postulante-form.jsp 28.9 KB
Newer Older
1 2 3
<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core" %>
<%@ taglib prefix="form" uri="http://www.springframework.org/tags/form" %>
<%@ page contentType="text/html;charset=UTF-8" language="java" %>
4 5 6 7 8 9 10 11 12
<!doctype html>
<html lang="en">
  <head>
    <!-- Required meta tags -->
    <meta charset="utf-8">
    <meta name="viewport" content="width=device-width, initial-scale=1">

    <!-- Bootstrap CSS -->
    <link href="https://cdn.jsdelivr.net/npm/bootstrap@5.1.3/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-1BmE4kWBq78iYhFldvKuhfTAU6auU8tT94WrHftjDbrCEXSU1oBoqyl2QvZ6jIW3" crossorigin="anonymous">
13 14
    <title>Curriculum</title>
    <link href="../css/formPostulanteStyle.css" rel="stylesheet" type="text/css"/>
15
    <link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap-icons@1.7.1/font/bootstrap-icons.css">
16
    <link rel="icon" href="../img/LogoRoshka.ico">
17
    <link rel="stylesheet" href="https://fonts.googleapis.com/css?family=Shippori+Antique+B1">
18 19
  </head>

Nelson Ruiz committed
20
  <body class="container">
21 22 23 24 25
    <div class="row">
      <div id="errorSection" class="col" tabindex="-1">

      </div>
    </div>
26 27 28
    <form name="postulante" method="post" class="needs-validation" novalidate >
                      <div class="container mt-3" style="background-color:#ffff; background: #5791EE40;">
                          <div class="card p-3 text-center" style="background-color:#ffff; background: #5791EE40;">
Nelson Ruiz committed
29
                              <div class="d-flex flex-row justify-content-center mb-3">
Nelson Ruiz committed
30
                                
Nelson Ruiz committed
31
                              </div>
32
                              <h4 class="text-start">Datos Personales</h4>
Nelson Ruiz committed
33
                              <div class="row">
34
                                  
Nelson Ruiz committed
35 36

                                  <div class="inputs mb-3 col-md-6">
Nelson Ruiz committed
37
                                    <label for="nombre" class="form-label">Nombre</label>
38
                                    <input type="text" name="nombre" class="form-control  " id="nombre" required>
39
                                    
Nelson Ruiz committed
40 41
                                  </div>
                                  
Nelson Ruiz committed
42
                                  <div class="inputs mb-3 col-md-6">
Nelson Ruiz committed
43
                                    <label for="apellido" class="form-label">Apellido</label>
44
                                    <input type="text" name="apellido" class="form-control  " id="apellido" required>
45
                                    
Nelson Ruiz committed
46 47 48
                                  </div>
          

Nelson Ruiz committed
49
                                  <div class="inputs mb-3 col-md-6">
50
                                    <label for="correo" class="form-label">Email</label>
51
                                    <input type="email" name="correo" class="form-control  " id="correo" required>
52
                                    
Nelson Ruiz committed
53
                                  </div>
54 55 56 57 58 59 60 61 62

                                  <div class="inputs mb-3 col-md-6"> 
                                    <label for="nacionalidad" class="form-label"> Nacionalidad</label> 
                                    <select name="nacionalidad" id="nacionalidad" class="bg-light">
                                      <c:forEach items="${nacionalidades}" var="nacionalidad">
                                        <option value="${nacionalidad.getDescripcion()}">${nacionalidad.getDescripcion()}</option>
                                      </c:forEach>
                                    
                                  </select> </div>
63 64 65

                                  <div class="inputs mb-3 col-md-6"> 
                                    <label for="tipoDocumento" class="form-label"> Tipo de documento</label> 
66
                                    <select name="tipoDocumento" id="tipoDocumento" class="bg-light" required>
67 68 69 70
                                        <option value='CI' selected>C.I</option>
                                        <option value='PAS'>Pasport</option>
                                        <option value='Otro'>Otro</option>
                                    </select> 
71
                                  </div>
Nelson Ruiz committed
72
                              
Nelson Ruiz committed
73
                                  <div class="inputs  mb-3 col-md-6">
74 75
                                    <label for="nroDocument" class="form-label">Numero de Documento</label>
                                    <input type="number" name="nroDocument" class="form-control  " id="nroDocument" required>
76
                                    
