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  1. <!DOCTYPE html>
  2. <html lang="en">
  3. <head>
  4. <title>Bootstrap Example</title>
  5. <meta charset="utf-8">
  6. <meta name="viewport" content="width=device-width, initial-scale=1">
  7. <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.0/css/bootstrap.min.css">
  8. <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>
  9. <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.0/js/bootstrap.min.js"></script>
  10. </head>
  11. <body>
  12.  
  13. <div class="container">
  14. <h2>Form control: input</h2>
  15. <p>The form below contains two input elements; one of type text and one of type password:</p>
  16. <form action="https://docs.google.com/forms/d/e/1FAIpQLScki5CAVpe3A6XWhmeF73fw9bh7CQpYlNs0913RToNp3HkmCw/formResponse" method="POST">
  17. <div class="form-group">
  18. <label for="usr">Name:</label>
  19. <input type="text" class="form-control" name="entry.1278956928" id="usr">
  20. </div>
  21. <div class="form-group">
  22. <label for="pwd">Phone:</label>
  23. <input type="text" class="form-control" name="entry.1493622810" id="pwd">
  24. </div>
  25. <button type="submit" class="btn btn-default">Submit</button>
  26. </form>
  27. </div>
  28.  
  29. </body>
  30. </html>
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