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<div class="container">
<form class="form-horizontal">
<fieldset>
<!-- Form Name -->
<legend>Sample Information</legend>
<div>
<ul>
<li>Sample Name should be used to describe your sample appropriately. Please be as specific as possible, as this required field will be used to identify each sample. For example: normal human serum, anti-KLH serum, anti-Man9 serum, etc.</li>
</ul>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="sampleName">Sample Name</label>
<div class="controls">
<input id="antibodyName" name="sampleName" type="text" placeholder="" class="input-xlarge">
<p class="help-block"></p>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="serumSampleName">Serum Sample Name</label>
<div class="controls">
<input id="antibodyType" name="serumSampleName" type="text" placeholder="" class="input-xlarge">
<p class="help-block"></p>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="experimentTitle">Experiment title and rationale for assay</label>
<div class="controls">
<input id="antibodyIsotype" name="experimentTitle" type="text" placeholder="" class="input-xlarge">
<p class="help-block"></p>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="serumSpeciesOrigination">Species in which your serum originated (human, mouse, etc.) with Scientific Name and Strain: Type Age and Gender</label>
<div class="controls">
<input id="serumSpeciesOrigination" name="serumSpeciesOrigination" type="text" placeholder="" class="input-xlarge">
<p class="help-block">if Human , type 1.Race/ethnicity: 2.ABO Blood Type: 3. Diagnosis/disease</p>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="immunizationProtocol">Describe immunization protocol used</label>
<div class="controls">
<input id="species" name="immunizationProtocol" type="text" placeholder="" class="input-xlarge">
<p class="help-block">1.Immunogen (structure, concentration, etc.): 2.If conjugated immunogen, what was the carrier protein: 3.Dose (immunogen and adjuvant) and route of immunization: 4.Schedule of immunization (weekly, biweekly, etc)</p>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="serumCollectionInformation">Serum collection and processing information</label>
<div class="controls">
<input id="expressionDetails" name="serumCollectionInformation" type="text" placeholder="" class="input-xlarge">
<p class="help-block">type 1.Anti-coagulant: 2.Dilution in what diluent: 3.Condition of storage: 4.Time in storage: 5.Post collection processing (IgG depletion, ammonium sulfate precipitated, etc.)</p>
</div>
</div>
<!-- Text input-->
<div class="control-group">
<label class="control-label" for="sampleTestMethod">Method(s) by which the sample was tested for activity</label>
<div class="controls">
<input id="commercialAntibody" name="sampleTestMethod" type="text" placeholder="" class="input-xlarge">
<p class="help-block"></p>
</div>
</div>
</fieldset>
</form>
</div>