Nelson Ruiz committed
77 78
                                  </div>
                                  
79 80 81 82 83 84
                                  <div class="inputs mb-3 col-md-6"> 
                                    <label for="departamentos" class="form-label"> Departamentos</label> 
                                    <select  id="departamentos" class="bg-light">
                                      <c:forEach items="${departamentos}" var="departamentos">
                                        <option value="${departamentos.getId()}">${departamentos.getNombre()}</option>
                                      </c:forEach>
85
                                      
86
                                    </select> 
Nelson Ruiz committed
87
                                  </div>
88 89 90 91 92

                                  <div class="inputs mb-3 col-md-6"> 
                                    <label for="ciudad" class="form-label"> Ciudad</label> 
                                    <select name="ciudadId" id="ciudad" class="bg-light">
                                      
93
                                      
94 95
                                    </select> 
                                  </div>
96 97 98 99 100 101 102
                                  
                                  <div class="inputs mb-3 col-md-6">
                                    <label for="direccion" class="form-label">direccion</label>
                                    <input type="text" name="direccion" class="form-control  " id="direccion" required> </textarea>
                                  </div>
                                  
                                  
Nelson Ruiz committed
103
                                  <div class="inputs mb-3 col-md-6">
Nelson Ruiz committed
104
                                    <label for="telefono" class="form-label">Telefono</label>
105
                                    <input type="number" name="telefono" class="form-control  " id="telefono" required>
106
                                    
Nelson Ruiz committed
107
                                  </div>
108
                                  
109 110 111
                                  <div class="inputs mb-3 col-md-6">
                                    <label for="fechaNacimiento" class="form-label">Fecha de nacimiento</label>
                                    <input type="date" name="fechaNacimiento" class="form-control  " id="fechaNacimiento" required>
112 113
                                    
                                  </div>
114 115 116 117
                                  
                                  <div class="inputs mb-3 col-md-6">
                                    <label for="formFile" class="form-label">Cargar cv</label>
                                    <input class="form-control" type="file" id="cvFile">
118
                                  </div>
119 120
                                  
                                  <br>
Nelson Ruiz committed
121
                        
122
                                  <div class="inputs mb-3 col-md-4"> <label for="nivelIngles" class="form-label"> Nivel de ingles</label> 
123
                                    <select name="nivelIngles" id="nivelIngles" class="content-select">
124 125 126 127 128
                                    <option value="1" selected>Ingles muy basico</option>
                                    <option value="2" >Comprendo algunas cosas y puedo leer con la ayuda del traductor</option>
                                    <option value="3" >Puedo leer tranquilamente</option>
                                    <option value="4" >Puedo escribir documentacion</option>
                                    <option value="5" >Puedo escribir y hablar tranquilamente</option>
129 130
                                    </select> 
                                  </div>
Nelson Ruiz committed
131
                                
132
                                  <div class="inputs mb-3 col-md-4"> 
133
                                    <label for="disponibilidad" class="form-label"> Disponibilidad</label> 
134
                                    <select name="disponibilidad" id="disponibilidad" class="content-select">
135 136 137 138
                                      <c:forEach items="${disponibilidades}" var="disponibilidad">
                                        <option value="${disponibilidad.getCode()}">${disponibilidad.getDescripcion()}</option>
                                      </c:forEach>
                                    
139
                                  </select> </div>
Nelson Ruiz committed
140
                                
141
                                  <div class="inputs mb-3 col-md-4"> 
142
                                    <label for="estadoCivil" class="form-label"> Estado Civil</label> 
143
                                    <select name="estadoCivil" id="estadoCivil" class="content-select">
144 145
                                      <c:forEach items="${estadosCiviles}" var="estadoCivil">
                                        <option value="${estadoCivil.getDescripcion()}">${estadoCivil.getDescripcion()}</option>
146
                                      </c:forEach>
147
                                    </select> 
148
                                  </div>
149
                                  <!-- Button Agregar Cargo al que postulas -->
Joel Florentin committed
150
                                  <hr>
151 152
                                  <div class="inputs mb-3 col-md-12">

153 154
                                    <div class="row w-100 gy-2 mx-auto">
                                      <div class="col-12 px-0">
Joel Florentin committed
155
                                        <h4 class="text-start">Cargos <i class="bi bi-plus-square" data-bs-toggle="modal" data-bs-target="#cargoForm"></i></h4>	
156 157 158 159 160 161
                                      </div>
                                      <div class="col-12">
                                        <div class="mt-3 gap-2 row row-cols-4" style="display: flex;" id="cargos">
                                        </div>
                                      </div>
                                      <div class="col-12">
Joel Florentin committed
162
                                        <p id="no-valid-cargo" style="display: none; color: red;" class="text-center">
163 164 165 166 167 168
                                          *Agrega por lo menos un cargo
                                        </p>
                                      </div>
                                    </div>
                                  </div>
                                  
