<form action="action-pages/senior/contact-edit-action.php" method="post">	
<input type="hidden" name="sid" value="<?php echo $id; ?>" />
<table class="table m-n" width="100%">
									
									<tbody>
										  <tr>
										    <td style="width:200px"><strong>Address Line 1</strong></td>
										    <td><input type="text" name="add1" value="<?php echo $GetStep1Contact1['add1']; ?>" class="form-control" required/></td>
									      </tr>
										   <tr>
										    <td style="width:200px"><strong>Address Line 2</strong></td>
										    <td><input type="text" name="add2" value="<?php echo $GetStep1Contact1['add2']; ?>" class="form-control" required/></td>
									      </tr>

										   <tr>
										    <td style="width:200px"><strong>State</strong></td>
										    <td>
											
											<script type="text/javascript">
$(document).ready(function(e) {
 
  
    $('#state').change(function(e){
		  $.post('module/insert1.php',{state:$(this).val()},function(data){
			   $('#city').html(data);
			  });
		});
		
     $('#sem').change(function(e){
		  $.post('module/insert.php',{subject:$(this).val()},function(data){
		  		
			   $('#subject').html(data);
			  });
		});		
});
</script>
									
									
											<select id="state" name="state" class="form-control" style="" >
           <option value="">Select State </option>
        <?php 
		  $GetState=mysql_query('SELECT * FROM `state` ORDER BY `state` ASC');
		  while($GetState1=mysql_fetch_array($GetState)) 
		  {
		  
		   ?>
          
          <option value="<?php echo $GetState1['ids']; ?>"
		   <?php
		  if($GetStep1Contact1['state'] == $GetState1['ids'])
		  {
		  ?>
		  
		  selected="selected"
		  <?php
		  }
		  ?>
		  ><?php echo $GetState1['state']; ?></option>
          <?php } ?> 
          </select></td>
									      </tr>


										   <tr>
										    <td style="width:200px"><strong>City</strong></td>
										    <td><select id="city" name="city" class="form-control"  style="">
           <option value="">Select District</option>
<?php
$GetLtdis=mysql_query("SELECT * FROM `city` WHERE `state_id` ='$GetStep1Contact1[state]' ORDER BY `cityname` ASC");
while($GetLtdis1=mysql_fetch_assoc($GetLtdis))
{
?>
           <option value="<?php echo $GetLtdis1['city_id'];  ?>"
		    <?php
		  if($GetStep1Contact1['city'] == $GetLtdis1['city_id'])
		  {
		  ?>
		  
		  selected="selected"
		  <?php
		  }
		  ?>
		   
		   ><?php echo $GetLtdis1['cityname'];  ?></option>
<?php
}
?>		   
         </select></td>
									      </tr>
										  <tr>
										    <td><strong>Student Mobile </strong></td>
										    <td><input type="text" name="student_mobile" value="<?php echo $GetStep1Contact1['student_mobile']; ?>" class="form-control" required/></td>
									      </tr>
										  <tr>
										    <td><strong>Parent's Mobile </strong></td>
										    <td><input type="text" name="parent_mobile" value="<?php echo $GetStep1Contact1['parent_mobile']; ?>" class="form-control" required/></td>
									      </tr>
										  <tr>
										    <td><strong>Landline No. </strong></td>
										    <td><input type="text" name="landline" value="<?php echo $GetStep1Contact1['landline']; ?>" class="form-control"/></td>
									      </tr>
										  <tr>
										    <td><strong>Parent's Email </strong></td>

										    <td><input type="text" name="parent_email" value="<?php echo $GetStep1Contact1['parent_email']; ?>" class="form-control" /></td>
									      </tr>
									</tbody>
								</table>
								
								<button class="btn btn-primary" type="submit">Submit</button>&nbsp;&nbsp;<button class="btn btn-primary" type="reset">Reset</button>

								</form>