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index.html
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<!doctype html>
<html>
<head>
<meta charset="utf-8">
<title>Open Loo</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="style.css" type="text/css">
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css" integrity="sha384-BVYiiSIFeK1dGmJRAkycuHAHRg32OmUcww7on3RYdg4Va+PmSTsz/K68vbdEjh4u" crossorigin="anonymous">
<script src="https://www.gstatic.com/firebasejs/3.6.9/firebase-app.js"></script>
<script src="https://www.gstatic.com/firebasejs/3.6.9/firebase.js"></script>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/1.12.4/jquery.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js" integrity="sha384-Tc5IQib027qvyjSMfHjOMaLkfuWVxZxUPnCJA7l2mCWNIpG9mGCD8wGNIcPD7Txa" crossorigin="anonymous"></script>
</head>
<body>
<div class="text-center">
<h1>Open Loo</h1>
<h5>Part of OpenAhmedabad Project</h5>
</div>
<form style="margin: 0 16px;" action="" onsubmit="submitData()">
<div class="form-group">
<label for="inputLatitude" class="control-label">Latitude</label>
<input type="text" class="form-control" id="inputLatitude" placeholder="Manually enter latitude here">
</div>
<div class="form-group">
<label for="inputLongitude" class="control-label">Longitude</label>
<input type="text" class="form-control" id="inputLongitude" placeholder="Manually enter longitude here">
</div>
<div class="form-group">
<label for="inputName" class="control-label">Name</label>
<input type="text" class="form-control" id="inputName" placeholder="Name of the loo (if any)">
</div>
<div class="form-group">
<label for="inputAddress" class="control-label">Address<span style="color: red">*</span></label>
<textarea class="form-control" id="inputAddress" rows="3" placeholder="Where is it ?" required></textarea>
</div>
<div class="form-group">
<label for="inputFees" class="control-label">Fees<span style="color: red">*</span></label>
<div class="input-group">
<div class="input-group-addon">₹</div>
<input type="number" class="form-control" id="inputFees" placeholder="Amount (0 if free)" required>
<div class="input-group-addon">.00</div>
</div>
</div>
<div class="form-group">
<label for="inputRating" class="control-label">Cleanliness</label>
<div class="input-group">
<input type="number" class="form-control" id="inputRating" placeholder="Rate from 0 to 9">
<div class="input-group-addon">Ratings from 0 to 9</div>
</div>
</div>
<div class="form-group">
<div class="col-sm-offset-2 col-sm-10">
<button type="submit" class="btn btn-default">Submit</button>
</div>
</div>
</form>
<script src="script.js"></script>
</body>
</html>