIONAL_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERNATIONAL">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERNATIONAL_fieldblock}
											
{BEGIN FATHERCLAN_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERCLAN}  r-vertical-field" 
	data-fieldname="FATHERCLAN" 
	data-signal-error-for="FATHERCLAN{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field30" {$item_integrated_edit_field30} data-pageid="{$pageid}" data-field="FATHERCLAN" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERCLAN}">
		{BEGIN FATHERCLAN_label}{$label OnlineApplicationFormSBS FATHERCLAN }{END FATHERCLAN_label}
	</label>
	<div class="r-edit-field">
		{$FATHERCLAN_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERCLAN">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERCLAN_fieldblock}
											
{BEGIN FATHERRELIGION_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERRELIGION}  r-vertical-field" 
	data-fieldname="FATHERRELIGION" 
	data-signal-error-for="FATHERRELIGION{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field31" {$item_integrated_edit_field31} data-pageid="{$pageid}" data-field="FATHERRELIGION" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERRELIGION}">
		{BEGIN FATHERRELIGION_label}{$label OnlineApplicationFormSBS FATHERRELIGION }{END FATHERRELIGION_label}
	</label>
	<div class="r-edit-field">
		{$FATHERRELIGION_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERRELIGION">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERRELIGION_fieldblock}
											
{BEGIN FATHERBIRTHPLACE_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_FATHERBIRTHPLACE}  r-vertical-field" 
	data-fieldname="FATHERBIRTHPLACE" 
	data-signal-error-for="FATHERBIRTHPLACE{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field32" {$item_integrated_edit_field32} data-pageid="{$pageid}" data-field="FATHERBIRTHPLACE" >


	<label class="r-edit-label control-label" for="{$labelfor_FATHERBIRTHPLACE}">
		{BEGIN FATHERBIRTHPLACE_label}{$label OnlineApplicationFormSBS FATHERBIRTHPLACE }{END FATHERBIRTHPLACE_label}
	</label>
	<div class="r-edit-field">
		{$FATHERBIRTHPLACE_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="FATHERBIRTHPLACE">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END FATHERBIRTHPLACE_fieldblock}
	
								</td>
			{END cellblock_section3_c3}
								</tr>
			</tbody></table>
{END section3_block}
						</div>
					<div role="tabpanel" class="tab-pane " id="tab_section4{$pageid}"> 
			{BEGIN section4_block}




 
	 
												<table 
	data-body-align="center"
	data-location="section4" id="form_section4_{$pageid}" data-makeup="small" {$form_section4} data-pageid="{$pageid}" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr>
										

{BEGIN cellblock_section4_c3}
<td
	{$cell_section4_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="section4_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN MOTHERNAME_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERNAME}  r-vertical-field" 
	data-fieldname="MOTHERNAME" 
	data-signal-error-for="MOTHERNAME{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field33" {$item_integrated_edit_field33} data-pageid="{$pageid}" data-field="MOTHERNAME" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERNAME}">
		{BEGIN MOTHERNAME_label}{$label OnlineApplicationFormSBS MOTHERNAME }{END MOTHERNAME_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERNAME_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERNAME">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERNAME_fieldblock}
											
{BEGIN MOTHERSURNAME_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERSURNAME}  r-vertical-field" 
	data-fieldname="MOTHERSURNAME" 
	data-signal-error-for="MOTHERSURNAME{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field34" {$item_integrated_edit_field34} data-pageid="{$pageid}" data-field="MOTHERSURNAME" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERSURNAME}">
		{BEGIN MOTHERSURNAME_label}{$label OnlineApplicationFormSBS MOTHERSURNAME }{END MOTHERSURNAME_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERSURNAME_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERSURNAME">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERSURNAME_fieldblock}
											
{BEGIN MOTHERCLAN_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERCLAN}  r-vertical-field" 
	data-fieldname="MOTHERCLAN" 
	data-signal-error-for="MOTHERCLAN{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field35" {$item_integrated_edit_field35} data-pageid="{$pageid}" data-field="MOTHERCLAN" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERCLAN}">
		{BEGIN MOTHERCLAN_label}{$label OnlineApplicationFormSBS MOTHERCLAN }{END MOTHERCLAN_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERCLAN_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERCLAN">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERCLAN_fieldblock}
											
{BEGIN MotherVillage_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MotherVillage}  r-vertical-field" 
	data-fieldname="MotherVillage" 
	data-signal-error-for="MotherVillage{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field36" {$item_integrated_edit_field36} data-pageid="{$pageid}" data-field="MotherVillage" >


