"User profile form requirement input"
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<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 ----------> <!DOCTYPE html> <html lang="en"> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="viewport" content="width=device-width, initial-scale=1"> <meta name="description" content=""> <meta name="author" content=""> <title>User profile form requirement</title> <link href="https://maxcdn.bootstrapcdn.com/font-awesome/4.5.0/css/font-awesome.min.css" rel="stylesheet" integrity="sha256-3dkvEK0WLHRJ7/Csr0BZjAWxERc5WH7bdeUya2aXxdU= sha512-+L4yy6FRcDGbXJ9mPG8MT/3UCDzwR9gPeyFNMCtInsol++5m3bk2bXWKdZjvybmohrAsn3Ua5x8gfLnbE1YkOg==" crossorigin="anonymous"> <!-- Bootstrap Core CSS --> <!-- <link href="css/bootstrap.min.css" rel="stylesheet"> --> <link href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.6/css/bootstrap.min.css" rel="stylesheet" integrity="sha256-7s5uDGW3AHqw6xtJmNNtr+OBRJUlgkNJEo78P4b0yRw= sha512-nNo+yCHEyn0smMxSswnf/OnX6/KwJuZTlNZBjauKhTK0c+zT+q5JOCx0UFhXQ6rJR9jg6Es8gPuD2uZcYDLqSw==" crossorigin="anonymous"> <!-- Custom CSS --> <style> body { padding-top: 70px; /* Required padding for .navbar-fixed-top. Remove if using .navbar-static-top. Change if height of navigation changes. */ } .othertop{margin-top:10px;} </style> <!-- HTML5 Shim and Respond.js IE8 support of HTML5 elements and media queries --> <!-- WARNING: Respond.js doesn't work if you view the page via file:// --> <!--[if lt IE 9]> <script src="https://oss.maxcdn.com/libs/html5shiv/3.7.0/html5shiv.js"></script> <script src="https://oss.maxcdn.com/libs/respond.js/1.4.2/respond.min.js"></script> <![endif]--> </head> <body> <div class="container"> <div class="row"> <div class="col-md-10 "> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>User profile form requirement</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Name (Full name)">Name (Full name)</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-user"> </i> </div> <input id="Name (Full name)" name="Name (Full name)" type="text" placeholder="Name (Full name)" class="form-control input-md"> </div> </div> </div> <!-- File Button --> <div class="form-group"> <label class="col-md-4 control-label" for="Upload photo">Upload photo</label> <div class="col-md-4"> <input id="Upload photo" name="Upload photo" class="input-file" type="file"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Date Of Birth">Date Of Birth</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-birthday-cake"></i> </div> <input id="Date Of Birth" name="Date Of Birth" type="text" placeholder="Date Of Birth" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Father">Father's name</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-male" style="font-size: 20px;"></i> </div> <input id="Father" name="Father" type="text" placeholder="Father's name" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Mother">Mother's Name</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-female" style="font-size: 20px;"></i> </div> <input id="Mother" name="Mother" type="text" placeholder="Mother's Name" class="form-control input-md"> </div> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="Gender">Gender</label> <div class="col-md-4"> <label class="radio-inline" for="Gender-0"> <input type="radio" name="Gender" id="Gender-0" value="1" checked="checked"> Male </label> <label class="radio-inline" for="Gender-1"> <input type="radio" name="Gender" id="Gender-1" value="2"> Female </label> <label class="radio-inline" for="Gender-2"> <input type="radio" name="Gender" id="Gender-2" value="3"> Other </label> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="radios">Marital Status:</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"> Married </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2"> Unmarried </label> </div> </div> <!-- Text input--> <!-- <div class="form-group"> <label class="col-md-4 control-label" for="Temporary Address">Temporary Address</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-home" style="font-size:20px;"></i> </div> <input id="Temporary Address" name="Temporary Address" type="text" placeholder="Temporary Address" class="form-control input-md"> </div> </div> </div> --> <div class="form-group"> <label class="col-md-4 control-label col-xs-12" for="Permanent Address">Permanent Address</label> <div class="col-md-2 col-xs-4"> <input id="Permanent Address" name="Permanent Address" type="text" placeholder="District" class="form-control input-md "> </div> <div class="col-md-2 col-xs-4"> <input id="Permanent Address" name="Permanent Address" type="text" placeholder="Area" class="form-control input-md "> </div> </div> <div class="form-group"> <label class="col-md-4 control-label" for="Permanent Address"></label> <div class="col-md-2 col-xs-4"> <input id="Permanent Address" name="Permanent Address" type="text" placeholder="Street" class="form-control input-md "> </div> </div> <div class="form-group"> <label class="col-md-4 control-label col-xs-12" for="Temporary Address">Temporary Address</label> <div class="col-md-2 col-xs-4"> <input id="Temporary Address" name="Temporary Address" type="text" placeholder="District" class="form-control input-md "> </div> <div class="col-md-2 col-xs-4"> <input id="Temporary Address" name="Temporary Address" type="text" placeholder="Area" class="form-control input-md "> </div> </div> <div class="form-group"> <label class="col-md-4 control-label" for="Temporary Address"></label> <div class="col-md-2 col-xs-4"> <input id="Temporary Address" name="Temporary Address" type="text" placeholder="Street" class="form-control input-md "> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Primary