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<!DOCTYPE html>
<html lang="en">
<head>
<!-- start: Meta -->
<meta charset="utf-8">
<title>Genius Dashboard - Bootstrap Admin Template</title>
<meta name="description" content="Genius Dashboard - Bootstrap Admin Template.">
<meta name="author" content="Łukasz Holeczek">
<meta name="keyword" content="Genius, Dashboard, Bootstrap, Admin, Template, Theme, Responsive, Fluid, Retina">
<!-- end: Meta -->
<!-- start: Mobile Specific -->
<meta name="viewport" content="width=device-width, initial-scale=1">
<!-- end: Mobile Specific -->
<!-- start: CSS -->
<link href="assets/css/bootstrap.min.css" rel="stylesheet">
<link href="assets/css/style.min.css" rel="stylesheet">
<link href="assets/css/retina.min.css" rel="stylesheet">
<link href="assets/css/print.css" rel="stylesheet" type="text/css" media="print"/>
<!-- end: CSS -->
<!-- The HTML5 shim, for IE6-8 support of HTML5 elements -->
<!--[if lt IE 9]>
<script src="http://html5shim.googlecode.com/svn/trunk/html5.js"></script>
<script src="assets/js/respond.min.js"></script>
<![endif]-->
<!-- start: Favicon and Touch Icons -->
<link rel="apple-touch-icon-precomposed" sizes="144x144" href="assets/ico/apple-touch-icon-144-precomposed.png">
<link rel="apple-touch-icon-precomposed" sizes="114x114" href="assets/ico/apple-touch-icon-114-precomposed.png">
<link rel="apple-touch-icon-precomposed" sizes="72x72" href="assets/ico/apple-touch-icon-72-precomposed.png">
<link rel="apple-touch-icon-precomposed" sizes="57x57" href="assets/ico/apple-touch-icon-57-precomposed.png">
<link rel="shortcut icon" href="assets/ico/favicon.png">
<!-- end: Favicon and Touch Icons -->
</head>
<body>
<!-- start: Header -->
<header class="navbar">
<div class="container">
<button class="navbar-toggle" type="button" data-toggle="collapse" data-target=".sidebar-nav.nav-collapse">
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
<a id="main-menu-toggle" class="hidden-xs open"><i class="fa fa-bars"></i></a>
<a class="navbar-brand col-md-2 col-sm-1 col-xs-2" href="index.html"><span>Genius</span></a>
<div id="search" class="col-sm-4 col-xs-8 col-lg-3">
<select>
<option>everything</option>
<option>messages</option>
<option>comments</option>
<option>users</option>
</select>
<input type="text" placeholder="search" />
<i class="fa fa-search"></i>
</div>
<!-- start: Header Menu -->
<div class="nav-no-collapse header-nav">
<ul class="nav navbar-nav pull-right">
<li class="dropdown hidden-xs">
<a class="btn dropdown-toggle" data-toggle="dropdown" href="form-elements.html#">
<i class="fa fa-warning"></i>
<span class="number">11</span>
</a>
<ul class="dropdown-menu notifications">
<li class="dropdown-menu-title">
<span>You have 11 notifications</span>
</li>
<li>
<a href="form-elements.html#">
<span class="icon blue"><i class="fa fa-user"></i></span>
<span class="message">New user registration</span>
<span class="time">1 min</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon green"><i class="fa fa-comment-o"></i></span>
<span class="message">New comment</span>
<span class="time">7 min</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon green"><i class="fa fa-comment-o"></i></span>
<span class="message">New comment</span>
<span class="time">8 min</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon green"><i class="fa fa-comment-o"></i></span>
<span class="message">New comment</span>
<span class="time">16 min</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon blue"><i class="fa fa-user"></i></span>
<span class="message">New user registration</span>
<span class="time">36 min</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon yellow"><i class="fa fa-shopping-cart"></i></span>
<span class="message">2 items sold</span>
<span class="time">1 hour</span>
</a>
</li>
<li class="warning">
<a href="form-elements.html#">
<span class="icon red"><i class="fa fa-user"></i></span>
<span class="message">User deleted account</span>
<span class="time">2 hour</span>
</a>
</li>
<li class="warning">
<a href="form-elements.html#">
<span class="icon red"><i class="fa fa-shopping-cart"></i></span>
<span class="message">Transaction was canceled</span>
