"Email attach Fax"
Bootstrap 3.3.0 Snippet by hectorblanco95

<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"> <div class="col-sm-12 col-lg-12"> <h1 class="h1">Send a Fax <small>Test</small></h1> </div> </div> </div> <div class="container"> <div class="row"> <div class="col-md-8"> <div class="well well-sm"> <form id="FormEnvioCorreo"> <div class="row"> <div class="col-md-8"> <div class="form-group"> <label for="email"> Number Fax</label> <div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-envelope"></span> </span> <input type="email" id="email" name="email" class="form-control" placeholder="Enter number fax" required="required" value="1234567891012"> </div> <div class="form-group"> <label for="subject"> Subject</label> <input type="text" id="subject" name="subject" class="form-control" placeholder="Subject" required="required" value="Prueba"> </div> <div class="form-group"> <label for="name"> Attach</label> <input type="file" id="fileselect" name="documents" class="form-control" style=" width: 310px;"> </div> </div> </div> <div class="col-md-4"> <div class="form-group"> <label for="name"> Message</label> <textarea name="message" id="message" class="form-control" rows="9" cols="25" required="required" placeholder="Message">Prueba</textarea> </div> </div> <div class="col-md-12"> <div class="control-group"> <label class="control-label" for="button1id"></label> <div class="controls"> <button id="button1id" name="button1id" class="btn btn-success">Send</button> <button id="button2id" name="button2id" class="btn btn-danger">Clear</button> </div> </div> </div> </div> </form> </div> </div> <div class="col-md-4"> </div> </div> </div>

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