169
                                  <!-- Button Agregar Estudio -->
Joel Florentin committed
170
                                  <hr>
171 172
                                  <div class="inputs mb-3 col-md-12">

173 174
                                    <div class="row w-100  gy-2 mx-auto">
                                      <div class="col-12 px-0">
Joel Florentin committed
175
                                        <h4 class="text-start">Estudios <i class="bi bi-plus-square" data-bs-toggle="modal" data-bs-target="#estudioForm"></i></h4>	
176 177 178 179 180 181 182 183 184
                                      </div>
                                      <div class="col-12">
                                        <div class="mt-3 gap-2 row row-cols-4" id="estudios">
                                          
                                        </div>
                                      </div>
                                    </div>
                                  </div>
                                  
185

186
                                  <!-- Button Agregar Tecnologia -->
Joel Florentin committed
187
                                  <hr>
188 189
                                  <div class="inputs mb-3 col-md-12">

190 191
                                    <div class="row w-100  gy-2 mx-auto">
                                      <div class="col-12 px-0">
192
                                        
Joel Florentin committed
193
                                        <h4 class="text-start">Tecnologias <i class="bi bi-plus-square" data-bs-toggle="modal" data-bs-target="#tecnologiaForm"></i></h4>	
194 195 196 197 198 199 200 201
                                      </div>
                                      <div class="col-12">
                                        
                                          <div class="mt-3 gap-2 row row-cols-5" style="display: flex;" id="tecnologias">
                                          </div>
                                        
                                      </div>
                                      <div class="col-12">
Joel Florentin committed
202
                                        <p id="no-valid-tecno" style="display: none; color: red;" class="text-center">
203 204 205 206 207 208
                                          *Agrega por lo menos una tecnologia
                                        </p>   
                                      </div>
                                      
                                    
                                    </div>
209
                                  </div>
210

211
                                  <!-- Button Agregar Experiencia -->
Joel Florentin committed
212
                                  <hr>
213 214
                                  <div class="inputs mb-3 col-md-12">

215 216
                                    <div class="row w-100  gy-2 mx-auto">
                                      <div class="col-12 px-0">
Joel Florentin committed
217
                                        <h4 class="text-start">Experiencias <i class="bi bi-plus-square" data-bs-toggle="modal" data-bs-target="#experienciaForm"></i></h4>	
218 219 220 221 222 223 224 225
                                      </div>
                                      <div class="col-12">
                                        <div class="mt-3 gap-2 row row-cols-4" id="experiencias">
                                          
                                        </div>
                                      </div>
                                    </div>
                                  </div>
226
                                  <!-- Button Agregar Refencia personal -->
Joel Florentin committed
227
                                  <hr>
228
                                  <div class="inputs mb-3 col-md-12">
229 230
                                    <div class="row  w-100  gy-2 mx-auto">
                                      <div class="col-12 px-0">
Joel Florentin committed
231
                                        <h4 class="text-start">Referencia Personal <i class="bi bi-plus-square" data-bs-toggle="modal" data-bs-target="#referenciaForm"></i></h4>	
232 233 234 235 236 237 238 239 240
                                      </div>
                                      <div class="col-12">
                                        <div class="mt-3 gap-2 row row-cols-4" id="referencia">
                                          
                                        </div>
                                      </div>
                                    </div>
                                  </div>
                                  
