"HedgeMark Registration"
Bootstrap 3.2.0 Snippet by gumatt

<link href="//netdna.bootstrapcdn.com/bootstrap/3.2.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.2.0/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"> <form class="form-horizontal" role="form"> <h2>Registration Form</h2> <div class="form-group"> <label for="company" class="col-sm-3 control-label">Company Name</label> <div class="col-sm-9"> <input type="text" id="company" placeholder="Full Name" class="form-control" autofocus> </div> </div> <div class="form-group"> <label for="firstName" class="col-sm-3 control-label">Full Name</label> <div class="col-sm-9"> <input type="text" id="firstName" placeholder="Full Name" class="form-control" autofocus> <span class="help-block">Last Name, First Name, eg.: Smith, Harry</span> </div> </div> <div class="form-group"> <label for="email" class="col-sm-3 control-label">Email</label> <div class="col-sm-9"> <input type="email" id="email" placeholder="Email" class="form-control"> </div> </div> <div class="form-group"> <label for="password" class="col-sm-3 control-label">Password</label> <div class="col-sm-9"> <input type="password" id="password" placeholder="Password" class="form-control"> </div> </div> <hr /> <div class="form-group"> <label for="company" class="col-sm-3 control-label">Company Name</label> <div class="col-sm-9"> <input type="text" id="company" placeholder="Full Name" class="form-control" autofocus> </div> </div> <div class="form-group"> <label for="program" class="col-sm-3 control-label">Hedge Program Name</label> <div class="col-sm-9"> <input type="text" id="program" class="form-control"> <span class="help-block">Specify first hedge program (more can be added later)</span> </div> </div> <div class="form-group"> <label for="productClass" class="col-sm-3 control-label">Hedge Contracts Used</label> <div class="col-sm-9"> <select id="productClass" class="form-control"> <option>Crude</option> <option>Diesel</option> <option>Gasoline</option> <option>Natural Gas</option> <option>Propane</option> </select> </div> </div> <!-- /.form-group --> <div class="form-group"> <label for="hedgeAccount" class="col-sm-3 control-label">Hedge Account Name</label> <div class="col-sm-9"> <input type="text" id="hedgeAccount" class="form-control"> <span class="help-block">Specify first hedge account (more can be added later)</span> </div> </div> <div class="form-group"> <div class="col-sm-9 col-sm-offset-3"> <div class="checkbox"> <label> <input type="checkbox">I accept <a href="#">terms</a> </label> </div> </div> </div> <!-- /.form-group --> <div class="form-group"> <div class="col-sm-9 col-sm-offset-3"> <button type="submit" class="btn btn-primary btn-block">Register</button> </div> </div> </form> <!-- /form --> </div> <!-- ./container -->
body { background-color: #eee; } *[role="form"] { max-width: 530px; padding: 15px; margin: 0 auto; background-color: #fff; border-radius: 0.3em; } *[role="form"] h2 { margin-left: 5em; margin-bottom: 1em; }

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