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www.gsdjoumabah.com Open in urlscan Pro
109.234.165.193  Public Scan

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Submitted URL: https://gsdjoumabah.com/
Effective URL: https://www.gsdjoumabah.com/fr/
Submission: On March 01 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

POST https://www.gsdjoumabah.com/wp-admin/admin-ajax.php

<form action="https://www.gsdjoumabah.com/wp-admin/admin-ajax.php" method="post" id="wlsm-submit-registration-form">
  <input type="hidden" name="wlsm-submit-registration" value="5059a217c9">
  <input type="hidden" name="action" value="wlsm-p-submit-registration">
  <input type="hidden" name="school_id" value="1" id="wlsm_school">
  <div class="wlsm-form-group wlsm-row wlsm-mb-2">
    <div class="wlsm-col-12">
      <label class="wlsm-form-label wlsm-font-bold"> Ecole: </label>
    </div>
    <div class="wlsm-col-12 wlsm-px-0">
      <span class="wlsm-font-normal"> GS Djouma Bah </span>
    </div>
  </div>
  <!-- Personal Detail -->
  <div class="wlsm-form-section">
    <div class="wlsm-row">
      <div class="wlsm-col-12">
        <div class="wlsm-form-sub-heading wlsm-font-bold"> Informations personnelles </div>
      </div>
    </div>
    <div class="wlsm-row">
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_name" class="wlsm-font-bold">
          <span class="wlsm-important">*</span> Nom de l'élève : </label>
        <input type="text" name="name" class="wlsm-form-control" id="wlsm_name" placeholder="Saisir le nom de l'élève" value="" data-no-translation-placeholder="">
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label class="wlsm-font-bold wlsm-d-block">
          <span class="wlsm-important">*</span> Genre: </label>
        <div class="wlsm-form-check wlsm-form-check-inline">
          <input class="wlsm-form-check-input" type="radio" name="gender" id="wlsm_gender_Masculin" value="male" checked="checked" data-no-translation-id="">
          <label class="wlsm-ml-1 wlsm-form-check-label wlsm-font-bold" for="wlsm_gender_Masculin" data-no-translation-for=""> Masculin </label>
        </div>
        <div class="wlsm-form-check wlsm-form-check-inline">
          <input class="wlsm-form-check-input" type="radio" name="gender" id="wlsm_gender_Female" value="female" data-no-translation-id="">
          <label class="wlsm-ml-1 wlsm-form-check-label wlsm-font-bold" for="wlsm_gender_Female" data-no-translation-for=""> Female </label>
        </div>
        <div class="wlsm-form-check wlsm-form-check-inline">
          <input class="wlsm-form-check-input" type="radio" name="gender" id="wlsm_gender_Autre" value="other" data-no-translation-id="">
          <label class="wlsm-ml-1 wlsm-form-check-label wlsm-font-bold" for="wlsm_gender_Autre" data-no-translation-for=""> Autre </label>
        </div>
      </div>
      <div class="wlsm-form-group wlsm-col-4" id="registration_dob">
        <label for="wlsm_date_of_birth" class="wlsm-font-bold"> Date de naissance: </label>
        <span class="Zebra_DatePicker_Icon_Wrapper" style="display: inline-block; position: relative; float: none; inset: auto; margin: 0px; padding: 0px;"><input type="text" name="dob" class="wlsm-form-control" id="wlsm_date_of_birth"
            placeholder="Choisir" value="" data-no-translation-placeholder="" style="position: relative; float: none; inset: auto; margin: 0px; padding-right: 38px;"><button type="button" class="Zebra_DatePicker_Icon"
            style="top: 9.875px; right: 11px;">Pick a date</button></span>
      </div>
    </div>
    <div class="wlsm-row">
    </div>
    <div class="wlsm-row">
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_address" class="wlsm-font-bold"> Adresse: </label>
        <textarea name="address" class="wlsm-form-control" id="wlsm_address" cols="30" rows="3" placeholder="Enter student address" data-no-translation-placeholder=""></textarea>
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_email" class="wlsm-font-bold"> Email: </label>
        <input type="email" name="email" class="wlsm-form-control" id="wlsm_email" placeholder="Enter student email address" value="" data-no-translation-placeholder="">
      </div>
    </div>
    <div class="wlsm-row">
    </div>
  </div>
  <!-- Admission Detail -->
  <div class="wlsm-form-section">
    <div class="wlsm-row">
      <div class="wlsm-col-12">
        <div class="wlsm-form-sub-heading wlsm-font-bold"> Informations Scolaires </div>
      </div>
    </div>
    <div class="wlsm-row">
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_school_class" class="wlsm-font-bold">
          <span class="wlsm-important">*</span> Classe: </label>
        <select name="class_id" class="wlsm-form-control" data-nonce="811c2b914f" id="wlsm_school_class">
          <option value="" data-no-translation="" data-trp-gettext="">Select Class</option>
          <option value="1"> 1ère Année </option>
          <option value="2"> 2ème Année </option>
          <option value="3"> 3ème Année </option>
          <option value="4"> 4ème Année </option>
          <option value="5"> 5ème Année </option>
          <option value="6"> 6ème Année </option>
          <option value="7"> 7ème Année </option>
          <option value="8"> 8ème Année </option>
          <option value="9"> 9ème Année </option>
          <option value="10"> 10ème Année </option>
          <option value="11"> 11ème SM </option>
          <option value="12"> 11ème SS </option>
          <option value="13"> 11ème SE </option>
          <option value="14"> 12ème SM </option>
          <option value="15"> 12ème SE </option>
          <option value="16"> 12ème SS </option>