241 242
                      
                        
Nelson Ruiz committed
243 244
                                
                                <div class="mt-3 gap-2 d-flex justify-content-end">
Joel Florentin committed
245 246
                                  <a class="px-3 btn btn-sm btn-light" href="/work-with-us">Cancelar</a>
                                  <button class="px-3 btn btn-sm btn-light" type="submit">Guardar</button>
Nelson Ruiz committed
247
                                </div>
Nelson Ruiz committed
248
                              </div>
249
                          </div>
Nelson Ruiz committed
250
                      </div>
251
    </form>
willgonzz committed
252
    <!---------------------------------------Modal de Cargos disponibles---------------------------------------------------------------->
253
    <div class="modal fade" id="cargoForm" tabindex="-1" role="dialog" aria-labelledby="cargoForm" aria-hidden="true" >
willgonzz committed
254 255 256 257
      <div class="modal-dialog" role="document">
        <div class="modal-content">
          <div class="modal-header">
            <h5 class="modal-title" id="exampleModalLabel" >CargosDisponibles</h5>
258
            <button type="button" class="close" data-bs-dismiss="modal" aria-label="Close" style="color:#21130d;">
willgonzz committed
259 260 261 262 263 264 265 266
              <span aria-hidden="true">&times;</span>
            </button>
          </div>
          <div class="modal-body">
            <form name="cargo-form" class="needs-validation" novalidate>
              <label for="cargo-nombre" class="form-label">Cargo</label>
              <div class="input-group mb-3">
                <select class="form-select" name="cargo-id" aria-label="Default select example" required>
267
                  
willgonzz committed
268 269 270 271 272 273 274 275
                  <c:forEach items="${CargosDisponibles}" var="convocatoria">
                                <option value="${convocatoria.getId()}">${convocatoria.getCargo().getNombre()}</option>
                  </c:forEach>>
                </select>
              </div>
            </form>
        </div>
        <div class="modal-footer">
276 277
          <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Cerrar</button>
          <button type="button" class="btn btn-primary" onclick="agregarFieldCargo()">Agregar</button>
willgonzz committed
278 279 280 281 282
        </div>
      </div>
    </div>
  </div>  
  <!-------------------------------------------------------------------------------------------------------------------------->
283

284
      <!--Modal de Experiencia-->
285 286 287 288 289
      <div class="modal fade" id="experienciaForm" tabindex="-1" role="dialog" aria-labelledby="experienciaForm" aria-hidden="true">
        <div class="modal-dialog" role="document">
          <div class="modal-content">
            <div class="modal-header">
              <h5 class="modal-title" id="exampleModalLabel">Experiencia</h5>
290
              <button type="button" class="close" data-bs-dismiss="modal" aria-label="Close" style="color:#21130d;">
291 292 293 294
                <span aria-hidden="true">&times;</span>
              </button>
            </div>
            <div class="modal-body">
295
                <form name="experiencia-form" class="needs-validation" novalidate>
296

Nelson Ruiz committed
297
                        <div class="inputs">
298 299
                            <label for="institucionExperiencia" class="inputs form-label">Institucion</label>
                            <input type="text" class="inputs form-control  " name="institucion" id="institucionExperiencia" required>
Nelson Ruiz committed
300 301
                        </div>
                        <div class="inputs">
302 303
                            <label for="fechaDesdeExperiencia" class="form-label">Fecha Desde</label>
                            <input type="date" class="form-control" name="fechaDesde" id="fechaDesdeExperiencia" required>
304 305 306
                            <div class="invalid-feedback errorFechaDesde">
                              
                            </div>
Nelson Ruiz committed
307 308 309
                        </div>
                         
                        <div class="inputs">
310 311
                            <label for="fechaHastaExperiencia" class="form-label">Fecha Hasta</label>
                            <input type="date" class="form-control" name="fechaHasta" id="fechaHastaExperiencia" >
312 313
                            <div class="invalid-feedback errorfechaHasta"></div>
                          </div>
Nelson Ruiz committed
314 315 316
                        
                        <div class="inputs">
                            <label for="cargo" class="form-label">Cargo</label>
317
                            <input type="text" class="form-control " name="cargo" id="cargo" required>
Nelson Ruiz committed
318 319 320
                        </div>

                        <div class="inputs">
321
                          <label for="descripcion" class="form-label">Descripcion</label>
322
                          <textarea  class="form-control" name="descripcion" id="descripcion" required></textarea>
323 324 325 326 327 328 329 330 331

                        </div>
                        <div class="inputs">
                          <label for="refNombre" class="form-label">Nombre de la Referencia</label>
                          <input type="text" class="form-control  " name="nombreReferencia" id="refNombre" >
                        </div>
                        <div class="inputs">
                          <label for="refTel" class="form-label">Telefono de la Referencia</label>
                          <input type="text" class="form-control  " name="telefonoReferencia" id="refTel" >
Nelson Ruiz committed
332
                        </div>
333 334 335 336 337 338 339 340 341 342 343 344 345 346 347
                        
