"Leave Request Form - Bevat Employees"
Bootstrap 3.0.0 Snippet by cresignsys

<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 ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Leave Request Form - Bevat Employees</legend> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">Company Name</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">Bevat</option> <option value="2">ABS</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Name">Name</label> <div class="col-md-4"> <input id="Name" name="Name" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Totalleaverequired">Total leave required</label> <div class="col-md-4"> <input id="Totalleaverequired" name="Totalleaverequired" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Pleaseselectthetypeofleave.">Please select the type of leave.</label> <div class="col-md-4"> <select id="Pleaseselectthetypeofleave." name="Pleaseselectthetypeofleave." class="form-control"> <option value="1">Sick Leave (Illness or Injury)</option> <option value="2">Personal Leave</option> <option value="3">Emergency Leave</option> <option value="4">Leave without pay</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Leaverequiredfrom">Leave required from (Date)</label> <div class="col-md-4"> <input id="Leaverequiredfrom" name="Leaverequiredfrom" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Fulldayorhalfday">Full day or half day</label> <div class="col-md-4"> <select id="Fulldayorhalfday" name="Fulldayorhalfday" class="form-control"> <option value="1">Morning</option> <option value="2">Afternoon</option> <option value="3">Full Day</option> </select> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="ReasonforLeave">Reason for Leave</label> <div class="col-md-4"> <textarea class="form-control" id="ReasonforLeave" name="ReasonforLeave"></textarea> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="submit"></label> <div class="col-md-4"> <button id="submit" name="submit" class="btn btn-primary">Submit</button> </div> </div> </fieldset> </form>

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