<style>* { box-sizing: border-box; } body {margin: 0;}.ai-form-container{max-width:400px;margin-top:0px;margin-right:auto;margin-bottom:0px;margin-left:auto;padding-top:20px;padding-right:20px;padding-bottom:20px;padding-left:20px;border-top-width:1px;border-right-width:1px;border-bottom-width:1px;border-left-width:1px;border-top-style:solid;border-right-style:solid;border-bottom-style:solid;border-left-style:solid;border-top-color:rgb(204, 204, 204);border-right-color:rgb(204, 204, 204);border-bottom-color:rgb(204, 204, 204);border-left-color:rgb(204, 204, 204);border-image-source:initial;border-image-slice:initial;border-image-width:initial;border-image-outset:initial;border-image-repeat:initial;background-color:rgb(249, 249, 249);}.ai-form-group{margin-bottom:10px;}.ai-form-label{font-weight:bold;}.ai-form-input{width:100%;padding-top:5px;padding-right:5px;padding-bottom:5px;padding-left:5px;margin-top:5px;}.ai-form-button{padding-top:10px;padding-right:20px;padding-bottom:10px;padding-left:20px;background-color:rgb(0, 123, 255);color:rgb(255, 255, 255);border-top-width:initial;border-right-width:initial;border-bottom-width:initial;border-left-width:initial;border-top-style:none;border-right-style:none;border-bottom-style:none;border-left-style:none;border-top-color:initial;border-right-color:initial;border-bottom-color:initial;border-left-color:initial;border-image-source:initial;border-image-slice:initial;border-image-width:initial;border-image-outset:initial;border-image-repeat:initial;cursor:pointer;}.ai-form-button:hover{background-color:rgb(0, 86, 179);}</style><meta charset="UTF-8"><meta name="viewport" content="width=device-width, initial-scale=1.0"><title>Payment Collection Form</title><div class="ai-form-container"><img src="https://iob.momentpay.co.in/uploads/iob.png" alt="logo" width="200" id="ilik"><form method="get" id="paymentForm"><div class="ai-form-group"><label for="ai-form-school" class="ai-form-label">School:</label><select id="ai-form-school" class="ai-form-input"><option value="">Select School</option><option value="Royal">Royal</option><option value="Narayana">Narayana</option><option value="Gogia">Gogia</option></select></div><div class="ai-form-group"><label for="ai-form-admission" class="ai-form-label">Admission Number:</label><input type="text" id="ai-form-admission" class="ai-form-input"></div><div class="ai-form-group"><label for="ai-form-name" class="ai-form-label">Name:</label><input type="text" id="ai-form-name" class="ai-form-input"></div><div class="ai-form-group"><label for="ai-form-email" class="ai-form-label">Email:</label><input type="email" id="ai-form-email" class="ai-form-input"></div><div class="ai-form-group"><label for="total_amount" class="ai-form-label">Total Amount:</label><input type="text" id="total_amount" class="ai-form-input"></div><button type="submit" class="ai-form-button">Submit Payment</button></form></div>