                        <div class="inputs">
                          <label for="motivoSalida" class="form-label">Motivo de Salida</label>
                          <textarea class="form-control  " name="motivoSalida" id="motivoSalida" ></textarea>
                        </div>
                        <div class="inputs">
                          <label for="tipoExperiencia" class="form-label"> Tipo de Experiencia</label> 
                            <select name="tipoExperiencia" id="tipoExperiencia" class="bg-light">
                              <c:forEach items="${tiposExperencia}" var="tipoExperiencia">
                                <option value="${tipoExperiencia.getDescripcion()}">${tipoExperiencia.getDescripcion()}</option>
                              </c:forEach>
                            
                            </select>
                        </div>
                        
Nelson Ruiz committed
348
                          
349

350 351 352
                </form>
            </div>
            <div class="modal-footer">
353 354
              <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Cerrar</button>
              <button id="agregar-exp" type="button" class="btn btn-primary" onclick="agregarFieldExpierncia()">Agregar</button>
355 356 357 358
            </div>
          </div>
        </div>
      </div>
willgonzz committed
359
    <!--------------------------------------------------------------------------------------->
360
      <div class="modal fade" id="tecnologiaForm" tabindex="-1" role="dialog" aria-labelledby="tecnologiaForm" aria-hidden="true">
willgonzz committed
361 362 363 364
        <div class="modal-dialog" role="document">
          <div class="modal-content">
            <div class="modal-header">
              <h5 class="modal-title" id="exampleModalLabel" >tecnologia</h5>
365
              <button type="button" class="close" data-bs-dismiss="modal" aria-label="Close" style="color:#21130d;">
willgonzz committed
366 367 368 369
                <span aria-hidden="true">&times;</span>
              </button>
            </div>
            <div class="modal-body">
370
              <form name="tecnologia-form" class="needs-validation" novalidate>
Joel Florentin committed
371 372
                <label for="tecnologia-nombre" class="form-label">Tecnologia</label>
                <div class="input-group mb-3">
373
                  <select class="form-select" name="tecnologia-id" aria-label="Default select example" required>
374
                    
Joel Florentin committed
375 376 377 378 379 380 381 382 383
                    <c:forEach items="${tecnologias}" var="tecnologia">
                      <option value="${tecnologia.id}">${tecnologia.nombre}</option>
                    </c:forEach>
                  </select>
                </div>
                  
                  
                  <input type="text" class="form-control d-none" name="tecnologia-nombre" id="tecnologia-nombre" >
                  <label for="nivel" class="form-label">Nivel</label>
384
                  <input type="range" class="form-range" name="nivel" id="nivel" min="1" max="5" required>
Joel Florentin committed
385 386 387
              </form>
          </div>
          <div class="modal-footer">
388 389
            <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Cerrar</button>
            <button type="button" class="btn btn-primary" onclick="agregarFieldTecnologia()">Agregar</button>
willgonzz committed
390 391
          </div>
        </div>
Joel Florentin committed
392 393 394
      </div>
    </div>      
  <!--------------------------------------------------------------------------------------->
395

396 397 398 399 400 401 402

      <!--Modal de Estudios-->
      <div class="modal fade" id="estudioForm" tabindex="-1" role="dialog" aria-labelledby="estudioForm" aria-hidden="true">
        <div class="modal-dialog" role="document">
          <div class="modal-content">
            <div class="modal-header">
              <h5 class="modal-title" id="exampleModalLabel">Estudios</h5>
403
              <button type="button" class="close" data-bs-dismiss="modal" aria-label="Close" style="color:#21130d;">
404 405 406 407
                <span aria-hidden="true">&times;</span>
              </button>
            </div>
            <div class="modal-body">
408
              <form name="estudio-form" class="needs-validation" novalidate>
409 410 411 412


                <div class="form-group">
                    <label for="tipoDeEstudio">Tipo de Estudio</label>
413
                    <select name="tipoDeEstudio" id="tipoDeEstudio" required>
414
                        
