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<!DOCTYPE html>
​
<html lang="en">
<head>
    <meta charset="UTF-8">
​
    <title>Document</title>
</head>
​
<body>
    <div>
        <form action="">
            <div>
                <div class="box">
                    <label for="txt-titulo">Título:</label><input id="txt-titulo" required="true" type="text">
                </div>
​
                <div class="box">
                    <input id="txt-tipo-efeito-fixo" name="txt-tipo-efeito" required="true" type="radio" value="1"><label for="txt-tipo-efeito-fixo">Fixo</label>
                </div>
​
                <div class="box">
                    <input id="txt-tipo-efeito-rolativo" name="txt-tipo-efeito" required="true" type="radio" value="2"><label for="txt-tipo-efeito-rolativo">Rotativo</label>
                </div>
​
                <div class="box">
                    <input id="txt-tipo-efeito-piscando" name="txt-tipo-efeito" required="true" type="radio" value="3"><label for="txt-tipo-efeito-piscando">Piscando</label>
                </div>
​
                <div class="box">
                    <label for="txt-link">Link:</label><input id="txt-link" required="true" type="url">
                </div>
​
                <div class="box">
                    <source media="" src=""><!-- fallback for browsers without support -->
                    <img alt="" src=""> 
                </div>
​
                <div class="box">
                    <label for="txt-descrica">Descrição:</label><input id="txt-descricao" required="true" type="text">
                </div>
​
                <div class="box">
                    <label for="">Grupo(s)</label><br>
​
                    <ul>
                        <li><input type="checkbox"><label for="">Nome</label></li>
                    </ul>
                </div>
​
                <div class="box">
                    <label for="">Cliente(s):</label><br>
​
                    <ul>
                        <li><input type="checkbox"><label for="">Nome</label></li>
                    </ul>
                </div>
​
                <div class="box">
                    <label for="">Usuário(s)</label><br>
​
                    <ul>
                        <li><input type="checkbox"><label for="">Nome</label></li>
                    </ul>
                </div>
​
                <div class="box">
                    <label for="">Enviar por e-mail:</label><input id="confirm-msg" type="checkbox">
                </div><input class="btn" type="submit" value="Cadastrar">
            </div>
        </form>
    </div>
</body>
</html>
 
​
Output

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