<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"> <form class="form-horizontal"> <div class="row"> <div class="form-group col-xs-12 col-sm-6"> <label for="inputEmail3" class="col-sm-4 control-label">NFA/IC/EC/MSD</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> <div class="form-group col-xs-12 col-sm-6"> <div class="row"> <label for="inputPassword3" class="col-sm-4 control-label">Heating Oil</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> </div> </div> <div class="row"> <div class="form-group col-xs-12 col-sm-6"> <label for="inputEmail3" class="col-sm-4 control-label">Industrial Operations</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"></div> </div> <div class="form-group col-xs-12 col-sm-6"> <div class="row"> <label for="inputPassword3" class="col-sm-4 control-label">Fill Material</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> </div> </div> <div class="row"> <div class="form-group col-xs-12 col-sm-6"> <label for="inputEmail3" class="col-sm-4 control-label">If yes</label> <div class="col-sm-6"> <div class="checkbox"> <label> <input type="checkbox" value=""> Current </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Former </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Neighboring properties </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> <input type="text" class="form-control" placeholder="Other"> </label> </div> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> <div class="form-group col-xs-12 col-sm-6"> <div class="row"> <label for="inputPassword3" class="col-sm-4 control-label">Surface water/wetlands</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> </div> </div> <div class="row"> <div class="form-group col-xs-12 col-sm-6"> <label for="inputEmail3" class="col-sm-4 control-label">Staining</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> <div class="form-group col-xs-12 col-sm-6"> <div class="row"> <label for="inputPassword3" class="col-sm-4 control-label">Suspect ACMs</label> <div class="col-sm-6"> <select class="form-control"> <option value="" disabled selected>Select one...</option> <option>Yes</option> <option>No</option> <option>N/A</option> </select> </div> <div class="col-sm-2"> <div class="checkbox"> <label> <input type="checkbox" value=""> Action </label> </div> </div> </div> </div> </div> </form> </div>