anchor.diff:  <h1>Apply for Medi-Cal</h1>
   <hr>
  -<form role="form" name="apply" action="applications" method="post">
  +<form role="form" class="form-horizontal" name="apply" action="applications" method="post">
     <div class="row">
  -    <div class="form-group col-xs-4">
  +    <div class="form-group col-sm-5">
         <label for="name_first">First name</label>
  -        <input type="text" class="form-control" name="name_first" id="name_first" placeholder="Juanita" required>
  -        <span class="help-block">Include your legal first name.</span>
  +        <input type="text" name="name_first" id="name_first" placeholder="Juanita" class="form-control" required />
  +        <span class="help-block">Your legal first name.</span>
       </div>
   
  -    <div class="form-group col-xs-2">
  +    <div class="form-group col-sm-2">
         <label for="name_middle_initial">Middle initial</label>
  -        <input type="text" class="form-control" name="name_middle_initial" id="name_middle_initial" placeholder="Q">
  -        <span class="help-block">Include the initial of your legal middle name, if you have one.</span>
  +        <input type="text" name="name_middle_initial" id="name_middle_initial" placeholder="Q" class="form-control" />
  +        <span class="help-block">The initial of your legal middle name, if you have one.</span>
       </div>
   
  -    <div class="form-group col-xs-5">
  +    <div class="form-group col-sm-6">
         <label for="name_last">Last name</label>
  -        <input type="text" class="form-control" name="name_last" id="name_last" placeholder="Smith" required>
  -        <span class="help-block">Include your legal last name.</span>
  +        <input type="text" name="name_last" id="name_last" placeholder="Smith" class="form-control" required />
  +        <span class="help-block">Your legal last name.</span>
       </div>
     </div>
   
  -  <div class="form-group">
  -    <label for="name_last">Last name</label>
  -      <input type="text" class="form-control" name="name_last" id="name_last" placeholder="Smith" required>
  -      <span class="help-block">Include your legal last name.</span>
  +  <div class="row">
  +    <div class="form-group col-sm-9">
  +      <label for="home_address">Address
  +        <input type="text" class="form-control col-sm-9" name="home_address" placeholder="1234 Example Street" required />
  +      </label>
  +    </div>
  +    <div class="form-group col-sm-3">
  +      <label for="home_apt">Apartment number
  +        <input type="text" class="form-control col-sm-3" name="home_apt" placeholder="Apt. 3" /><!-- @todo: Determine whether this needs to be in a separate field on the PDF for it to be usable. -->
  +      </label>
  +    </div>
     </div>
   
  -  <div class="form-group">
  -    <label for="home_address">Address</label>
  -      <input type="text" class="form-control" name="home_address" placeholder="1234 Example Street" required>
  -    <label for="home_apt">Apartment number</label>
  -      <input type="text" class="form-control" name="home_apt" placeholder="Apt. 3"> <!-- @todo: Determine whether this needs to be in a separate field on the PDF for it to be usable. -->
  -    <label for="home_city">City</label> <!-- @todo: Reconcile with home_city_state -->
  -      <input type="text" class="form-control" name="home_city" placeholder="San Francisco" required>
  -      <div class="input-group">
  -        <input type="text" class="form-control" name="home_zip_code" placeholder="941..." required>
  -      </div>
  +  <div class="row">
  +    <div class="form-group col-sm-9">
  +      <label for="home_city">City <!-- @todo: Reconcile with home_city_state -->
  +        <input type="text" class="form-control col-sm-9" name="home_city" placeholder="San Francisco" required>
  +      </label>
         <span class="help-block">You have to live in California to be eligible for Medi-Cal. If you don't live in California, apply for Medicaid.</span>
  +    </div>
  +    <div class="form_group col-sm-3">
  +      <label for="zip">ZIP code
  +        <input type="text" class="form-control col-sm-3" name="home_zip_code" placeholder="941..." required>
  +      </label>
  +    </div>
     </div>
   
     <!-- State: CA -->
  
positive.code:   </div>
  
    <div class="form-group">
        <fieldset id="dob">
          <legend id="dob-label">Date of birth</legend>
          <label for="dob_month">Month
            <input id="dob_month" name="dob_month" type="month" required />
          </label>
          <label for="dob_day">Day
            <input id="dob_day" name="dob_day" type="day" required />
          </label>
          <label for="dob_year">Year
            <input id="dob_year" name="dob_year" type="year" required />
          </label>
        </fieldset>
    </div>
  
    <div class="form-group">
        <label for="ssn">Social Security Number</label>
        <input for="ssn" name="ssn" type="text" placeholder="000-33-0000" />
        <span class="help-block">You may be able to receive Medi-Cal even if you do not have a Social Security Number.</span>
    </div>
  
    <div class="form-group">
  
negative.code:   </div>
  
    <div class="form-group">
        <label for="ssn">Social Security Number</label>
        <input for="ssn" name="ssn" type="text" placeholder="000-33-0000" />
        <span class="help-block">You may be able to receive Medi-Cal even if you do not have a Social Security Number.</span>
    </div>
  
    <div class="form-group">
      <fieldset id="citizen-field">
        <legend id="citizen-label">Are you a U.S. citizen or national?</legend>
        <label for="citizen_yes" class="radio-inline">
         <input type="radio" name="citizen" id="citizen_yes" value="Yes" required />
         Yes
        </label>
        <label for="citizen_no" class="radio-inline">
          <input type="radio" name="citizen" id="citizen_no" value="No" required />
          No
        </label>
      </fieldset>
      <fieldset id="us-entry-dates">
        <legend id="us-entry-dates-label">If "No," on what date did you enter the U.S.?</legend>
        <label for="us_entry_month">
          Month
          <input id="us_entry_month" name="us_entry_month" type="month" required />
        </label>
        <label for="us_entry_day">
          Day
          <input id="us_entry_day" name="us_entry_day" type="day" required />
        </label>
        <label for="us_entry_year">
          Year
          <input id="us_entry_year" name="us_entry_year" type="year" required />
        </label>
      </fieldset>
    </div>
  
  