<span class="time">6 hour</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon green"><i class="fa fa-comment-o"></i></span>
<span class="message">New comment</span>
<span class="time">yesterday</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="icon blue"><i class="fa fa-user"></i></span>
<span class="message">New user registration</span>
<span class="time">yesterday</span>
</a>
</li>
<li class="dropdown-menu-sub-footer">
<a>View all notifications</a>
</li>
</ul>
</li>
<!-- start: Notifications Dropdown -->
<li class="dropdown hidden-xs">
<a class="btn dropdown-toggle" data-toggle="dropdown" href="form-elements.html#">
<i class="fa fa-tasks"></i>
<span class="number">17</span>
</a>
<ul class="dropdown-menu tasks">
<li>
<span class="dropdown-menu-title">You have 17 tasks in progress</span>
</li>
<li>
<a href="form-elements.html#">
<span class="header">
<span class="title">iOS Development</span>
<span class="percent"></span>
</span>
<div class="taskProgress progressSlim progressBlue">80</div>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="header">
<span class="title">Android Development</span>
<span class="percent"></span>
</span>
<div class="taskProgress progressSlim progressYellow">47</div>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="header">
<span class="title">Django Project For Google</span>
<span class="percent"></span>
</span>
<div class="taskProgress progressSlim progressRed">32</div>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="header">
<span class="title">SEO for new sites</span>
<span class="percent"></span>
</span>
<div class="taskProgress progressSlim progressGreen">63</div>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="header">
<span class="title">New blog posts</span>
<span class="percent"></span>
</span>
<div class="taskProgress progressSlim progressPink">80</div>
</a>
</li>
<li>
<a class="dropdown-menu-sub-footer">View all tasks</a>
</li>
</ul>
</li>
<!-- end: Notifications Dropdown -->
<!-- start: Message Dropdown -->
<li class="dropdown hidden-xs">
<a class="btn dropdown-toggle" data-toggle="dropdown" href="form-elements.html#">
<i class="fa fa-envelope"></i>
<span class="number">9</span>
</a>
<ul class="dropdown-menu messages">
<li>
<span class="dropdown-menu-title">You have 9 messages</span>
</li>
<li>
<a href="form-elements.html#">
<span class="avatar"><img src="assets/img/avatar.jpg" alt="Avatar"></span>
<span class="header">
<span class="from">
Łukasz Holeczek
</span>
<span class="time">
6 min
</span>
</span>
<span class="message">
Lorem ipsum dolor sit amet consectetur adipiscing elit, et al commore
</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="avatar"><img src="assets/img/avatar2.jpg" alt="Avatar"></span>
<span class="header">
<span class="from">
Megan Abott
</span>
<span class="time">
56 min
</span>
</span>
<span class="message">
Lorem ipsum dolor sit amet consectetur adipiscing elit, et al commore
</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="avatar"><img src="assets/img/avatar3.jpg" alt="Avatar"></span>
<span class="header">
<span class="from">
Kate Ross
</span>
<span class="time">
3 hours
</span>
</span>
<span class="message">
Lorem ipsum dolor sit amet consectetur adipiscing elit, et al commore
</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="avatar"><img src="assets/img/avatar4.jpg" alt="Avatar"></span>
<span class="header">
<span class="from">
Julie Blank
</span>
<span class="time">
yesterday
</span>
</span>
<span class="message">
Lorem ipsum dolor sit amet consectetur adipiscing elit, et al commore
</span>
</a>
</li>
<li>
<a href="form-elements.html#">
<span class="avatar"><img src="assets/img/avatar5.jpg" alt="Avatar"></span>
<span class="header">
<span class="from">
Jane Sanders
</span>
<span class="time">
Jul 25, 2012
</span>
</span>
<span class="message">
Lorem ipsum dolor sit amet consectetur adipiscing elit, et al commore
</span>
</a>
</li>
<li>
<a class="dropdown-menu-sub-footer">View all messages</a>
</li>
</ul>
</li>
<!-- end: Message Dropdown -->
<li>
<a class="btn" href="form-elements.html#">
<i class="fa fa-wrench"></i>
</a>
</li>
<!-- start: User Dropdown -->
<li class="dropdown">
