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<div class="row">
    <div class="col-md-12 col-sm-12 col-xs-12">
        <div class="x_panel">
            <div class="x_title">
                <h2>Registro de aspirantes a los programas de posgrado de Maestría en Sistemas Computacionales y
                    Maestría en Gestión Administrativa</h2>
                <div class="clearfix"></div>
            </div>
            <div class="x_content" style='margin-left: 10%'>
                <form id="form-nueva" data-parsley-validate>
                    <?php echo csrf_field(); ?>
                    <div class="form-group row text-lg-right">
                        <label for="apellido_paterno" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">Apellido
                            paterno <span class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="text" class="form-control" id="apellido_paterno" name="apellido_paterno"
                                required>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label for="apellido_materno" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">Apellido
                            materno <span class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="text" class="form-control" id="apellido_materno" name="apellido_materno"
                                required>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label for="nombre" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">Nombre(s) <span
                                class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="text" class="form-control" id="nombre" name="nombre" required>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label for="fecha_nacimiento" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">Fecha de
                            nacimiento <span class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="date" class="form-control" id="fecha_nacimiento" name="fecha_nacimiento"
                                required>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth" for="genero">Género <span
                                class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <select class="custom-select mr-sm-2" id="genero" name="genero" required>
                                <option value="Masculino" select>Masculino</option>
                                <option value="Femenino">Femenino</option>
                                <option value="Otro">Otro</option>
                            </select>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth" for="pais_origen">País de origen
                            <span class="required">*</span>
                        </label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <select class="custom-select mr-sm-2" id="pais_origen" name="pais_origen" required>
                                <option value="México" checked>México</option>
                                <option value="Otro">Otro</option>
                            </select>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth" for="estado_civil">Estado civil
                            <span class="required">*</span>
                        </label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <select class="custom-select mr-sm-2" id="estado_civil" name="estado_civil" required>
                                <option value="Soltero(a)" checked>Soltero(a)</option>
                                <option value="Casado(a)">Casado(a)</option>
                                <option value="Divorciado(a)">Divorciado(a)</option>
                                <option value="Viudo(a)">Viudo(a)</option>
                                <option value="Unión libre">Unión libre</option>
                            </select>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label for="curp" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">CURP <span
                                class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="text" class="form-control" id="curp" name="curp" required>
                        </div>
                    </div>
                    <fieldset class="form-group">
                        <div class="row">
                            <legend class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth">¿Tienes alguna discapacidad?
                                <span class="required">*</span>
                            </legend>
                            <div class="col-md-6 col-sm-6 col-xs-12">
                                <div class="form-check">
                                    <input class="" type="radio" name="discapasidad" id="discapasidad1"
                                        value="si" checked>
                                    <label class="form-check-label" for="discapasidad1">
                                        Si
                                    </label>
                                </div>
                                <div class="form-check">
                                    <input class="" type="radio" name="discapasidad" id="discapasidad2"
                                        value="no">
                                    <label class="form-check-label" for="discapasidad2">
                                        No
                                    </label>
                                </div>
                            </div>
                        </div>
                    </fieldset>
                    <fieldset class="form-group">
                        <div class="row">
                            <legend class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth">¿Hablas alguna lengua indígena? <span class="required">*</span></legend>
                            <div class="col-md-6 col-sm-6 col-xs-12">
                                <div class="form-check">
                                    <input class="" type="radio" name="lengua" id="lengua1" value="si"
                                        checked>
                                    <label class="form-check-label" for="lengua1">
                                        Si
                                    </label>
                                </div>
                                <div class="form-check">
                                    <input class="" type="radio" name="lengua" id="lengua2" value="no">
                                    <label class="form-check-label" for="lengua2">
                                        No
                                    </label>
                                </div>
                            </div>
                        </div>
                    </fieldset>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth" for="pais_contacto">País de
                            residencia
                            <span class="required">*</span>
                        </label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <select class="custom-select mr-sm-2" id="pais_contacto" name="pais_contacto" required>
