You could use this: Demo
CSS
.header {
color: #008eff;
font-size: 13pt;
font-weight: bold;
}
.bold {
font-weight: bold;
}
input {
border: 0px;
background-color: #eee;
}
td {
border: 1px solid #ddd;
background-color: #eee;
height: 20px;
}
HTML
<table>
<thead>
<tr>
<td colspan="4" class="header">1. Location of your Hotel/Resort/Property</td>
</tr>
</thead>
<tbody>
<tr>
<td class="bold">Name</td>
<td><input type="text" /></td>
<td class="bold">Designation</td>
<td><input type="text" /></td>
</tr>
<tr>
<td class="bold">Organization</td>
<td><input type="text" /></td>
<td></td>
<td></td>
</tr>
<tr>
<td class="bold">Email</td>
<td><input type="text" /></td>
<td></td>
<td></td>
</tr>
<tr>
<td class="bold">Hotel/Resort/Property Name</td>
<td><input type="text" /></td>
<td class="bold">Website address</td>
<td><input type="text" /></td>
</tr>
</tbody>
</table>