Occupation">Primary Occupation</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-briefcase"></i> </div> <input id="Primary Occupation" name="Primary Occupation" type="text" placeholder="Primary Occupation" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Secondary Occupation (if any)">Secondary Occupation (if any)</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-briefcase"></i> </div> <input id="Secondary Occupation (if any)" name="Secondary Occupation (if any)" type="text" placeholder="Secondary Occupation (if any)" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Skills">Skills</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-graduation-cap"></i> </div> <input id="Skills" name="Skills" type="text" placeholder="Skills" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Phone number ">Phone number </label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-phone"></i> </div> <input id="Phone number " name="Phone number " type="text" placeholder="Primary Phone number " class="form-control input-md"> </div> <div class="input-group othertop"> <div class="input-group-addon"> <i class="fa fa-mobile fa-1x" style="font-size: 20px;"></i> </div> <input id="Phone number " name="Secondary Phone number " type="text" placeholder=" Secondary Phone number " class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Email Address">Email Address</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-envelope-o"></i> </div> <input id="Email Address" name="Email Address" type="text" placeholder="Email Address" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Availability time">Availability time</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-clock-o"></i> </div> <input id="Availability time" name="Availability time" type="text" placeholder="Availability time" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Available Service Area">Available Service Area</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-street-view"></i> </div> <input id="Available Service Area" name="Available Service Area" type="text" placeholder="Available Service Area" class="form-control input-md"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Citizenship No.">Citizenship No.</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-sticky-note-o"></i> </div> <input id="Citizenship No." name="Citizenship No." type="text" placeholder="Citizenship No." class="form-control input-md"> </div> </div> </div> <!-- Multiple Checkboxes --> <div class="form-group"> <label class="col-md-4 control-label" for="Languages Known">Languages Known</label> <div class="col-md-4"> <div class="checkbox"> <label for="Languages Known-0"> <input type="checkbox" name="Languages Known" id="Languages Known-0" value="1"> Nepali </label> </div> <div class="checkbox"> <label for="Languages Known-1"> <input type="checkbox" name="Languages Known" id="Languages Known-1" value="2"> Newari </label> </div> <div class="checkbox"> <label for="Languages Known-2"> <input type="checkbox" name="Languages Known" id="Languages Known-2" value="3"> English </label> </div> <div class="checkbox"> <label for="Languages Known-3"> <input type="checkbox" name="Languages Known" id="Languages Known-3" value="4"> Hindi </label> </div> <div class="othertop"> <label for="Languages Known-4"> </label> <input type="input" name="LanguagesKnown" id="Languages Known-4" placeholder="Other Language"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="License No.">License No.</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-sticky-note-o"></i> </div> <input id="License No." name="License No." type="text" placeholder="License No." class="form-control input-md"> </div> </div> </div> <!-- Multiple Radios --> <div class="form-group"> <label class="col-md-4 control-label" for="Owns Vehicle">Owns Vehicle?</label> <div class="col-md-4"> <div class="checkbox"> <label for="Owns Vehicle-0"> <input type="checkbox" name="Owns Vehicle" id="Owns Vehicle-0" value="1"> 4 wheeler </label> </div> <div class="checkbox"> <label for="Owns Vehicle-1"> <input type="checkbox" name="Owns Vehicle" id="Owns Vehicle-1" value="2"> Bike </label> </div> <div class="checkbox"> <label for="Owns Vehicle-2"> <input type="checkbox" name="Owns Vehicle" id="Owns Vehicle-2" value="3"> Bicycle </label> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Working Experience (time period)">Working Experience (time period)</label> <div class="col-md-4"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-clock-o"></i> </div> <input id="Working Experience (time period)" name="Working Experience" type="text" placeholder="Enter time period " class="form-control input-md"> </div> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="Overview (max 200 words)">Overview (max 200 words)</label> <div class="col-md-4"> <textarea class="form-control" rows="10" id="Overview (max 200 words)" name="Overview (max 200 words)">Overview</textarea> </div> </div> <div class="form-group"> <label class="col-md-4 control-label" ></label> <div class="col-md-4"> <a href="#" class="btn btn-success"><span class="glyphicon glyphicon-thumbs-up"></span> Submit</a> <a href="#" class="btn btn-danger" value=""><span class="glyphicon glyphicon-remove-sign"></span> Clear</a> </div> </div> </fieldset> </form> </div> <div class="col-md-2 hidden-xs"> <img src="http://websamplenow.com/30/userprofile/images/avatar.jpg" class="img-responsive img-thumbnail "> </div> </div> </div> <!-- jQuery Version 1.11.1 --> <script src="js/jquery.js"></script> <!-- Bootstrap Core JavaScript --> <script src="js/bootstrap.min.js"></script> </body> </html>

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