<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 Name --> <legend>Relatório Pró-Reitoria de Extensão</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Nome da Atividade</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="Nome da Atividade" class="form-control input-md" required=""> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic_tipoatv">Tipo da Atividade</label> <div class="col-md-4"> <select id="selectbasic_tipoatv" name="selectbasic_tipoatv" class="form-control"> <option value="1">Programa</option> <option value="2">Projeto</option> <option value="3">Curso</option> <option value="4">Evento</option> <option value="5">Serviço</option> </select> </div> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput_data">Data</label> <div class="col-md-4"> <input id="textinput_data" name="textinput_data" type="text" placeholder="Período" class="form-control input-md"> <span class="help-block">Digite a data xx/xx/xxxx</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput_cursosvinculados">Cursos Vinculados</label> <div class="col-md-4"> <input id="textinput_cursosvinculados" name="textinput_cursosvinculados" type="text" placeholder="" class="form-control input-md" required=""> <span class="help-block">Informe os cursos de graduação vinculados a atividade, separe os cursos com virgula.</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput_alunos">Total de Alunos Organizadores</label> <div class="col-md-1"> <input id="textinput_alunos" name="textinput_alunos" type="text" placeholder="" class="form-control input-md" required=""> <span class="help-block">Total</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput_prof_coord">Prof(s) Coordenador</label> <div class="col-md-4"> <input id="textinput_prof_coord" name="textinput_prof_coord" type="text" placeholder="" class="form-control input-md" required=""> <span class="help-block">Informe o Nome do(s) Prof(s) Coordenadores, separado por virgula</span> </div> </div> <!-- Prepended checkbox --> <div class="form-group"> <label class="col-md-4 control-label" for="prependedcheckbox_aluno">Total de Alunos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon"> <input type="checkbox"> </span> <input id="prependedcheckbox_aluno" name="prependedcheckbox_aluno" class="form-control" type="text" placeholder="Alunos"> </div> <p class="help-block">click e digite o total de alunos</p> </div> </div> <!-- Prepended checkbox --> <div class="form-group"> <label class="col-md-4 control-label" for="prependedcheckbox_egressos">Total de Egressos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon"> <input type="checkbox"> </span> <input id="prependedcheckbox_egressos" name="prependedcheckbox_egressos" class="form-control" type="text" placeholder="Egressos"> </div> <p class="help-block">click e digite o total de egressos</p> </div> </div> <!-- Prepended checkbox --> <div class="form-group"> <label class="col-md-4 control-label" for="prependedcheckbox_comu">Total Comunidade</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon"> <input type="checkbox"> </span> <input id="prependedcheckbox_comu" name="prependedcheckbox_comu" class="form-control" type="text" placeholder="Comunidade"> </div> <p class="help-block">click e digite o total da comunidade</p> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea_objetivo">Objetivo Principal</label> <div class="col-md-4"> <textarea class="form-control" id="textarea_objetivo" name="textarea_objetivo"></textarea> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea_desc">Justificativa</label> <div class="col-md-4"> <textarea class="form-control" id="textarea_desc" name="textarea_desc"></textarea> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_custosimp">Custos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Impressos</span> <input id="prependedtext_custosimp" name="prependedtext_custosimp" class="form-control" placeholder="R$" type="text"> </div> <p class="help-block">cartaz,folder,folheto,etc </p> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_brindes">Custos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Brindes</span> <input id="prependedtext_brindes" name="prependedtext_brindes" class="form-control" placeholder="R$" type="text"> </div> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_locacao">Custos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Locação</span> <input id="prependedtext_locacao" name="prependedtext_locacao" class="form-control" placeholder="R$" type="text"> </div> <p class="help-block">locação/estrutura</p> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_midias">Custos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Mídias</span> <input id="prependedtext_midias" name="prependedtext_midias" class="form-control" placeholder="R$" type="text"> </div> <p class="help-block">Fotos/Vídeos</p> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_outros">Custos</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Outros</span> <input id="prependedtext_outros" name="prependedtext_outros" class="form-control" placeholder="R$" type="text"> </div> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_inscr">Receitas</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Inscrições</span> <input id="prependedtext_inscr" name="prependedtext_inscr" class="form-control" placeholder="R$" type="text"> </div> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_patro">Receitas</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Patrocínio</span> <input id="prependedtext_patro" name="prependedtext_patro" class="form-control" placeholder="R$" type="text"> </div> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_doacao">Receitas</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Doação</span> <input id="prependedtext_doacao" name="prependedtext_doacao" class="form-control" placeholder="R$" type="text"> </div> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext_outras">Receitas</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">Outras</span> <input id="prependedtext_outras" name="prependedtext_outras" class="form-control" placeholder="R$" type="text"> </div> </div> </div>