<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>
<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">Estimate a Job <small>It's easy!</small></h3>
</div>
<div class="panel-body">
<form role="form">
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<input class="form-control" type="text" name="PIN" placeholder="Employee PIN" />
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<label class="form-control" for="club_member">Club Member? <input type="checkbox" name="club_member" /></label>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-4">
<div class="form-group">
<label class="btn btn-primary" for="type1">Delivery·<input type="radio" name="type" id="type1" value="delivery"></label>
</div>
</div>
<div class="col-xs-12 col-sm-4">
<div class="form-group">
<label class="btn btn-primary" for="type2">Pickup·<input type="radio" name="type" id="type2" value="pickup"></label>
</div>