<a class="btn account dropdown-toggle" data-toggle="dropdown" href="form-elements.html#">
<div class="avatar"><img src="assets/img/avatar.jpg" alt="Avatar"></div>
<div class="user">
<span class="hello">Welcome!</span>
<span class="name">Łukasz Holeczek</span>
</div>
</a>
<ul class="dropdown-menu">
<li><a href="form-elements.html#"><i class="fa fa-user"></i> Profile</a></li>
<li><a href="form-elements.html#"><i class="fa fa-cog"></i> Settings</a></li>
<li><a href="form-elements.html#"><i class="fa fa-envelope"></i> Messages</a></li>
<li><a href="page-login.html"><i class="fa fa-off"></i> Logout</a></li>
</ul>
</li>
<!-- end: User Dropdown -->
</ul>
</div>
<!-- end: Header Menu -->
</div>
</header>
<!-- end: Header -->
<div class="container">
<div class="row">
<!-- start: Main Menu -->
<div id="sidebar-left" class="col-lg-2 col-sm-1 ">
<div class="sidebar-nav nav-collapse collapse navbar-collapse">
<ul class="nav main-menu">
<li><a href="index.html"><i class="fa fa-bar-chart-o"></i><span class="hidden-sm text"> Dashboard</span></a></li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-eye"></i><span class="hidden-sm text"> UI Features</span> <span class="chevron closed"></span></a>
<ul>
<li><a class="submenu" href="ui-sliders-progress.html"><i class="fa fa-eye"></i><span class="hidden-sm text"> Sliders & Progress</span></a></li>
<li><a class="submenu" href="ui-nestable-list.html"><i class="fa fa-eye"></i><span class="hidden-sm text"> Nestable Lists</span></a></li>
<li><a class="submenu" href="ui-elements.html"><i class="fa fa-eye"></i><span class="hidden-sm text"> Elements</span></a></li>
</ul>
</li>
<li><a href="widgets.html"><i class="fa fa-dashboard"></i><span class="hidden-sm text"> Widgets</span></a></li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-folder-o"></i><span class="hidden-sm text"> Example Pages</span> <span class="chevron closed"></span></a>
<ul>
<li><a class="submenu" href="page-inbox.html"><i class="fa fa-envelope-o"></i><span class="hidden-sm text"> Inbox</span></a></li>
<li><a class="submenu" href="page-invoice.html"><i class="fa fa-file-text"></i><span class="hidden-sm text"> Invoice</span></a></li>
<li><a class="submenu" href="page-todo.html"><i class="fa fa-tasks"></i><span class="hidden-sm text"> ToDo & Timeline</span></a></li>
<li><a class="submenu" href="page-profile.html"><i class="fa fa-male"></i><span class="hidden-sm text"> Profile</span></a></li>
<li><a class="submenu" href="page-pricing-tables.html"><i class="fa fa-table"></i><span class="hidden-sm text"> Pricing Tables</span></a></li>
<li><a class="submenu" href="page-404.html"><i class="fa fa-unlink"></i><span class="hidden-sm text"> 404</span></a></li>
<li><a class="submenu" href="page-500.html"><i class="fa fa-unlink"></i><span class="hidden-sm text"> 500</span></a></li>
<li><a class="submenu" href="page-lockscreen.html"><i class="fa fa-lock"></i><span class="hidden-sm text"> LockScreen</span></a></li>
<li><a class="submenu" href="page-lockscreen2.html"><i class="fa fa-lock"></i><span class="hidden-sm text"> LockScreen2</span></a></li>
<li><a class="submenu" href="page-login.html"><i class="fa fa-key"></i><span class="hidden-sm text"> Login Page</span></a></li>
<li><a class="submenu" href="page-register.html"><i class="fa fa-sign-in"></i><span class="hidden-sm text"> Register Page</span></a></li>
</ul>
</li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-edit"></i><span class="hidden-sm text"> Forms</span> <span class="chevron closed"></span></a>
<ul>
<li><a class="submenu" href="form-elements.html"><i class="fa fa-edit"></i><span class="hidden-sm text"> Form elements</span></a></li>
<li><a class="submenu" href="form-wizard.html"><i class="fa fa-edit"></i><span class="hidden-sm text"> Wizard</span></a></li>
<li><a class="submenu" href="form-dropzone.html"><i class="fa fa-edit"></i><span class="hidden-sm text"> Dropzone Upload</span></a></li>
<li><a class="submenu" href="form-x-editable.html"><i class="fa fa-edit"></i><span class="hidden-sm text"> X-editable</span></a></li>
</ul>
</li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-list-alt"></i><span class="hidden-sm text"> Charts</span> <span class="chevron closed"></span></a>
<ul>
