"Formulario de Solicitudes"
Bootstrap 3.0.0 Snippet by pedroluisonline

<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/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>Formulario de Solicitud</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="cedula">Cédula</label> <div class="col-md-4"> <input id="cedula" name="cedula" type="text" placeholder="Solicitante" class="form-control input-md"> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="sistema">Sistema</label> <div class="col-md-4"> <select id="sistema" name="sistema" class="form-control"> <option value="1">Option one</option> <option value="2">Option two</option> </select> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="descripcion">Descripción de la Solicitud</label> <div class="col-md-4"> <textarea class="form-control" id="descripcion" name="descripcion"></textarea> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="dpto">Departamento</label> <div class="col-md-4"> <select id="dpto" name="dpto" class="form-control"> <option value="1">Option one</option> <option value="2">Option two</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="extension">Extensión</label> <div class="col-md-4"> <input id="extension" name="extension" type="text" placeholder="Teléfono de su Oficina" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="usbid">USBID</label> <div class="col-md-4"> <input id="usbid" name="usbid" type="text" placeholder="email@usb.ve" class="form-control input-md"> </div> </div> <!-- Button (Double) --> <div class="form-group"> <label class="col-md-4 control-label" for="enviar">Enviar</label> <div class="col-md-8"> <button id="enviar" name="enviar" class="btn btn-primary">Enviar</button> <button id="borrar" name="borrar" class="btn btn-default">Borrar</button> </div> </div> </fieldset> </form> </div> </div>

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