<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>
<form class="form-horizontal">
<fieldset>
<legend>Contribution Category</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="txtContributionCategory">Contribution Category</label>
<div class="col-md-4">
<input id="txtContributionCategory" name="txtContributionCategory" type="text" placeholder="" class="form-control input-md" required="">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="txtDisplaySequence">DisplaySequence</label>
<div class="col-md-1">
<input id="txtDisplaySequence" name="txtDisplaySequence" type="text" placeholder="" class="form-control input-md" required="">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="rdoCAUsage">CA Usage</label>
<div class="col-md-4">
<label class="radio-inline" for="rdoCAUsage-0">
<input type="radio" name="rdoCAUsage" id="rdoCAUsage-0" value="Apply" checked="checked">
Apply
</label>