New Application Form

New App

<form class="form-horizontal">
<fieldset>

<!-- Form Name -->
<legend>Form Name</legend>

<!-- Text input-->
<div class="form-group">
  <label class="col-md-4 control-label" for="ScholarshipName">Scholarship Name:</label>  
  <div class="col-md-4">
  <input id="ScholarshipName" name="ScholarshipName" type="text" placeholder="Enter the name" class="form-control input-md" required="">
  <span class="help-block">help</span>  
  </div>
</div>

<!-- Text input-->
<div class="form-group">
  <label class="col-md-4 control-label" for="duedate">Due Date:</label>  
  <div class="col-md-4">
  <input id="duedate" name="duedate" type="text" placeholder="mm/dd/yyyy" class="form-control input-md" required="">
  <span class="help-block">help</span>  
  </div>
</div>

<!-- Select Basic -->
<div class="form-group">
  <label class="col-md-4 control-label" for="selectbasic">Level of Scholarship:</label>
  <div class="col-md-4">
    <select id="selectbasic" name="selectbasic" class="form-control">
      <option value="1">Local</option>
      <option value="2">State</option>
      <option value="3">National</option>
    </select>
  </div>
</div>

<!-- Select Basic -->
<div class="form-group">
  <label class="col-md-4 control-label" for="selectbasic">Submission Method:</label>
  <div class="col-md-4">
    <select id="selectbasic" name="selectbasic" class="form-control">
      <option value="1">Online</option>
      <option value="2">Email</option>
      <option value="3">Mail</option>
    </select>
  </div>
</div>

<!-- Text input-->
<div class="form-group">
  <label class="col-md-4 control-label" for="website">Website:</label>  
  <div class="col-md-4">
  <input id="website" name="website" type="text" placeholder="URL" class="form-control input-md">
  <span class="help-block">help</span>  
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="transcript">Official Transcript Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="transcript-0">
      <input type="radio" name="transcript" id="transcript-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="transcript-1">
      <input type="radio" name="transcript" id="transcript-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="actsat">Official ACT/SAT Scores Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="actsat-0">
      <input type="radio" name="actsat" id="actsat-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="actsat-1">
      <input type="radio" name="actsat" id="actsat-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="personalstatement">Personal Statement Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="personalstatement-0">
      <input type="radio" name="personalstatement" id="personalstatement-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="personalstatement-1">
      <input type="radio" name="personalstatement" id="personalstatement-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Text input-->
<div class="form-group">
  <label class="col-md-4 control-label" for="textinput">If yes to Personal Statement: Word Count:</label>  
  <div class="col-md-4">
  <input id="textinput" name="textinput" type="text" placeholder="Number" class="form-control input-md">
  <span class="help-block">help</span>  
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="resume">Resume Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="resume-0">
      <input type="radio" name="resume" id="resume-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="resume-1">
      <input type="radio" name="resume" id="resume-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="project">Project Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="project-0">
      <input type="radio" name="project" id="project-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="project-1">
      <input type="radio" name="project" id="project-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="work">Work Experience Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="work-0">
      <input type="radio" name="work" id="work-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="work-1">
      <input type="radio" name="work" id="work-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Community Service Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Honors/Awards Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Leadership Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Organization Involvement Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Parental Financial Information Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Recommendations Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Multiple Radios -->
<div class="form-group">
  <label class="col-md-4 control-label" for="radios">Extra Questions Required:</label>
  <div class="col-md-4">
  <div class="radio">
    <label for="radios-0">
      <input type="radio" name="radios" id="radios-0" value="1" checked="checked">
      Yes
    </label>
	</div>
  <div class="radio">
    <label for="radios-1">
      <input type="radio" name="radios" id="radios-1" value="2">
      No
    </label>
	</div>
  </div>
</div>

<!-- Text input-->
<div class="form-group">
  <label class="col-md-4 control-label" for="textinput">If Yes, How many?</label>  
  <div class="col-md-4">
  <input id="textinput" name="textinput" type="text" placeholder="Number" class="form-control input-md">
  <span class="help-block">help</span>  
  </div>
</div>

<!-- Button (Double) -->
<div class="form-group">
  <label class="col-md-4 control-label" for="button1id"></label>
  <div class="col-md-8">
    <button id="button1id" name="button1id" class="btn btn-success">Submit</button>
    <button id="button2id" name="button2id" class="btn btn-danger">Cancel</button>
  </div>
</div>

</fieldset>
</form>