          <option value="17"> Internat </option>
          <option value="18"> Semi-Internat </option>
          <option value="19"> Externat </option>
          <option value="20"> Academie </option>
          <option value="21"> Maternelle </option>
          <option value="28"> Grande section </option>
          <option value="29"> Moyenne section </option>
          <option value="30"> Petite section </option>
          <option value="31"> Garderie </option>
        </select>
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_section" class="wlsm-font-bold">
          <span class="wlsm-important">*</span> Section: </label>
        <select name="section_id" class="wlsm-form-control" id="wlsm_section">
          <option value="" data-no-translation="" data-trp-gettext="">Select Section</option>
        </select>
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <div class="wlsm-photo-box wlsm-mt-2">
          <div class="wlsm-photo-section">
            <label for="wlsm_photo" class="wlsm-font-bold"> Photo: </label>
            <div class="custom-file mb-3">
              <input type="file" class="custom-file-input" id="wlsm_photo" name="photo">
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <!-- Parent Detail -->
  <div class="wlsm-form-section" id="registration_parent_detail">
    <div class="wlsm-row">
      <div class="wlsm-col-12">
        <div class="wlsm-form-sub-heading wlsm-font-bold"> Informations des parents </div>
      </div>
    </div>
    <div class="wlsm-row">
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_father_name" class="wlsm-font-bold"> Nom du père: </label>
        <input type="text" name="father_name" class="wlsm-form-control" id="wlsm_father_name" placeholder="Prénoms &amp; nom" value="" data-no-translation-placeholder="">
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_father_phone" class="wlsm-font-bold"> Numéro mobile: </label>
        <input type="text" name="father_phone" class="wlsm-form-control" id="wlsm_father_phone" placeholder="Saisir le numéro" value="" data-no-translation-placeholder="">
      </div>
    </div>
    <div class="wlsm-row">
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_mother_name" class="wlsm-font-bold"> Autre: </label>
        <input type="text" name="mother_name" class="wlsm-form-control" id="wlsm_mother_name" placeholder="Saisir le nom" value="" data-no-translation-placeholder="">
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_mother_phone" class="wlsm-font-bold"> Téléphone: </label>
        <input type="text" name="mother_phone" class="wlsm-form-control" id="wlsm_mother_phone" placeholder="Numéro mobile" value="" data-no-translation-placeholder="">
      </div>
    </div>
    <div class="wlsm-row">
      <div class="wlsm-form-group wlsm-col-4">
        <div class="wlsm-parent-id-proof-box">
          <div class="wlsm-parent-id-proof-section">
            <label for="wlsm_parent_id_proof" class="wlsm-font-bold"> Upload Parent ID Proof: </label>
            <div class="custom-file mb-3">
              <input type="file" class="custom-file-input" id="wlsm_parent_id_proof" name="parent_id_proof">
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <!-- Student Login Detail -->
  <div class="wlsm-form-section">
    <div class="wlsm-row">
      <div class="wlsm-col-12">
        <div class="wlsm-form-sub-heading wlsm-font-bold"> Informations de connexion </div>
      </div>
    </div>
    <div class="wlsm-row wlsm-student-new-user">
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_username" class="wlsm-font-bold">
          <span class="wlsm-important">*</span> Utilisateur: </label>
        <input type="text" name="username" class="wlsm-form-control" id="wlsm_username" placeholder="Identifiant" data-no-translation-placeholder="">
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_login_email" class="wlsm-font-bold">
          <span class="wlsm-important">*</span> Email: </label>
        <input type="email" name="login_email" class="wlsm-form-control" id="wlsm_login_email" placeholder="E-mail" data-no-translation-placeholder="">
      </div>
      <div class="wlsm-form-group wlsm-col-4">
        <label for="wlsm_login_password" class="wlsm-font-bold">
          <span class="wlsm-important">*</span> Mot de passe: </label>
        <input type="password" name="password" class="wlsm-form-control" id="wlsm_login_password" placeholder="Mot de passe" data-no-translation-placeholder="">
      </div>
    </div>
  </div>
  <!-- Parent / Guardian Name and Login Detail -->
  <!-- Transport Detail -->
  <div class="wlsm-form-section wlsm-mt-2">
  </div>
  <div class="wlsm-border-top wlsm-pt-2 wlsm-mt-1">
    <button class="button wlsm-btn btn btn-primary" type="submit" id="wlsm-submit-registration-btn"> Enregistrer </button>
  </div>
</form>

Text Content

BIENVENUE
GROUPE SCOLAIRE MAMADOU DJOUMA BAH


Inscription d’un élève

Ecole:
GS Djouma Bah
Informations personnelles
* Nom de l'élève :
* Genre:
Masculin
Female
Autre
Date de naissance: Pick a date

Adresse:
Email:

Informations Scolaires
* Classe: Select Class 1ère Année 2ème Année 3ème Année 4ème Année 5ème Année
6ème Année 7ème Année 8ème Année 9ème Année 10ème Année 11ème SM 11ème SS 11ème
SE 12ème SM 12ème SE 12ème SS Internat Semi-Internat Externat Academie
Maternelle Grande section Moyenne section Petite section Garderie
* Section: Select Section
Photo:

Informations des parents
Nom du père:
Numéro mobile:
Autre:
Téléphone:
Upload Parent ID Proof:

Informations de connexion
* Utilisateur:
* Email:
* Mot de passe:

Enregistrer


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