"Signup-form"
Bootstrap 3.3.0 Snippet by praveenui

<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 ----------> <div class="container"> <div class="row"> <div class="col-xs-12 col-sm-8 col-md-6 col-sm-offset-2 col-md-offset-3"> <form role="form"> <h2 class="text-center">Sign Up</h2> <div class="row"> <div class="col-xs-12 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="first_name" id="first_name" class="form-control input-lg" placeholder="First Name" tabindex="1"> </div> </div> <div class="col-xs-12 col-sm-6 col-md-6"> <div class="form-group"> <input type="text" name="last_name" id="last_name" class="form-control input-lg" placeholder="Last Name" tabindex="2"> </div> </div> </div> <div class="form-group"> <input type="text" name="display_name" id="display_name" class="form-control input-lg" placeholder="Mobile No." tabindex="3"> </div> <div class="form-group"> <input type="email" name="email" id="email" class="form-control input-lg" placeholder="Email Address" tabindex="4"> </div> <div class="row"> <div class="col-xs-12 col-sm-6 col-md-6"> <div class="form-group"> <input type="password" name="password" id="password" class="form-control input-lg" placeholder="Password" tabindex="5"> </div> </div> <div class="col-xs-12 col-sm-6 col-md-6"> <div class="form-group"> <input type="password" name="password_confirmation" id="password_confirmation" class="form-control input-lg" placeholder="Confirm Password" tabindex="6"> </div> </div> </div> <div class="row"> <div class="col-xs-4 col-sm-3 col-md-3"> <span class="button-checkbox"> <label class="checkbox"><input type="checkbox" class="btn btn-primary" data-dismiss="modal">I Agree</label> </span> </div> <div class="col-xs-8 col-sm-9 col-md-9"> By clicking <strong class="label label-primary">Register</strong>, you agree to the <a href="#" data-toggle="modal" data-target="#t_and_c_m">Terms and Conditions</a> set out by this site, including our Cookie Use. </div> </div> <div class="row"> <div class="col-xs-12 col-md-6"><input type="submit" value="Register" class="btn btn-primary btn-block btn-lg" tabindex="7"></div> <div class="col-xs-12 col-md-6"><a href="#" class="btn btn-success btn-block btn-lg">Sign In</a></div> </div> </form> </div> </div> <!-- Modal --> <div class="modal fade" id="t_and_c_m" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true"> <div class="modal-dialog modal-lg"> <div class="modal-content"> <div class="modal-header"> <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button> <h4 class="modal-title" id="myModalLabel">Terms & Conditions</h4> </div> <div class="modal-body"> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Similique, itaque, modi, aliquam nostrum at sapiente consequuntur natus odio reiciendis perferendis rem nisi tempore possimus ipsa porro delectus quidem dolorem ad.</p> </div> <div class="modal-footer"> <label class="check-box"></label><input type="checkbox" class="btn btn-primary" data-dismiss="modal">I Agree</label> </div> </div><!-- /.modal-content --> </div><!-- /.modal-dialog --> </div><!-- /.modal --> </div>

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