Bootstrap form design - repost

This project received 13 bids from talented freelancers with an average bid price of $11 USD / hour.

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$8 - $15 USD / hour
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Project Description

I need someone to create a beautiful form using Twitter Bootstrap

Attached screenshot shows what fields is required. This layout is not 1:1 conversion - use your fantasy to make it good looking.

Page uses same layout as this one: [url removed, login to view] (span3 for left menu and span8 for right part)

File upload can be more creative than the one shown on screen.

Apply by sending a rough mockup.

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