<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>Form Print Dialog</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="textinput">Document</label>
<div class="col-md-4">
<input id="textinput" name="textinput" type="text" placeholder="Quotation" class="form-control input-md">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="checkboxes">Send email to contact</label>
<div class="col-md-4">
<input type="checkbox" name="checkboxes" id="checkboxes-0" value="1">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="selectbasic">Contact</label>
<div class="col-md-4">
<select id="selectbasic" name="selectbasic" class="form-control">
<option value="1">Stephen Curry</option>
<option value="2">Jeremy Lin</option>