<link href="//netdna.bootstrapcdn.com/bootstrap/3.2.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.2.0/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"> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Request Details</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="requestName">Your Name</label> <div class="col-md-4"> <input id="requestName" name="requestName" placeholder="Name" class="form-control input-md" required="" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="company_name">Company Name (To Analyze)</label> <div class="col-md-5"> <input id="company_name" name="company_name" placeholder="Company Name" class="form-control input-md" required="" type="text"> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="declineType">Decline Type</label> <div class="col-md-6"> <select id="declineType" name="declineType" class="form-control"> <option value="Exponential">Exponential (Conventional)</option> <option value="Hyperbolic">Hyperbolic (Unconventional)</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="minB">B Factor Range</label> <div class="col-md-2"> <input id="minB" name="minB" placeholder="min" class="form-control input-md" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="maxB"></label> <div class="col-md-2"> <input id="maxB" name="maxB" placeholder="max" class="form-control input-md" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="econLimOil">Economic Limits Oil (STB/D)</label> <div class="col-md-5"> <input id="econLimOil" name="econLimOil" placeholder="company specific range" class="form-control input-md" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="econLimGas">Economic Limits Gas (SCF/D)</label> <div class="col-md-4"> <input id="econLimGas" name="econLimGas" placeholder="company specific range" class="form-control input-md" type="text"> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="comments">Comments</label> <div class="col-md-4"> <textarea class="form-control" id="comments" name="comments"></textarea> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="deadline">Expected Deadline</label> <div class="col-md-4"> <input id="deadline" name="deadline" placeholder="date" class="form-control input-md" type="text"> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="uregency">Urgency</label> <div class="col-md-4"> <select id="uregency" name="uregency" class="form-control"> <option value="NormalLevel">Normal Level</option> <option value="Urgent">Urgent</option> <option value="VeryUrgent">Very Urgent</option> </select> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="submit"></label> <div class="col-md-4"> <button id="submit" name="submit" class="btn btn-default">Submit</button> </div> </div> </fieldset> </form> </div> </div>