--- /dev/null
+<?PHP include_once('header.php'); ?>
+
+
+ <div class='col-sm-12'> are you also eligible to sign each of these petitions in baltimore city </div>
+
+ <div class='col-sm-2'><input type='checkbox' checked> </div>
+
+ <div class='col-sm-10'>New Party: Maryland Green Party </div>
+
+
+ <div class='col-sm-2'><input type='checkbox' checked> </div>
+
+ <div class='col-sm-10'>New Party: Libertiarin Green Party </div>
+
+ <div class='col-sm-2'><input type='checkbox' checked> </div>
+
+ <div class='col-sm-10'>Charter Amendment: Baltimore Transit Eqiuity Coalision </div>
+
+
+ <div class='col-sm-12'> <button type="button" class="btn btn-success">Submit</button> <div>
+
+
+
+<?PHP include_once('footer.php');