<li><a class="submenu" href="charts-flot.html"><i class="fa fa-chevron-right"></i><span class="hidden-sm text"> Flot Charts</span></a></li>
<li><a class="submenu" href="charts-xcharts.html"><i class="fa fa-chevron-right"></i><span class="hidden-sm text"> xCharts</span></a></li>
<li><a class="submenu" href="charts-others.html"><i class="fa fa-chevron-right"></i><span class="hidden-sm text"> Other</span></a></li>
</ul>
</li>
<li><a href="typography.html"><i class="fa fa-font"></i><span class="hidden-sm text"> Typography</span></a></li>
<li><a href="gallery.html"><i class="fa fa-picture-o"></i><span class="hidden-sm text"> Gallery</span></a></li>
<li><a href="table.html"><i class="fa fa-align-justify"></i><span class="hidden-sm text"> Tables</span></a></li>
<li><a href="calendar.html"><i class="fa fa-calendar"></i><span class="hidden-sm text"> Calendar</span></a></li>
<li><a href="file-manager.html"><i class="fa fa-folder-open"></i><span class="hidden-sm text"> File Manager</span></a></li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-star"></i><span class="hidden-sm text"> Icons</span> <span class="chevron closed"></span></a>
<ul>
<li><a class="submenu" href="icons-halflings.html"><i class="fa fa-star"></i><span class="hidden-sm text"> Halflings</span></a></li>
<li><a class="submenu" href="icons-glyphicons-pro.html"><i class="fa fa-star"></i><span class="hidden-sm text"> Glyphicons PRO</span></a></li>
<li><a class="submenu" href="icons-filetypes.html"><i class="fa fa-star"></i><span class="hidden-sm text"> Filetypes</span></a></li>
<li><a class="submenu" href="icons-social.html"><i class="fa fa-star"></i><span class="hidden-sm text"> Social</span></a></li>
<li><a class="submenu" href="icons-font-awesome.html"><i class="fa fa-star"></i><span class="hidden-sm text"> Font Awesome</span></a></li>
</ul>
</li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-folder-open"></i><span class="hidden-sm text"> 4 Level Menu</span> <span class="chevron closed"></span></a>
<ul>
<li><a href="2nd-level.html"><i class="fa fa-folder"></i><span class="hidden-sm text"> 2nd Level</span></a></li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-folder-open"></i><span class="hidden-sm text"> 2nd Level</span> <span class="chevron closed"></span></a>
<ul>
<li><a href="3rd-level.html"><i class="fa fa-folder"></i><span class="hidden-sm text"> 3rd Level</span></a></li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-folder-open"></i><span class="hidden-sm text"> 3rd Level</span> <span class="chevron closed"></span></a>
<ul>
<li>
<a class="submenu" href="4th-level.html"><i class="fa fa-folder"></i><span class="hidden-sm text"> 4th Level</span></a>
</li>
</ul>
</li>
<li>
<a class="dropmenu" href="form-elements.html#"><i class="fa fa-folder-open"></i><span class="hidden-sm text"> 3rd Level</span> <span class="chevron closed"></span></a>
<ul>
<li>
<a class="submenu" href="4th-level2.html"><i class="fa fa-folder"></i><span class="hidden-sm text"> 4th Level</span></a>
</li>
</ul>
</li>
</ul>
</li>
</ul>
</li>
</ul>
</div>
<a href="form-elements.html#" id="main-menu-min" class="full visible-md visible-lg"><i class="fa fa-angle-double-left"></i></a>
</div>
<!-- end: Main Menu -->
<!-- start: Content -->
<div id="content" class="col-lg-10 col-sm-11 ">
<div class="row">
<div class="col-lg-12">
<div class="box">
<div class="box-header">
<h2><i class="fa fa-edit"></i>Form Elements</h2>
<div class="box-icon">
<a href="form-elements.html#" class="btn-setting"><i class="fa fa-wrench"></i></a>
<a href="form-elements.html#" class="btn-minimize"><i class="fa fa-chevron-up"></i></a>
<a href="form-elements.html#" class="btn-close"><i class="fa fa-times"></i></a>
</div>
</div>
<div class="box-content">
<form role="form">
<div class="form-group">
<label class="control-label" for="date01">Form with Datepicker</label>
<div class="controls">
<div class="input-group date col-sm-4">
<span class="input-group-addon"><i class="fa fa-calendar"></i></span>
<input type="text" class="form-control date-picker" id="date01" data-date-format="mm/dd/yyyy"/>
</div>
</div>
</div>
<div class="form-group">
<label class="control-label" for="timepicker1">Form with Timepicker</label>
<div class="controls">
