Approval Form for use on Inkdit.com

gistfile1.txt

<h2>Approval Form</h2>
<p>Relating to
<input name="relating to" type="text" class="required custom-input required" data-required="required">
</p>
<fieldset>
<legend>Submitted by</legend>
<div class="row">
<div class="six columns">
<label>Name:</label>
<input name="Name" type="text" data-required="required" />
</div>
<div class="six columns">
<label>Company:</label>
<input name="Company" type="text" />
</div>
</div>
<div class="row">
<div class="six columns">
<label>Phone Number:</label>
<input name="Phone Number" type="text" />
</div>
<div class="six columns">
<label>Email:</label>
<input name="Email" type="email">
</div>
</div>
</label>
</div>
</div><div class="row">
<div class="twelve columns">
<label>Web:</label>
<input name="Web" type="text" />
</div>
</div>
</label>
</div>
</div>
</fieldset>
<fieldset>
<legend>Items for approval:</legend>
<p>Notes<img src="/assets/images/text-area-placeholder.png" height="75" class="placeholder-text-area" name="Special Information"><br>
</p>
</fieldset>
<hr />
<h3>Approved by </h3>
<p><img src="/assets/sign-line-editor-graphic.png" height="104" width="100%" class="placeholder-signing-line"></p>