<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>
<form class="form-horizontal">
<fieldset>
<legend>Leave Request Form - Bevat Employees</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="selectbasic">Company Name</label>
<div class="col-md-4">
<select id="selectbasic" name="selectbasic" class="form-control">
<option value="1">Bevat</option>
<option value="2">ABS</option>
</select>
</div>
</div>
<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" type="text" placeholder="" class="form-control input-md">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="Totalleaverequired">Total leave required</label>
<div class="col-md-4">
<input id="Totalleaverequired" name="Totalleaverequired" type="text" placeholder="" class="form-control input-md" required="">