	<label class="r-edit-label control-label" for="{$labelfor_MotherVillage}">
		{BEGIN MotherVillage_label}{$label OnlineApplicationFormSBS MotherVillage }{END MotherVillage_label}
	</label>
	<div class="r-edit-field">
		{$MotherVillage_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MotherVillage">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MotherVillage_fieldblock}
											
{BEGIN MotherLLG_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MotherLLG}  r-vertical-field" 
	data-fieldname="MotherLLG" 
	data-signal-error-for="MotherLLG{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field37" {$item_integrated_edit_field37} data-pageid="{$pageid}" data-field="MotherLLG" >


	<label class="r-edit-label control-label" for="{$labelfor_MotherLLG}">
		{BEGIN MotherLLG_label}{$label OnlineApplicationFormSBS MotherLLG }{END MotherLLG_label}
	</label>
	<div class="r-edit-field">
		{$MotherLLG_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MotherLLG">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MotherLLG_fieldblock}
											
{BEGIN MotherDistrict_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MotherDistrict}  r-vertical-field" 
	data-fieldname="MotherDistrict" 
	data-signal-error-for="MotherDistrict{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field38" {$item_integrated_edit_field38} data-pageid="{$pageid}" data-field="MotherDistrict" >


	<label class="r-edit-label control-label" for="{$labelfor_MotherDistrict}">
		{BEGIN MotherDistrict_label}{$label OnlineApplicationFormSBS MotherDistrict }{END MotherDistrict_label}
	</label>
	<div class="r-edit-field">
		{$MotherDistrict_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MotherDistrict">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MotherDistrict_fieldblock}
											
{BEGIN MOTHERPROV_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERPROV}  r-vertical-field" 
	data-fieldname="MOTHERPROV" 
	data-signal-error-for="MOTHERPROV{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field39" {$item_integrated_edit_field39} data-pageid="{$pageid}" data-field="MOTHERPROV" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERPROV}">
		{BEGIN MOTHERPROV_label}{$label OnlineApplicationFormSBS MOTHERPROV }{END MOTHERPROV_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERPROV_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERPROV">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERPROV_fieldblock}
											
{BEGIN MOTHERRELIGION_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERRELIGION}  r-vertical-field" 
	data-fieldname="MOTHERRELIGION" 
	data-signal-error-for="MOTHERRELIGION{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field40" {$item_integrated_edit_field40} data-pageid="{$pageid}" data-field="MOTHERRELIGION" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERRELIGION}">
		{BEGIN MOTHERRELIGION_label}{$label OnlineApplicationFormSBS MOTHERRELIGION }{END MOTHERRELIGION_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERRELIGION_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERRELIGION">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERRELIGION_fieldblock}
											
{BEGIN MOTHERBIRTHPLACE_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERBIRTHPLACE}  r-vertical-field" 
	data-fieldname="MOTHERBIRTHPLACE" 
	data-signal-error-for="MOTHERBIRTHPLACE{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field41" {$item_integrated_edit_field41} data-pageid="{$pageid}" data-field="MOTHERBIRTHPLACE" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERBIRTHPLACE}">
		{BEGIN MOTHERBIRTHPLACE_label}{$label OnlineApplicationFormSBS MOTHERBIRTHPLACE }{END MOTHERBIRTHPLACE_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERBIRTHPLACE_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERBIRTHPLACE">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERBIRTHPLACE_fieldblock}
											
{BEGIN MOTHERJOB_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERJOB}  r-vertical-field" 
	data-fieldname="MOTHERJOB" 
	data-signal-error-for="MOTHERJOB{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field42" {$item_integrated_edit_field42} data-pageid="{$pageid}" data-field="MOTHERJOB" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERJOB}">
		{BEGIN MOTHERJOB_label}{$label OnlineApplicationFormSBS MOTHERJOB }{END MOTHERJOB_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERJOB_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERJOB">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERJOB_fieldblock}
											
{BEGIN MOTHERNATIONAL_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_MOTHERNATIONAL}  r-vertical-field" 
	data-fieldname="MOTHERNATIONAL" 
	data-signal-error-for="MOTHERNATIONAL{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field43" {$item_integrated_edit_field43} data-pageid="{$pageid}" data-field="MOTHERNATIONAL" >


	<label class="r-edit-label control-label" for="{$labelfor_MOTHERNATIONAL}">
		{BEGIN MOTHERNATIONAL_label}{$label OnlineApplicationFormSBS MOTHERNATIONAL }{END MOTHERNATIONAL_label}
	</label>
	<div class="r-edit-field">
		{$MOTHERNATIONAL_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="MOTHERNATIONAL">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END MOTHERNATIONAL_fieldblock}
	
