<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Form Name</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="destination">Destination</label> <div class="col-md-4"> <input id="destination" name="destination" type="text" placeholder="" class="form-control input-md" required=""> <span class="help-block">The destination of your travel</span> </div> </div> <!-- Multiple Radios --> <div class="form-group"> <label class="col-md-4 control-label" for="reason">What was the purpose of your trip?</label> <div class="col-md-4"> <div class="radio"> <label for="reason-0"> <input type="radio" name="reason" id="reason-0" value="Culture" checked="checked"> Culture </label> </div> <div class="radio"> <label for="reason-1"> <input type="radio" name="reason" id="reason-1" value="Business"> Business </label> </div> <div class="radio"> <label for="reason-2"> <input type="radio" name="reason" id="reason-2" value="Leisure"> Leisure </label> </div> <div class="radio"> <label for="reason-3"> <input type="radio" name="reason" id="reason-3" value="Others"> Others </label> </div> </div> </div> <!-- Multiple Radios --> <div class="form-group"> <label class="col-md-4 control-label" for="travel_type">Mainly which type of passengers did the travel group consist of?</label> <div class="col-md-4"> <div class="radio"> <label for="travel_type-0"> <input type="radio" name="travel_type" id="travel_type-0" value="Seniors" checked="checked"> Seniors </label> </div> <div class="radio"> <label for="travel_type-1"> <input type="radio" name="travel_type" id="travel_type-1" value="Adults"> Adults </label> </div> <div class="radio"> <label for="travel_type-2"> <input type="radio" name="travel_type" id="travel_type-2" value="Young"> Young people </label> </div> <div class="radio"> <label for="travel_type-3"> <input type="radio" name="travel_type" id="travel_type-3" value="Business"> Business people </label> </div> <div class="radio"> <label for="travel_type-4"> <input type="radio" name="travel_type" id="travel_type-4" value="Students"> Students / Scholars </label> </div> </div> </div> <!-- Multiple Radios --> <div class="form-group"> <label class="col-md-4 control-label" for="service">Did you buy any additional products or services that we recommended?</label> <div class="col-md-4"> <div class="radio"> <label for="service-0"> <input type="radio" name="service" id="service-0" value="no" checked="checked"> No </label> </div> <div class="radio"> <label for="service-1"> <input type="radio" name="service" id="service-1" value="yes"> Yes </label> </div> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="service_why">Why ?</label> <div class="col-md-4"> <textarea class="form-control" id="service_why" name="service_why"></textarea> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="satisfaction_team">How satisfied are you with the services of SNCB Europe Group Travel Department ?</label> <div class="col-md-4"> <label class="radio-inline" for="satisfaction_team-0"> <input type="radio" name="satisfaction_team" id="satisfaction_team-0" value="1" checked="checked"> 1 </label> <label class="radio-inline" for="satisfaction_team-1"> <input type="radio" name="satisfaction_team" id="satisfaction_team-1" value="2"> 2 </label> <label class="radio-inline" for="satisfaction_team-2"> <input type="radio" name="satisfaction_team" id="satisfaction_team-2" value="3"> 3 </label> <label class="radio-inline" for="satisfaction_team-3"> <input type="radio" name="satisfaction_team" id="satisfaction_team-3" value="4"> 4 </label> <label class="radio-inline" for="satisfaction_team-4"> <input type="radio" name="satisfaction_team" id="satisfaction_team-4" value="5"> 5 </label> <label class="radio-inline" for="satisfaction_team-5"> <input type="radio" name="satisfaction_team" id="satisfaction_team-5" value="6"> 6 </label> <label class="radio-inline" for="satisfaction_team-6"> <input type="radio" name="satisfaction_team" id="satisfaction_team-6" value="7"> 7 </label> <label class="radio-inline" for="satisfaction_team-7"> <input type="radio" name="satisfaction_team" id="satisfaction_team-7" value="8"> 8 </label> <label class="radio-inline" for="satisfaction_team-8"> <input type="radio" name="satisfaction_team" id="satisfaction_team-8" value="9"> 9 </label> <label class="radio-inline" for="satisfaction_team-9"> <input type="radio" name="satisfaction_team" id="satisfaction_team-9" value="10"> 10 </label> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="satisfaction_service">What do you think of the additional services offered (insurance, public transport etc.)?