"cotizacion"
Bootstrap 3.3.0 Snippet by JeanCarlosChavarriaHughes

<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 ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Cotización</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput_monto">Préstamo</label> <div class="col-md-4"> <input id="textinput_monto" name="textinput_monto" type="text" placeholder="Ingrese el monto a pedir" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput_cuota">Cuota</label> <div class="col-md-4"> <input id="textinput_cuota" name="textinput_cuota" type="text" placeholder="Ingrese el monto de cuota mensual" class="form-control input-md" required=""> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="button_contactAgent"></label> <div class="col-md-4"> <button id="button_contactAgent" name="button_contactAgent" class="btn btn-primary">Contactar Agente</button> </div> </div> </fieldset> </form>

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