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onlinefee.modikota.com Open in urlscan Pro
162.244.93.3  Public Scan

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Submitted URL: http://onlinefee.modikota.com/
Effective URL: https://onlinefee.modikota.com/
Submission: On May 21 via api from JP — Scanned from JP

Form analysis 1 forms found in the DOM

Name: customerData — POST CCavenue/ccavRequestHandler.php

<form method="post" id="customerData" name="customerData" action="CCavenue/ccavRequestHandler.php" novalidate="" onsubmit="return contactform();" class="customerData">
  <div class="col-lg-9">
    <h3>Student Details</h3>
    <div class="row">
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Student Name</span>
          <input type="hidden" name="tid" id="tid" value="1716259406693">
          <input type="hidden" name="merchant_id" id="tid" value="315498">
          <input type="text" class="form-control" name="delivery_name" id="delivery_name" value="" required="">
        </div>
        <span class="valid_error" data-valmsg-for="delivery_name"></span>
      </div>
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Father Name</span>
          <input type="text" name="merchant_param1" id="merchant_param1" class="form-control" value="" required="">
        </div>
        <span class="valid_error" data-valmsg-for="merchant_param1"></span>
      </div>
    </div>
    <div class="row">
      <div class="form-group col-lg-12">
        <div class="input-group">
          <span class="input-group-addon">Street Address</span>
          <textarea class="form-control" name="delivery_address" id="delivery_address" required=""></textarea>
        </div>
        <span class="valid_error" data-valmsg-for="delivery_address"></span>
      </div>
    </div>
    <div class="row">
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">City</span>
          <input type="text" class="form-control" name="delivery_city" id="delivery_city" required="">
        </div>
        <span class="valid_error" data-valmsg-for="delivery_city"></span>
      </div>
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Zip/Pincode</span>
          <input type="text" class="form-control" name="delivery_zip" required="">
        </div>
        <span class="valid_error" data-valmsg-for="delivery_zip"></span>
      </div>
    </div>
    <div class="row">
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Email</span>
          <input type="email" name="billing_email" id="weemail" class="form-control" value="" required="">
        </div>
        <span class="valid_error" data-valmsg-for="weemail"></span>
      </div>
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Mobile No.</span>
          <input type="text" class="form-control" id="wemobile" name="delivery_tel" value="" required="">
        </div>
        <span class="valid_error" data-valmsg-for="wemobile"></span>
      </div>
    </div>
    <h3>Payment Details</h3>
    <div class="row">
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Class</span>
          <select class="form-control" name="merchant_param2" id="merchant_param2" required="">
            <option value="">Select</option>
            <option value="Nursery">Nursery</option>
            <option value="LKG">LKG</option>
            <option value="HKG">HKG</option>
            <option value="I">I</option>
            <option value="II">II</option>
            <option value="III">III</option>
            <option value="IV">IV</option>
            <option value="V">V</option>
            <option value="VI">VI</option>
            <option value="VII">VII</option>
            <option value="VIII">VIII</option>
            <option value="IX">IX</option>
            <option value="X">X</option>
            <option value="XI">XI</option>
            <option value="XII">XII</option>
          </select>
        </div>
        <span class="valid_error" data-valmsg-for="merchant_param2"></span>
      </div>
      <div class="form-group col-sm-6">
        <div class="input-group">
          <div class="input-group-addon">
            <span class="input-group-text">Type of Fee</span>
          </div>
          <select class="form-control" name="merchant_param4" id="merchant_param4" required="">
            <option value="">Select</option>
            <option value="School Fee">School Fee</option>
            <option value="Other Fee">Other Fee</option>
          </select>
        </div>
        <span class="valid_error" data-valmsg-for="merchant_param4"></span>
      </div>
      <div class="form-group col-sm-6">
        <div class="input-group">
          <span class="input-group-addon">Amout to Be Paid (in INR)</span>
          <input type="text" name="amount" id="amount" class="form-control" value="" required="">
          <input type="hidden" name="currency" value="INR">
          <input type="hidden" name="redirect_url" value="https://onlinefee.modikota.com/CCavenue/ccavResponseHandler.php">
          <input type="hidden" name="cancel_url" value="https://onlinefee.modikota.com/CCavenue/ccavResponseHandler.php">
          <input type="hidden" name="language" value="EN">
        </div>
        <span class="valid_error" data-valmsg-for="amount"></span>
      </div>
    </div>
    <div class="row">
      <div class="form-group col-lg-12">
        <div class="input-group">
          <span class="input-group-addon">Remarks</span>
          <textarea class="form-control" name="description"></textarea>
          <input type="hidden" name="delivery_country" value="India">
        </div>
      </div>
    </div>
    <div class="btnbar">
      <button class="btn btn-orange">Pay Now</button><br><br>
    </div>
  </div>
</form>

Text Content

PAY FEE ONLINE


STUDENT DETAILS

Student Name
Father Name
Street Address
City
Zip/Pincode
Email
Mobile No.


PAYMENT DETAILS

Class Select Nursery LKG HKG I II III IV V VI VII VIII IX X XI XII
Type of Fee
Select School Fee Other Fee
Amout to Be Paid (in INR)
Remarks
Pay Now




CONTACT DETAILS

SCHOOL:

Modi Public School
Dadabari Extension Kota-324009
Email: mps_kota@yahoo.com

FOR ADMISSION CONTACT:

Modi Public School,
Dadabari Extension Kota-324009
Ph.: 0744-2505496, 2502321
Websites: http://www.modikota.com

CORPORATE OFFICE:

Modi House, Kotri Road
Gumanpura, Kota
Ph.: 0744-2391070-71