<div class="input-group col-sm-4 bootstrap-timepicker">
<span class="input-group-addon"><i class="fa fa-clock-o"></i></span>
<input type="text" class="form-control timepicker" id="timepicker1" value="11:30 PM">
</div>
</div>
</div>
<div class="form-group">
<label class="control-label" for="daterange">Form with DateRangePicker</label>
<div class="controls">
<div class="input-group col-sm-4">
<span class="input-group-addon"><i class="fa fa-calendar"></i></span>
<input type="text" class="form-control" id="daterange" value="09/09/2013 - 09/28/2013">
</div>
</div>
</div>
<div class="form-group">
<label class="control-label" for="colorpicker1">Form with Colorpicker</label>
<div class="controls">
<div class="input-group color col-sm-4">
<span class="input-group-addon"><i class="fa fa-tint"></i></span>
<input type="text" class="form-control" id="colorpicker1" value="#FFFFFF">
</div>
</div>
</div>
<div class="form-group">
<label class="control-label" for="textarea2">Textarea with Input Limits & Autosizing</label>
<div class="controls">
<textarea id="limit" rows="6" style="width:100%"></textarea>
</div>
</div>
<div class="form-group hidden-xs">
<label class="control-label">Textarea with Bootstrap Wysiwig</label>
<div class="btn-toolbar" data-role="editor-toolbar" data-target=".editor">
<div class="btn-group">
<a class="btn dropdown-toggle" data-toggle="dropdown" title="Font"><i class="fa fa-font"></i><b class="caret"></b></a>
<ul class="dropdown-menu"></ul>
</div>
<div class="btn-group">
<a class="btn dropdown-toggle" data-toggle="dropdown" title="Font Size"><i class="fa fa-text-height"></i> <b class="caret"></b></a>
<ul class="dropdown-menu">
<li><a data-edit="fontSize 5"><font size="5">Huge</font></a></li>
<li><a data-edit="fontSize 3"><font size="3">Normal</font></a></li>
<li><a data-edit="fontSize 1"><font size="1">Small</font></a></li>
</ul>
</div>
<div class="btn-group">
<a class="btn" data-edit="bold" title="Bold (Ctrl/Cmd+B)"><i class="fa fa-bold"></i></a>
<a class="btn" data-edit="italic" title="Italic (Ctrl/Cmd+I)"><i class="fa fa-italic"></i></a>
<a class="btn" data-edit="strikethrough" title="Strikethrough"><i class="fa fa-strikethrough"></i></a>
<a class="btn" data-edit="underline" title="Underline (Ctrl/Cmd+U)"><i class="fa fa-underline"></i></a>
</div>
<div class="btn-group">
<a class="btn" data-edit="insertunorderedlist" title="Bullet list"><i class="fa fa-list-ul"></i></a>
<a class="btn" data-edit="insertorderedlist" title="Number list"><i class="fa fa-list-ol"></i></a>
<a class="btn" data-edit="outdent" title="Reduce indent (Shift+Tab)"><i class="fa fa-outdent"></i></a>
<a class="btn" data-edit="indent" title="Indent (Tab)"><i class="fa fa-indent"></i></a>
</div>
<div class="btn-group">
<a class="btn" data-edit="justifyleft" title="Align Left (Ctrl/Cmd+L)"><i class="fa fa-align-left"></i></a>
<a class="btn" data-edit="justifycenter" title="Center (Ctrl/Cmd+E)"><i class="fa fa-align-center"></i></a>
<a class="btn" data-edit="justifyright" title="Align Right (Ctrl/Cmd+R)"><i class="fa fa-align-right"></i></a>
<a class="btn" data-edit="justifyfull" title="Justify (Ctrl/Cmd+J)"><i class="fa fa-align-justify"></i></a>
</div>
<div class="btn-group">
<a class="btn dropdown-toggle" data-toggle="dropdown" title="Hyperlink"><i class="fa fa-link"></i></a>
<div class="dropdown-menu input-append">
<input class="span2" placeholder="URL" type="text" data-edit="createLink"/>
<button class="btn" type="button">Add</button>
</div>
<a class="btn" data-edit="unlink" title="Remove Hyperlink"><i class="fa fa-cut"></i></a>
</div>
<div class="btn-group">
<a class="btn" data-edit="undo" title="Undo (Ctrl/Cmd+Z)"><i class="fa fa-undo"></i></a>
<a class="btn" data-edit="redo" title="Redo (Ctrl/Cmd+Y)"><i class="fa fa-repeat"></i></a>
</div>
</div>
<div class="editor">
Go ahead…
</div>
</div>
<br/>
<div class="form-group hidden-xs">
<label class="control-label" for="textarea2">Textarea with CLEditor</label>
<div class="controls">
<textarea class="cleditor" id="textarea2" rows="3"></textarea>
</div>
</div>
<div class="form-actions">
<button type="submit" class="btn btn-primary">Save changes</button>
<button type="reset" class="btn">Cancel</button>
