<link href="//netdna.bootstrapcdn.com/bootstrap/3.1.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.1.0/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"> <div class="row centered-form"> <div class="col-xs-12 col-sm-8 col-md-4 col-sm-offset-2 col-md-offset-4"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Please sign up for your Conversation <small>It's free!</small></h3> </div> <div class="panel-body"> <form role="form"> <div class="row"> <div class="col-xs-6 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="username" id="username" class="form-control input-sm" placeholder="Your Full Name" required> </div> </div> <div class="col-xs-6 col-sm-6 col-md-6"> <div class="form-group"> <input type="email" name="email" id="email" class="form-control input-sm" placeholder="Email Address" required> </div> </div> </div> <div class="row"> <div class="col-xs-6 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="city" id="city" class="form-control input-sm" placeholder="Your City" required> </div> </div> <div class="col-xs-6 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="qualification" id="qualification" class="form-control input-sm" placeholder="Minimum Qualification"> </div> </div> </div> <div class="form-group"> <span class="label label-info">Rate your Experience with eMitra (1 Poor to 5 Excellent)</span> </div> <div class="form-group"> <input name="radioGroup" id="radio1" value="1" type="radio" checked required title="Poor"/> 1 <i class="glyphicon glyphicon-star"></i> <input name="radioGroup" id="radio2" value="2" type="radio" required title="Average"/> 2 <i class="glyphicon glyphicon-star"></i> <input name="radioGroup" id="radio3" value="3" type="radio" required title="Good"/> 3 <i class="glyphicon glyphicon-star"></i> <input name="radioGroup" id="radio4" value="4" type="radio" required title="Very Good"/> 4 <i class="glyphicon glyphicon-star"></i> <input name="radioGroup" id="radio5" value="5" type="radio" required title="Excellent"/> 5 <i class="glyphicon glyphicon-star"></i> </div> <input type="submit" value="Submit" class="btn btn-info btn-block"> </form> </div> </div> </div> </div> </div>

body{ background-color: #525252; } .centered-form{ margin-top: 60px; } .centered-form .panel{ background: rgba(255, 255, 255, 0.8); box-shadow: rgba(0, 0, 0, 0.3) 20px 20px 20px; }