415 416 417 418
                        <c:forEach items="${tiposDeEstudio}" var="tipo">
                            <option value="${tipo}">${tipo.name}</option>
                        </c:forEach>
                    </select>
Joel Florentin committed
419
                </div>
420 421 422
<%--                <label for="tipoDeEstudio" class="form-label">Tipo De Estudio</label>--%>
<%--                <input type="text" class="form-control  " name="tipoDeEstudio" id="tipoDeEstudio">--%>
                <div class="form-group">
423 424
                    <label for="institucionEstudio" class="form-label">Institucion</label>
                    <input type="text" class="form-control" name="institucion" id="institucionEstudio" required>
Joel Florentin committed
425
                </div>
426 427
                <div class="form-group">
                    <label for="temaDeEstudio" class="form-label">Carrera/Bachiller/Tema de Curso</label>
428
                    <input type="text" class="form-control" name="temaDeEstudio" id="temaDeEstudio" required>
429 430 431
                </div>
                  <div class="form-group">
                      <label for="estado">Estado</label>
432
                      <select name="estado" id="estado" required>
433
                          
434 435 436 437
                          <c:forEach items="${estadosEstudio}" var="estado">
                              <option value="${estado}">${estado.name}</option>
                          </c:forEach>
                      </select>
Joel Florentin committed
438
                  </div>
439
                <div class="form-group">
440 441
                    <label for="fechaDesdeEstudio" class="form-label">Fecha Desde</label>
                    <input type="date" class="form-control  " name="fechaDesde" id="fechaDesdeEstudio" required>
442 443 444
                    <div class="invalid-feedback errorFechaDesde">
                              
                    </div>
445 446
                </div>
                <div class="form-group">
447 448
                    <label for="fechaHastaEstudio" class="form-label">Fecha Hasta</label>
                    <input type="date" class="form-control  " name="fechaHasta" id="fechaHastaEstudio" >
449 450 451
                    <div class="invalid-feedback errorFechaHasta">
                              
                    </div>
Joel Florentin committed
452
                </div>
453 454


Joel Florentin committed
455 456 457
            </form>
        </div>
        <div class="modal-footer">
458 459
          <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Cerrar</button>
          <button type="button" class="btn btn-primary" onclick="agregarFieldEstudio()">Agregar</button>
460 461
        </div>
      </div>
Joel Florentin committed
462 463
    </div>
  </div>
464 465
    <meta name="_csrf" content="${_csrf.token}"/>
    <meta name="_csrf_header" content="${_csrf.headerName}"/>
466 467 468 469 470 471
    <!--Modal de referencias-->
       <div class="modal fade" id="referenciaForm" tabindex="-1" role="dialog" aria-labelledby="referenciaForm" aria-hidden="true">
        <div class="modal-dialog" role="document">
          <div class="modal-content">
            <div class="modal-header">
              <h5 class="modal-title" id="exampleModalLabel">Referencias Personales</h5>
472
              <button type="button" class="close" data-bs-dismiss="modal" aria-label="Close" style="color:#21130d;">
473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497
                <span aria-hidden="true">&times;</span>
              </button>
            </div>
            <div class="modal-body">
              <form name="referencia-form" class="needs-validation" novalidate>
                <div class="form-group">
                    <label for="nombre" class="form-label">Nombre</label>
                    <input type="text" class="form-control" name="nombre" id="nombre" required>
                </div>
                <div class="form-group">
                    <label for="relacion" class="form-label">Relacion</label>
                    <input type="text" class="form-control" name="relacion" id="relacion" required>
                </div>

                <div class="form-group">
                  <label for="telefono" class="form-label">Telefono</label>
                  <input type="number" class="form-control" name="telefono" id="telefono" required>
              </div>
                 
                


            </form>
        </div>
        <div class="modal-footer">
498 499
          <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Cerrar</button>
          <button type="button" class="btn btn-primary" onclick="agregarFieldReferencia()">Agregar</button>
500 501 502 503
        </div>
      </div>
    </div>
      </div>
504

505

506
    <!-- Optional JavaScript; choose one of the two! -->
507 508
    <script src="https://cdn.jsdelivr.net/npm/@popperjs/core@2.10.2/dist/umd/popper.min.js" integrity="sha384-7+zCNj/IqJ95wo16oMtfsKbZ9ccEh31eOz1HGyDuCQ6wgnyJNSYdrPa03rtR1zdB" crossorigin="anonymous"></script>
    <script src="https://cdn.jsdelivr.net/npm/bootstrap@5.1.3/dist/js/bootstrap.min.js" integrity="sha384-QJHtvGhmr9XOIpI6YVutG+2QOK9T+ZnN4kzFN1RtK3zEFEIsxhlmWl5/YESvpZ13" crossorigin="anonymous"></script>
509 510
    <script>
      var ciudades = ${ciudades};
511
          </script>
512
    <script src="./main.js"></script>
513 514
  </body>
</html>