</div>
</form>
</div>
</div>
</div><!--/col-->
</div><!--/row-->
<div class="row">
<div class="col-lg-12">
<div class="box">
<div class="box-header">
<h2><i class="fa fa-edit"></i>Form Elements with Masked Input</h2>
<div class="box-icon">
<a href="form-elements.html#" class="btn-setting"><i class="fa fa-wrench"></i></a>
<a href="form-elements.html#" class="btn-minimize"><i class="fa fa-chevron-up"></i></a>
<a href="form-elements.html#" class="btn-close"><i class="fa fa-times"></i></a>
</div>
</div>
<div class="box-content">
<form class="form-horizontal">
<div class="form-group">
<label class="control-label" for="date">Date input</label>
<div class="controls">
<div class="input-group col-sm-4">
<span class="input-group-addon"><i class="fa fa-calendar"></i></span>
<input type="text" id="date" class="form-control">
</div>
<span class="help-block col-sm-8">ex. 99/99/9999</span>
</div>
</div>
<div class="form-group">
<label class="control-label" for="date">Phone input</label>
<div class="controls">
<div class="input-group col-sm-4">
<span class="input-group-addon"><i class="fa fa-phone"></i></span>
<input type="text" id="phone" class="form-control">
</div>
<span class="help-block col-sm-8">ex. (999) 999-9999</span>
</div>
</div>
<div class="form-group">
<label class="control-label" for="date">Taxpayer Identification Numbers</label>
<div class="controls">
<div class="input-group col-sm-4">
<span class="input-group-addon"><i class="fa fa-usd"></i></span>
<input type="text" id="tin" class="form-control">
</div>
<span class="help-block col-sm-8">ex. 99-9999999</span>
</div>
</div>
<div class="form-group">
<label class="control-label" for="date">Social Security number</label>
<div class="controls">
<div class="input-group col-sm-4">
<span class="input-group-addon"><i class="fa fa-male"></i></span>
<input type="text" id="ssn" class="form-control">
</div>
<span class="help-block col-sm-8">ex. 999-99-9999</span>
</div>
</div>
<div class="form-group">
<label class="control-label" for="date">Eye Script</label>
<div class="controls">
<div class="input-group col-sm-4">
<span class="input-group-addon"><i class="fa fa-asterisk"></i></span>
<input type="text" id="eyescript" class="form-control">
</div>
<span class="help-block col-sm-8">ex. ~9.99 ~9.99 999</span>
</div>
</div>
<div class="form-actions">
<button type="submit" class="btn btn-primary">Save changes</button>
<button type="reset" class="btn">Cancel</button>
</div>
</form>
</div>
</div>
</div><!--/col-->
</div><!--/row-->
<div class="row">
<div class="col-lg-12">
<div class="box">
<div class="box-header">
<h2><i class="fa fa-edit"></i>Form Elements</h2>
<div class="box-icon">
<a href="form-elements.html#" class="btn-setting"><i class="fa fa-wrench"></i></a>
<a href="form-elements.html#" class="btn-minimize"><i class="fa fa-chevron-up"></i></a>
<a href="form-elements.html#" class="btn-close"><i class="fa fa-times"></i></a>
</div>
</div>
<div class="box-content">
<form class="form-horizontal">
<div class="form-group">
<label class="control-label" for="focusedInput">Focused input</label>
<div class="controls">
<input class="form-control focused" id="focusedInput" type="text" value="This is focused…">
</div>
</div>
<div class="form-group">
<label class="control-label">Uneditable input</label>
<div class="controls">
<span class="input-xlarge uneditable-input">Some value here</span>
</div>
</div>
<div class="form-group">
<label class="control-label" for="disabledInput">Disabled input</label>
<div class="controls">
<input class="form-control disabled" id="disabledInput" type="text" placeholder="Disabled input here…" disabled="">
</div>
</div>
<div class="form-group">
<label class="control-label" for="optionsCheckbox2">Disabled checkbox</label>
<div class="controls">
<label class="checkbox">
<input type="checkbox" id="optionsCheckbox2" value="option1" disabled="">
This is a disabled checkbox
</label>
</div>
</div>
<div class="form-group has-success">
<label class="control-label" for="inputSuccess">Input with success</label>
<input type="text" class="form-control" id="inputSuccess">
</div>
<div class="form-group has-warning">
<label class="control-label" for="inputWarning">Input with warning</label>
