<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/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 style="margin-left:auto; margin-right:auto; width:95%;"><br/> <div class="col-md-12"> <div class="row"> <div class="col-md-12"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Pre-Approval</h3> </div> <table class="table table-bordered"> <tr> <td class="col-xs-3">Name of Traveller(s)</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Department</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Job No / Q Number</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Description of Trip</td> <td><textarea class="form-control"></textarea></td> </tr> </table> </div> </div> </div> <div class="row"> <div class="col-md-6"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Flights - Departing Journey</h3> </div> <table class="table table-bordered"> <tr> <td class="col-xs-3">Departing From</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Destination</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Airline</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Flight Number</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Date</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Time</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Return Destination</td> <td><textarea class="form-control"></textarea></td> <td class="col-xs-3">Estimated Costs</td> <td><input class="form-control"></input></td> </tr> </table> </div> </div> <div class="col-md-6"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Flights - Returning Journey</h3> </div> <table class="table table-bordered"> <tr> <td class="col-xs-3">Departing From</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Destination</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Airline</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Flight Number</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Date</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Time</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Return Destination</td> <td><textarea class="form-control"></textarea></td> <td class="col-xs-3">Estimated Costs</td> <td><input class="form-control"></input></td> </tr> </table> </div> </div> </div> <div class="row"> <div class="col-md-6"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Accommodation</h3> </div> <table class="table table-bordered"> <tr> <td class="col-xs-3">Hotel Name (If Known)</td> <td><input class="form-control"></input></td> <td class="col-xs-3">No. of Rooms (Single/Double)</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">City/Town</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Country</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Arrival Date</td> <td><input class="form-control"></input></td> <td class="col-xs-3">No. of Nights</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Breakfast Required?</td> <td><textarea class="form-control"></textarea></td> <td class="col-xs-3">Estimated Costs</td> <td><input class="form-control"></input></td> </tr> </table> </div> </div> <div class="col-md-6"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Train/Underground Tickets</h3> </div> <table class="table table-bordered"> <tr> <td class="col-xs-3">Name of Traveller(s)</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Department</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Job No / Q Number</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Description of Trip</td> <td><textarea class="form-control"></textarea></td> </tr> </table> </div> </div> </div> <div class="row"> <div class="col-md-6"> <div class="panel panel-default"> <div class="panel-heading"> <h3 class="panel-title">Car Hire</h3> </div> <table class="table table-bordered"> <tr> <td class="col-xs-3">Company (if known)</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Car Type (if known)</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">City/Town</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Country</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Drop Off Location</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Date and Time</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Collection Location</td> <td><input class="form-control"></input></td> <td class="col-xs-3">Date and Time</td> <td><input class="form-control"></input></td> </tr> <tr> <td class="col-xs-3">Estimated Costs</td> <td colspan="3"><textarea class="form-control"></textarea></td> </tr> </table> </div> </div> <div class="col-md-6"><button type="submit" class="btn btn-success btn-lg">Submit Travel & Accommodation Request</button></div> </div> </div> </div>