<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 ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Service Request Form</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="name">Contact Name</label> <div class="col-md-4"> <input id="name" name="name" 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="contact#">Contact Phone</label> <div class="col-md-4"> <input id="contact#" name="contact#" placeholder="(xxx) xxx-xxxx" class="form-control input-md" required="" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="e-mail">E-mail</label> <div class="col-md-4"> <input id="e-mail" name="e-mail" placeholder="ex: you@emailaddress.com" class="form-control input-md" required="" type="text"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="city">City</label> <div class="col-md-4"> <input id="city" name="city" placeholder="city of residence / company" class="form-control input-md" required="" type="text"> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">Select Service</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="Logo Design">Logo Design</option> <option value="Website Design">Website Design</option> <option value="Business Card Design">Business Card Design</option> <option value="SEO Service">SEO Service</option> <option value="*Other">*Other</option> </select> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea">Additional Info</label> <div class="col-md-4"> <textarea class="form-control" id="textarea" name="textarea"></textarea> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="submit">Submit</label> <div class="col-md-4"> <button id="submit" name="submit" class="btn btn-success">Submit</button> </div> </div> </fieldset> </form>

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