"Social Security Number Form"
Bootstrap 3.3.0 Snippet by uxengineer

<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="my-container"> <h1 class="h1-header">Bootstrap Social Security Number Inline Form</h1> <div id="1stQuestion" class="social-security-question"> <!--INSERT THE SSN QUESTION HERE--> <span class="header">Please enter the account's Social Security number:</span> </div> <div class="center-text"> <input type="text" id="SSNArea" class="form-control input-group" maxlength="3" placeholder="XXX" required /><span class="color-gray padding-left-and-right-five-px">-</span> <input type="text" id="SSNGroup" class="form-control input-group" maxlength="2" placeholder="XX" required /><span class="color-gray padding-left-and-right-five-px">-</span> <input type="text" id="SSNSerial" class="form-control input-group" maxlength="4" placeholder="XXX" required /> </div> </div>
.my-container { width: 500px; margin-left: auto; margin-right: auto; border: none; } .h1-header { font-family: 'Segoe UI'; font-size: 1.650em; color: #777777; font-weight: normal; padding: 0px 15px 10px 15px; text-align: center; } .header { font-family: 'Segoe UI'; font-size: 1.125em; color: #777777; font-weight: normal; padding: 0px 15px; text-align: center; border: none; } .color-gray { color: #7a7a7a; } .padding-left-and-right-five-px { padding-left: 5px; padding-right: 5px; } .social-security-question { font-family: 'Segoe UI'; font-size: 1.286em !important; color: #777777; font-weight: normal; padding: 0px 5px; text-align: center; } .center-text { text-align: center; } #SSNArea { font-weight: normal; font-family: 'Segoe UI'; font-size: 20px; text-align: center; width: 130px; min-width: 85px; display: inline; } #SSNGroup { font-weight: normal; font-family: 'Segoe UI'; font-size: 20px; text-align: center; width: 125px; min-width: 65px; display: inline; } #SSNSerial { font-weight: normal; font-family: 'Segoe UI'; font-size: 20px; text-align: center; width: 130px; min-width: 85px; display: inline; } @media (max-width:767px) { #SSNArea { font-weight: normal; font-family: 'Segoe UI'; font-size: 20px; text-align: center; width: 75px; display: inline; } #SSNGroup { font-weight: normal; font-family: 'Segoe UI'; font-size: 20px; text-align: center; width: 65px; display: inline; } #SSNSerial { font-weight: normal; font-family: 'Segoe UI'; font-size: 20px; text-align: center; width: 75px; display: inline; } .social-security-question { font-family: 'Segoe UI'; font-size: 1.125em !important; color: #777777; font-weight: normal; padding: 0px 5px; text-align: center; } }

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