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"Bestelformulier"
Bootstrap 3.2.0 Snippet by
ritchiebos
3.2.0
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<link href="//netdna.bootstrapcdn.com/bootstrap/3.2.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.2.0/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>Bestelformulier</legend> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">Bestellen als</label> <div class="col-md-6"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">particuliere klant (consument)</option> <option value="2">zakelijke klant</option> </select> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="radios">Aanspreekvorm</label> <div class="col-md-4"> <label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked"> Heer </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2"> Mevrouw </label> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Voornaam *</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="Verplicht!" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Achternaam *</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="Verplicht!" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">E-mail *</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="Verplicht!" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Postcode *</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="Verplicht!" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Plaats *</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="Verplicht!" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Straat en huisnummer *</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="Verplicht!" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Telefoonnummer</label> <div class="col-md-6"> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> <!-- Multiple Checkboxes --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">Producten</label> <div class="col-md-4"> <div class="checkbox"> <label for="checkboxes-0"> <input type="checkbox" name="checkboxes" id="checkboxes-0" value="1"> Asus G750JS-T4146H </label> </div> <div class="checkbox"> <label for="checkboxes-1"> <input type="checkbox" name="checkboxes" id="checkboxes-1" value="2"> Lenovo Thinkpad T440s </label> </div> <div class="checkbox"> <label for="checkboxes-2"> <input type="checkbox" name="checkboxes" id="checkboxes-2" value="3"> MSI GE60 2PE-246NL </label> </div> <div class="checkbox"> <label for="checkboxes-3"> <input type="checkbox" name="checkboxes" id="checkboxes-3" value="4"> Toshiba Qosmio X70-A-12N </label> </div> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="singlebutton"></label> <div class="col-md-4"> <button id="singlebutton" name="singlebutton" class="btn btn-success">Verzenden</button> </div> </div> </fieldset> </form>
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