<input type="text" class="form-control" id="inputWarning">
</div>
<div class="form-group has-error">
<label class="control-label" for="inputError">Input with error</label>
<input type="text" class="form-control" id="inputError">
</div>
<div class="form-group">
<label class="control-label" for="selectError3">Plain Select</label>
<div class="controls">
<select id="selectError3" class="form-control">
<option>Option 1</option>
<option>Option 2</option>
<option>Option 3</option>
<option>Option 4</option>
<option>Option 5</option>
</select>
</div>
</div>
<div class="form-group">
<label class="control-label" for="selectError">Modern Select</label>
<div class="controls">
<select id="selectError" class="form-control" data-rel="chosen">
<option>Option 1</option>
<option>Option 2</option>
<option>Option 3</option>
<option>Option 4</option>
<option>Option 5</option>
</select>
</div>
</div>
<div class="form-group">
<label class="control-label" for="selectError1">Multiple Select / Tags</label>
<div class="controls">
<select id="selectError1" class="form-control" multiple data-rel="chosen">
<option>Option 1</option>
<option selected>Option 2</option>
<option>Option 3</option>
<option>Option 4</option>
<option>Option 5</option>
</select>
</div>
</div>
<div class="form-group">
<label class="control-label" for="selectError2">Group Select</label>
<div class="controls">
<select class="form-control" data-placeholder="Your Favorite Football Team" id="selectError2" data-rel="chosen">
<option value=""></option>
<optgroup label="NFC EAST">
<option>Dallas Cowboys</option>
<option>New York Giants</option>
<option>Philadelphia Eagles</option>
<option>Washington Redskins</option>
</optgroup>
<optgroup label="NFC NORTH">
<option>Chicago Bears</option>
<option>Detroit Lions</option>
<option>Green Bay Packers</option>
<option>Minnesota Vikings</option>
</optgroup>
<optgroup label="NFC SOUTH">
<option>Atlanta Falcons</option>
<option>Carolina Panthers</option>
<option>New Orleans Saints</option>
<option>Tampa Bay Buccaneers</option>
</optgroup>
<optgroup label="NFC WEST">
<option>Arizona Cardinals</option>
<option>St. Louis Rams</option>
<option>San Francisco 49ers</option>
<option>Seattle Seahawks</option>
</optgroup>
<optgroup label="AFC EAST">
<option>Buffalo Bills</option>
<option>Miami Dolphins</option>
<option>New England Patriots</option>
<option>New York Jets</option>
</optgroup>
<optgroup label="AFC NORTH">
<option>Baltimore Ravens</option>
<option>Cincinnati Bengals</option>
<option>Cleveland Browns</option>
<option>Pittsburgh Steelers</option>
</optgroup>
<optgroup label="AFC SOUTH">
<option>Houston Texans</option>
<option>Indianapolis Colts</option>
<option>Jacksonville Jaguars</option>
<option>Tennessee Titans</option>
</optgroup>
<optgroup label="AFC WEST">
<option>Denver Broncos</option>
<option>Kansas City Chiefs</option>
<option>Oakland Raiders</option>
<option>San Diego Chargers</option>
</optgroup>
</select>
</div>
</div>
<div class="form-actions">
<button type="submit" class="btn btn-primary">Save changes</button>
<button class="btn">Cancel</button>
</div>
</form>
</div>
</div>
</div><!--/col-->
</div><!--/row-->
<div class="row">
<div class="col-lg-12">
<div class="box">
<div class="box-header">
<h2><i class="fa fa-edit"></i>Form Elements</h2>
<div class="box-icon">
<a href="form-elements.html#" class="btn-setting"><i class="fa fa-wrench"></i></a>
<a href="form-elements.html#" class="btn-minimize"><i class="fa fa-chevron-up"></i></a>
<a href="form-elements.html#" class="btn-close"><i class="fa fa-times"></i></a>
</div>
</div>
<div class="box-content">
<form class="form-horizontal">
<div class="form-group">
<label class="control-label" for="prependedInput">Prepended text</label>
<div class="controls">
<div class="input-prepend input-group">
<span class="input-group-addon">@</span><input id="prependedInput" class="form-control" size="16" type="text">
</div>
<p class="help-block">Here's some help text</p>
</div>
</div>
<div class="form-group">
<label class="control-label" for="appendedInput">Appended text</label>
<div class="controls">
<div class="input-group">
