<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>Basileia International Membership Application</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">First Name</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter first name</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Last Name</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter last name</span> </div> </div> <!-- Button Drop Down --> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Title</label> <div class="col-md-4"> <div class="input-group"> <input id="textinput" name="textinput" class="form-control" placeholder="placeholder" type="text" required=""> <div class="input-group-btn"> <button type="button" class="btn btn-default dropdown-toggle" data-toggle="dropdown"> Action <span class="caret"></span> </button> <ul class="dropdown-menu pull-right"> <li><a href="#">Apostle</a></li> <li><a href="#">Prophet</a></li> <li><a href="#">Pastor</a></li> <li><a href="#">Teacher</a></li> <li><a href="#">Bishop</a></li> <li><a href="#">Dr.</a></li> <li><a href="#">Founder</a></li> </ul> </div> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinpu">Email</label> <div class="col-md-4"> <input id="textinpu" name="textinpu" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter your email address</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Name of Your Organization</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter name of your ministry, network, or church</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Address</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter street address</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">State</label> <div class="col-md-1"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">state</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">City</label> <div class="col-md-2"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter city</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Zip code</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md" required=""> <span class="help-block">enter zip code</span> </div> </div> <!-- Button Drop Down --> <div class="form-group"> <label class="col-md-4 control-label" for="buttondropdown">Does Your Ministry Have a Spiritual Covering?</label> <div class="col-md-4"> <div class="input-group"> <input id="buttondropdown" name="buttondropdown" class="form-control" placeholder="placeholder" type="text" required=""> <div class="input-group-btn"> <button type="button" class="btn btn-default dropdown-toggle" data-toggle="dropdown"> Action <span class="caret"></span> </button> <ul class="dropdown-menu pull-right"> <li><a href="#">Yes</a></li> <li><a href="#">Not at this time</a></li> </ul> </div> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">If yes, who</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md"> <span class="help-block">enter name of person or organization</span> </div> </div> </fieldset> </form>