<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01//EN" "[URL unfurl="true"]http://www.w3.org/TR/html4/strict.dtd">[/URL]
<html>
<head>
<title>Sample Page</title>
<style>
body {
margin: 0;
padding-left: 0px; /* LC fullwidth */
padding-right: 220px; /* RC fullwidth + CC padding */
min-width: 30em;
margin-bottom: 3em;
background: url(images/backdrop.jpg) repeat;
}
em {
color: red;
font-size:12px;
margin-right: .2em;
}
.row {
clear: both;
}
.label {
width: 18em;
text-align: right;
text-decoration: none;
float: left;
font-family: Verdana, Helvetica, sans-serif;
font-size: 10px;
color: #696969;
}
.display {
text-align: left;
text-decoration: none;
float: left;
margin-left: 5px;
font-family: Arial, Helvetica, sans-serif;
font-size:12px;
}
</style>
</head>
<body>
<form name="SampReq" action="ProcessRequestSection.php" method="POST">
<div>
<h1> Section Request Form <font size="1px" style="valign:top"><em>*</em><i> - Denotes required
fields.</i></font></h1>
</div>
<div class="row">
<span class="label">Date:</span>
<span class="display"><?php echo date("m/d/y, g:i a");?></span>
</div>
<div class="row">
<span class="label">Principal Investigator:</span>
<span class="display">Name Goes Here</span>
</div>
<div class="row">
<span class="label">Contact Person:</span>
<span class="display">Their Name</span>
</div>
<div class="row">
<span class="label">Phone:</span>
<span class="display">000-000-0000</span>
</div>
<div class="row">
<span class="label">Email:</span>
<span class="display">a@b.com</span>
</div>
</form>
</div><div style="clear: both"></div>
</body>
</html>
