<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 ----------> <link href="https://maxcdn.bootstrapcdn.com/font-awesome/4.7.0/css/font-awesome.min.css" rel="stylesheet"> <div class="container" > <div class="row" style="background-color: #ededed; "> <div class="col-md-12"> <img src='https://s3.amazonaws.com/portfolio-eduluz1976/logo_blake.png'> <div class="pull-right"> <a class="btn btn-default btn-success fa-2x">Next step <i class="fa fa-arrow-circle-right"></i></a> </div> </div> </div> <div class="row"> <div class="col-md-3 col-applicant" > <legend>Primary applicant</legend> <div> <img src="https://s3-sa-east-1.amazonaws.com/resources-projetos/icons/avatar/businessman.png" class="img-circle" style="width:128px; height:128px; "> <br> <a class="btn btn-default btn-gray"> <i class="fa fa-cloud-upload"></i> Change</a> </div> <div> <form class="form-vertical"> <fieldset> <div class="form-group"> <label class="control-label col-md-12" for="textinput ">First name</label> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-sm col-md-12" value="John"> <label class="control-label col-md-12" for="textinput ">Last name</label> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-sm col-md-12" value="Doe"> <label class="control-label col-md-12" for="appendedtext">Nationality</label> <div class="input-group col-md-12"> <input id="appendedtext" name="appendedtext" class="form-control" value="England" type="text"> <span class="input-group-addon"> <i class="fa fa-search"></i> </span> </div> <label class="control-label col-md-12" for="textinput ">Birthday (mm/dd/yyyy)</label> <div class="input-group col-md-12"> <input id="textinput" name="textinput" type="text" class="form-control input-sm " value="01/15/1972"> </div> </div> </fieldset> </form> </div> </div> <div class="col-md-3 col-applicant" > <legend>Spouse</legend> <img src="https://s3-sa-east-1.amazonaws.com/resources-projetos/icons/avatar/woman-10.png" class="img-circle" style="width:128px; height:128px"> <br> <a class="btn btn-default btn-gray"> <i class="fa fa-cloud-upload"></i> Upload</a> <form class="form-vertical"> <fieldset> <div class="form-group"> <label class="control-label col-md-12" for="textinput ">First name</label> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-sm col-md-12" value="April"> <label class="control-label col-md-12" for="textinput ">Last name</label> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-sm col-md-12" value="Smith"> <label class="control-label col-md-12" for="appendedtext">Nationality</label> <div class="input-group col-md-12"> <input id="appendedtext" name="appendedtext" class="form-control" value="USA" type="text"> <span class="input-group-addon"> <i class="fa fa-search"></i> </span> </div> <label class="control-label col-md-12" for="textinput ">Birthday (mm/dd/yyyy)</label> <div class="input-group col-md-12"> <input id="textinput" name="textinput" type="text" class="form-control input-sm " value="05/23/1978"> </div> </div> </fieldset> </form> </div> <div class="col-md-3 col-applicant" style="text-align:center"> <legend>Child 1</legend> <img src="https://s3-sa-east-1.amazonaws.com/resources-projetos/icons/i_nophoto128.gif" class="img-circle" style="width:128px; height:128px"> <br> <a class="btn btn-default btn-gray"> <i class="fa fa-cloud-upload"></i> Upload</a> <form class="form-vertical"> <fieldset> <div class="form-group"> <label class="control-label col-md-12" for="textinput ">First name</label> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-sm col-md-12" value=""> <label class="control-label col-md-12" for="textinput ">Last name</label> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-sm col-md-12" value=""> <label class="control-label col-md-12" for="appendedtext">Nationality</label> <div class="input-group col-md-12"> <input id="appendedtext" name="appendedtext" class="form-control" value="" type="text"> <span class="input-group-addon"> <i class="fa fa-search"></i> </span> </div> <label class="control-label col-md-12" for="textinput ">Birthday (mm/dd/yyyy)</label> <div class="input-group col-md-12"> <input id="textinput" name="textinput" type="text" class="form-control input-sm " value=""> </div> </div> </fieldset> </form> </div> <div class="col-md-3"> <legend>More?</legend> <div class="btn btn-default btn-primary fa-2x"> <i class="fa fa-plus-square"></i> Add applicant</div> </div> </div> </div>

fieldset { margin-top: 10px; } .form-group { text-align: left; } .col-applicant { border-right: solid 1px #888; text-align:center; font-size: small; } .control-label { font-size: smaller; } .control-label INPUT { font-size: smaller; } label { margin-top: 20px; }