<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 ----------> <div class="container"> <div class="row"> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Campaign</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="campaign_no">Campaign No.</label> <div class="col-md-4"> <label > 1111 </label> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="date_created">Date Created</label> <div class="col-md-4"> <input id="date_created" name="date_created" placeholder="Date Created" class="form-control input-md" type="text"> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="status">Status</label> <div class="col-md-4"> <label class="radio-inline" for="status-0"> <input name="status" id="status-0" value="1" checked="checked" type="radio"> Active </label> <label class="radio-inline" for="status-1"> <input name="status" id="status-1" value="0" type="radio"> Inactive </label> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="name">name</label> <div class="col-md-4"> <input id="name" name="name" placeholder="Campaign Name" class="form-control input-md" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Date Effective</label> <div class="col-md-4"> <input id="textinput" name="textinput" placeholder="" class="form-control input-md" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="date_expire">Date Expire</label> <div class="col-md-4"> <input id="date_expire" name="date_expire" placeholder="" class="form-control input-md" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="description">Description</label> <div class="col-md-4"> <input id="description" name="description" placeholder="Campaign Description" class="form-control input-md" type="text"> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="content">Content</label> <div class="col-md-4"> <textarea class="form-control" id="content" name="content"></textarea> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="remark">Remark</label> <div class="col-md-4"> <textarea class="form-control" id="remark" name="remark"></textarea> </div> </div> <!-- Multiple Checkboxes --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">Campign Repeat Frequency</label> <div class="col-md-4"> <div class="checkbox"> <label for="checkboxes-0"> <input name="checkboxes" id="checkboxes-0" value="1" type="checkbox"> Daily </label> </div> <div class="checkbox"> <label for="checkboxes-1"> <input name="checkboxes" id="checkboxes-1" value="2" type="checkbox"> Weekly </label> </div> <div class="checkbox"> <label for="checkboxes-2"> <input name="checkboxes" id="checkboxes-2" value="3" type="checkbox"> Monthly </label> </div> <div class="checkbox"> <label for="checkboxes-3"> <input name="checkboxes" id="checkboxes-3" value="4" type="checkbox"> Yearly </label> </div> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="include email">Include Subject of Email</label> <div class="col-md-4"> <label class="checkbox-inline" for="include email-0"> <input name="include email" id="include email-0" value="1" type="checkbox"> yes </label> <label class="checkbox-inline" for="include email-1"> <input name="include email" id="include email-1" value="0" type="checkbox"> no </label> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">Include Opt-Out Message</label> <div class="col-md-4"> <label class="checkbox-inline" for="checkboxes-0"> <input name="checkboxes" id="checkboxes-0" value="1" type="checkbox"> yes </label> <label class="checkbox-inline" for="checkboxes-1"> <input name="checkboxes" id="checkboxes-1" value="0" type="checkbox"> no </label> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="method send">Method to Send</label> <div class="col-md-4"> <label class="radio-inline" for="method send-0"> <input name="method send" id="method send-0" value="1" checked="checked" type="radio"> SMS </label> <label class="radio-inline" for="method send-1"> <input name="method send" id="method send-1" value="0" type="radio"> Phone </label> <label class="radio-inline" for="method send-2"> <input name="method send" id="method send-2" value="2" type="radio"> Fax </label> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">Check DNC</label> <div class="col-md-4"> <label class="checkbox-inline" for="checkboxes-0"> <input name="checkboxes" id="checkboxes-0" value="1" type="checkbox"> yes </label> <label class="checkbox-inline" for="checkboxes-1"> <input name="checkboxes" id="checkboxes-1" value="0" type="checkbox"> no </label> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">Send Date of Birth Greetings </label> <div class="col-md-4"> <label class="checkbox-inline" for="checkboxes-0"> <input name="checkboxes" id="checkboxes-0" value="1" type="checkbox"> yes </label> <label class="checkbox-inline" for="checkboxes-1"> <input name="checkboxes" id="checkboxes-1" value="0" type="checkbox"> no </label> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="campaign_anniversary_ind">Send Anniversary Greetings </label> <div class="col-md-4"> <label class="checkbox-inline" for="campaign_anniversary_ind-0"> <input name="campaign_anniversary_ind" id="campaign_anniversary_ind-0" value="1" type="checkbox"> yes </label> <label class="checkbox-inline" for="campaign_anniversary_ind-1"> <input name="campaign_anniversary_ind" id="campaign_anniversary_ind-1" value="0" type="checkbox"> no </label> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="campaign_check_before_send_ind">Seek your Confirmation before sending </label> <div class="col-md-4"> <label class="checkbox-inline" for="campaign_check_before_send_ind-0"> <input name="campaign_check_before_send_ind" id="campaign_check_before_send_ind-0" value="1" type="checkbox"> yes </label> <label class="checkbox-inline" for="campaign_check_before_send_ind-1"> <input name="campaign_check_before_send_ind" id="campaign_check_before_send_ind-1" value="0" type="checkbox"> no </label> </div> </div> <!-- Button --> <div class="form-group"> <div class="col-md-4"> <button id="singlebutton" name="singlebutton" class="btn btn-primary">Create</button> <button id="singlebutton" name="singlebutton" class="btn btn-primary">Edit</button> <button id="singlebutton" name="singlebutton" class="btn btn-primary">Delete</button> </div> </div> </fieldset> </form> </div> </div>