                                <option value="México" checked>México</option>
                                <option value="Cuba">Cuba</option>
                                <option value="Costa Rica">Costa Rica</option>
                                <option value="Guatemala">Guatemala</option>
                                <option value="Colombia">Colombia</option>
                                <option value="Argentina">Argentina</option>
                                <option value="Estados Unidos de America">Estados Unidos de America</option>
                                <option value="Canada">Canada</option>
                                <option value="Haiti">Haiti</option>
                                <option value="Otro">Otro</option>
                            </select>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label for="telefono" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">Número telefónico <span
                                class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="tel" class="form-control" id="telefono" name="telefono" required>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label for="correo" class="col-md-3 col-sm-3 col-xs-12 col-form-label text-md-right text-sm-right text-xl-right text-lg-rigth">Correo electrónico <span
                                class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <input type="email" class="form-control" id="correo" name="correo" required>
                        </div>
                    </div>
                    <fieldset class="form-group">
                        <div class="row">
                            <legend class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth">¿Es egresado(a) del TecNM
                                campus Zitácuaro? <span class="required">*</span></legend>
                            <div class="col-md-6 col-sm-6 col-xs-12">
                                <div class="form-check">
                                    <input class="" type="radio" name="egresado" id="egresado1" value="si"
                                        checked>
                                    <label class="form-check-label" for="egresado1">
                                        Si
                                    </label>
                                </div>
                                <div class="form-check">
                                    <input class="" type="radio" name="egresado" id="egresado2"
                                        value="no">
                                    <label class="form-check-label" for="egresado2">
                                        No
                                    </label>
                                </div>
                            </div>
                        </div>
                    </fieldset>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth" for="situasion_laboral">Situación
                            laboral <span class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <select class="custom-select mr-sm-2" id="situasion_laboral" name="situasion_laboral"
                                required>
                                <option value="Empleado(a)" checked>Empleado(a)</option>
                                <option value="Desempleado(a)">Desempleado(a)</option>
                                <option value="Empresario(a)">Empresario(a)</option>
                            </select>
                        </div>
                    </div>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth" for="convocatoria">¿Cómo se
                            enteró de la convocatoria? <span class="required">*</span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <select class="custom-select mr-sm-2" id="convocatoria" name="convocatoria" required>
                                <option value="Anuncios en redes sociales" checked>Anuncios en redes sociales</option>
                                <option value="Anuncios impresos">Anuncios impresos</option>
                                <option value="Recomendación personal">Recomendación personal</option>
                                <option value="Difusión en mi lugar de trabajo">Difusión en mi lugar de trabajo</option>
                            </select>
                        </div>
                    </div>
                    <fieldset class="form-group">
                        <div class="row">
                            <legend class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0 text-md-right text-sm-right text-xl-right text-lg-rigth">¿Qué posgrado es de su
                                interés? <span class="required">*</span></legend>
                            <div class="col-md-6 col-sm-6 col-xs-12">
                                <div class="form-check">
                                    <input class="" type="radio" name="maestria" id="maestria1"
                                        value="MSC" checked>
                                    <label class="form-check-label" for="maestria1">
                                        Maestría en Sistemas Computacionales
                                    </label>
                                </div>
                                <div class="form-check">
                                    <input class="" type="radio" name="maestria" id="maestria2"
                                        value="MGA">
                                    <label class="form-check-label" for="maestria2">
                                        Maestría en Gestión Administrativa
                                    </label>
                                </div>
                            </div>
                        </div>
                    </fieldset>
                    <div class="form-group row">
                        <label class="col-md-3 col-sm-3 col-xs-12 col-form-label pt-0" for="convocatoria"><span
                                class="required"></span></label>
                        <div class="col-md-6 col-sm-6 col-xs-12">
                            <div class="g-recaptcha" data-sitekey="6Lfuc8QfAAAAAIZC6uLhsyf10OYwoGkiDX2exf8B"></div>

                        </div>
                    </div>
                    <div class="form-group row">
                        <div class="col-md-9 col-sm-9 col-xs-12 offset-1">
                            <button type="reset"
                                class="btn btn-outline-primary col-md-3 col-sm-3 col-xs-12">Limpiar</button>
                            <button type="button" onclick="registroAspirantesAdmision(this.form);"
                                class="btn btn-outline-success col-md-3 col-sm-3 col-xs-12"
                                form="form-nueva">Enviar</button>

                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>

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