								</td>
			{END cellblock_section4_c3}
								</tr>
			</tbody></table>
{END section4_block}
						</div>
					<div role="tabpanel" class="tab-pane " id="tab_section5{$pageid}"> 
			{BEGIN section5_block}




 
	 
												<table 
	data-body-align="center"
	data-location="section5" id="form_section5_{$pageid}" data-makeup="small" {$form_section5} data-pageid="{$pageid}" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr>
										

{BEGIN cellblock_section5_c3}
<td
	{$cell_section5_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="section5_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN Documents_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_Documents}  r-vertical-field" 
	data-fieldname="Documents" 
	data-signal-error-for="Documents{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field44" {$item_integrated_edit_field44} data-pageid="{$pageid}" data-field="Documents" >


	<label class="r-edit-label control-label" for="{$labelfor_Documents}">
		{BEGIN Documents_label}{$label OnlineApplicationFormSBS Documents }{END Documents_label}
	</label>
	<div class="r-edit-field">
		{$Documents_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="Documents">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END Documents_fieldblock}
											
{BEGIN acceptletter_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_acceptletter}  r-vertical-field" 
	data-fieldname="acceptletter" 
	data-signal-error-for="acceptletter{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field45" {$item_integrated_edit_field45} data-pageid="{$pageid}" data-field="acceptletter" >


	<label class="r-edit-label control-label" for="{$labelfor_acceptletter}">
		{BEGIN acceptletter_label}{$label OnlineApplicationFormSBS acceptletter }{END acceptletter_label}
	</label>
	<div class="r-edit-field">
		{$acceptletter_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="acceptletter">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END acceptletter_fieldblock}
											
{BEGIN grade12cert_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_grade12cert}  r-vertical-field" 
	data-fieldname="grade12cert" 
	data-signal-error-for="grade12cert{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field46" {$item_integrated_edit_field46} data-pageid="{$pageid}" data-field="grade12cert" >


	<label class="r-edit-label control-label" for="{$labelfor_grade12cert}">
		{BEGIN grade12cert_label}{$label OnlineApplicationFormSBS grade12cert }{END grade12cert_label}
	</label>
	<div class="r-edit-field">
		{$grade12cert_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="grade12cert">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END grade12cert_fieldblock}
											
{BEGIN gradetencert_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_gradetencert}  r-vertical-field" 
	data-fieldname="gradetencert" 
	data-signal-error-for="gradetencert{$id}" 
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field47" {$item_integrated_edit_field47} data-pageid="{$pageid}" data-field="gradetencert" >


	<label class="r-edit-label control-label" for="{$labelfor_gradetencert}">
		{BEGIN gradetencert_label}{$label OnlineApplicationFormSBS gradetencert }{END gradetencert_label}
	</label>
	<div class="r-edit-field">
		{$gradetencert_editcontrol}	</div>
	<div class="r-edit-tooltip" data-helpfor="gradetencert">
		<div class="text-muted" >
				</div>
	</div>
</div>


{END gradetencert_fieldblock}
	
								</td>
			{END cellblock_section5_c3}
								</tr>
			</tbody></table>
{END section5_block}
						</div>
				</div>
	</div>
</div>  	
				{END grid_block}
									{BEGIN below-grid_block}
<div class="r-form" data-location="below-grid" id="form_below-grid_{$pageid}" data-makeup="small" {$form_below-grid} data-pageid="{$pageid}"
		data-v-width="2"
	data-v-margin="0"
	
>		
	 
		<div class="row">
			 
				<div 
	data-cellId="below-grid_c1" data-pageid="{$pageid}"	{$cell_below-grid_c1}
	class="			col-md-12
	">
	 
		<span data-itemtype="add_save" data-itemid="add_save" {$item_add_save} data-pageid="{$pageid}" data-small data-button-item>
	<a type="button" title="" class="btn btn-primary   
	" {$savebutton_attrs} >
							Save			</a>
</span>
	 
		{BEGIN back_button}
<span data-itemtype="add_back_list" data-itemid="add_back_list" {$item_add_back_list} data-pageid="{$pageid}" data-small data-button-item>
	<a type="button" title="" class="btn btn-default   
	" id="backButton{$id}" >
							Back to list			</a>
</span>
{END back_button}
	 
		{BEGIN cancel_button}
<span data-itemtype="add_cancel" data-itemid="add_cancel" {$item_add_cancel} data-pageid="{$pageid}" data-small data-button-item>
	<a type="button" title="" class="btn btn-default   
	" id="cancelButton{$id}" >
							Cancel			</a>
</span>
{END cancel_button}
	</div>					</div>
	</div>		
{END below-grid_block}
			</div>
		{$footer}
	{END body}
	</body>
</html>