</label> <div class="col-md-4"> <label class="radio-inline" for="satisfaction_service-0"> <input type="radio" name="satisfaction_service" id="satisfaction_service-0" value="1" checked="checked"> 1 </label> <label class="radio-inline" for="satisfaction_service-1"> <input type="radio" name="satisfaction_service" id="satisfaction_service-1" value="2"> 2 </label> <label class="radio-inline" for="satisfaction_service-2"> <input type="radio" name="satisfaction_service" id="satisfaction_service-2" value="3"> 3 </label> <label class="radio-inline" for="satisfaction_service-3"> <input type="radio" name="satisfaction_service" id="satisfaction_service-3" value="4"> 4 </label> <label class="radio-inline" for="satisfaction_service-4"> <input type="radio" name="satisfaction_service" id="satisfaction_service-4" value="5"> 5 </label> <label class="radio-inline" for="satisfaction_service-5"> <input type="radio" name="satisfaction_service" id="satisfaction_service-5" value="6"> 6 </label> <label class="radio-inline" for="satisfaction_service-6"> <input type="radio" name="satisfaction_service" id="satisfaction_service-6" value="7"> 7 </label> <label class="radio-inline" for="satisfaction_service-7"> <input type="radio" name="satisfaction_service" id="satisfaction_service-7" value="8"> 8 </label> <label class="radio-inline" for="satisfaction_service-8"> <input type="radio" name="satisfaction_service" id="satisfaction_service-8" value="9"> 9 </label> <label class="radio-inline" for="satisfaction_service-9"> <input type="radio" name="satisfaction_service" id="satisfaction_service-9" value="10"> 10 </label> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="satisfaction_speed">How did you find the speed of response to your request for information?</label> <div class="col-md-4"> <label class="radio-inline" for="satisfaction_speed-0"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-0" value="1" checked="checked"> 1 </label> <label class="radio-inline" for="satisfaction_speed-1"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-1" value="2"> 2 </label> <label class="radio-inline" for="satisfaction_speed-2"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-2" value="3"> 3 </label> <label class="radio-inline" for="satisfaction_speed-3"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-3" value="4"> 4 </label> <label class="radio-inline" for="satisfaction_speed-4"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-4" value="5"> 5 </label> <label class="radio-inline" for="satisfaction_speed-5"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-5" value="6"> 6 </label> <label class="radio-inline" for="satisfaction_speed-6"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-6" value="7"> 7 </label> <label class="radio-inline" for="satisfaction_speed-7"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-7" value="8"> 8 </label> <label class="radio-inline" for="satisfaction_speed-8"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-8" value="9"> 9 </label> <label class="radio-inline" for="satisfaction_speed-9"> <input type="radio" name="satisfaction_speed" id="satisfaction_speed-9" value="10"> 10 </label> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="satisfaction_quotation">How far did the quotations meet your needs for detail and clarify?</label> <div class="col-md-4"> <label class="radio-inline" for="satisfaction_quotation-0"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-0" value="1" checked="checked"> 1 </label> <label class="radio-inline" for="satisfaction_quotation-1"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-1" value="2"> 2 </label> <label class="radio-inline" for="satisfaction_quotation-2"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-2" value="3"> 3 </label> <label class="radio-inline" for="satisfaction_quotation-3"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-3" value="4"> 4 </label> <label class="radio-inline" for="satisfaction_quotation-4"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-4" value="5"> 5 </label> <label class="radio-inline" for="satisfaction_quotation-5"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-5" value="6"> 6 </label> <label class="radio-inline" for="satisfaction_quotation-6"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-6" value="7"> 7 </label> <label class="radio-inline" for="satisfaction_quotation-7"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-7" value="8"> 8 </label> <label class="radio-inline" for="satisfaction_quotation-8"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-8" value="9"> 9 </label> <label class="radio-inline" for="satisfaction_quotation-9"> <input type="radio" name="satisfaction_quotation" id="satisfaction_quotation-9" value="10"> 10 </label> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="suggest">Further feedback</label> <div class="col-md-4"> <textarea class="form-control" id="suggest" name="suggest"></textarea> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="validation"></label> <div class="col-md-4"> <button id="validation" name="validation" class="btn btn-info">Submit your responses</button> </div> </div> </fieldset> </form>