"Mix & Match Register"
Bootstrap 3.0.3 Snippet by javajack

<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.3/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.0.3/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-xs-12 col-sm-8 col-md-6 col-sm-offset-2 col-md-offset-3"> <form role="form"> <h2>Canvass Sign Up</h2> <hr/> <div class="row"> <div class="col-xs-6 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="first_name" id="first_name" class="form-control input-lg" placeholder="First Name" tabindex="1"> </div> </div> <div class="col-xs-6 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="last_name" id="last_name" class="form-control input-lg" placeholder="Last Name" tabindex="2"> </div> </div> </div> <div class="form-group"> <input type="text" name="phone_number" id="phone_number" class="form-control input-lg" placeholder="Phone Number" tabindex="3"> </div> <div class="form-group"> <input type="email" name="email" id="email" class="form-control input-lg" placeholder="Email Address" tabindex="4"> </div> <hr/> <div class="row"> <div class="col-xs-6 col-md-6"><input type="submit" value="Register" class="btn btn-primary btn-block btn-lg" tabindex="7"></div> </div> </form> </div> </div> </div>

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