<input id="appendedInput" class="form-control" size="16" type="text"><span class="input-group-addon">.00</span>
</div>
<span class="help-block">Here's more help text</span>
</div>
</div>
<div class="form-group">
<label class="control-label" for="appendedPrependedInput">Append and prepend</label>
<div class="controls">
<div class="input-prepend input-group">
<span class="input-group-addon">$</span>
<input id="appendedPrependedInput" class="form-control" size="16" type="text"><span class="input-group-addon">.00</span>
</div>
</div>
</div>
<div class="form-group">
<label class="control-label" for="appendedInputButton">Append with button</label>
<div class="controls">
<div class="input-group">
<input id="appendedInputButton" class="form-control" size="16" type="text">
<span class="input-group-btn"><button class="btn" type="button">Go!</button></span>
</div>
</div>
</div>
<div class="form-group">
<label class="control-label" for="appendedInputButtons">Two-button append</label>
<div class="controls">
<div class="input-group">
<input id="appendedInputButtons" size="16" class="form-control" type="text">
<span class="input-group-btn">
<button class="btn" type="button">Search</button>
<button class="btn" type="button">Options</button>
</span>
</div>
</div>
</div>
<div class="form-group">
<label class="control-label">Checkboxes</label>
<div class="controls">
<label class="checkbox inline">
<input type="checkbox" id="inlineCheckbox1" value="option1"> Option 1
</label>
<label class="checkbox inline">
<input type="checkbox" id="inlineCheckbox2" value="option2"> Option 2
</label>
<label class="checkbox inline">
<input type="checkbox" id="inlineCheckbox3" value="option3"> Option 3
</label>
</div>
</div>
<div class="form-group">
<label class="control-label">Radio buttons</label>
<div class="controls">
<label class="radio">
<input type="radio" name="optionsRadios" id="optionsRadios1" value="option1" checked="">
Option one is this and that—be sure to include why it's great
</label>
<div style="clear:both"></div>
<label class="radio">
<input type="radio" name="optionsRadios" id="optionsRadios2" value="option2">
Option two can be something else and selecting it will deselect option one
</label>
</div>
</div>
<div class="form-actions">
<button type="submit" class="btn btn-primary">Save changes</button>
<button class="btn">Cancel</button>
</div>
</form>
</div>
</div>
</div><!--/col-->
</div><!--/row-->
<div class="row hideInIE8">
<div class="col-lg-12">
<div class="box">
<div class="box-header">
<h2><i class="fa fa-edit"></i>Form Elements</h2>
<div class="box-icon">
<a href="form-elements.html#" class="btn-setting"><i class="fa fa-wrench"></i></a>
<a href="form-elements.html#" class="btn-minimize"><i class="fa fa-chevron-up"></i></a>
<a href="form-elements.html#" class="btn-close"><i class="fa fa-times"></i></a>
</div>
</div>
<div class="box-content">
<form class="form-horizontal">
<div class="form-group">
<label class="control-label">Checkboxes</label>
<div class="controls">
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch">
<input type="checkbox" class="switch-input">
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch switch-primary">
<input type="checkbox" class="switch-input" checked>
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch switch-success">
<input type="checkbox" class="switch-input" checked>
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch switch-warning">
<input type="checkbox" class="switch-input" checked>
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch switch-important">
<input type="checkbox" class="switch-input" checked>
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch switch-info">
<input type="checkbox" class="switch-input" checked>
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
<div class="col-md-1 col-sm-2 col-xs-3">
<label class="switch switch-danger">
<input type="checkbox" class="switch-input" checked>
<span class="switch-label" data-on="On" data-off="Off"></span>
<span class="switch-handle"></span>
</label>
</div>
</div>
</div>
</form>
</div>
</div>
</div><!--/col-->
</div><!--/row-->
</div>
<!-- end: Content -->
</div><!--/row-->
</div><!--/container-->
<div class="modal fade" id="myModal">
<div class="modal-dialog">