style.css

.form-row {
    position: relative;
    margin-bottom: 25px;
}

.form-row label {
    color: #7bae23;
    background: #f4f4f4;
    border-radius: 3px 0 0 3px;
    border-style: solid;
    border-color: #e0e0e0;
    border-top-width: 1px;
    border-right-width: 1px;
    border-bottom-width: 1px;
    border-left-width: 1px;
    border-top-width: 0;
    border-bottom-width: 0;
    border-left-width: 0;
}

.form-row label {
    position: absolute;
    top: 1px;
    bottom: 1px;
    left: 1px;
    overflow: hidden;
    font-size: 14px;
    line-height: 46px;
    height: 44px;
    margin: 0;
    padding: 0 15px;
    text-overflow: ellipsis;
    white-space: nowrap;
    width: 150px;
    z-index: 1;
}

.form-row input[type="text"],{
    display: block;
    margin-bottom: 0;
    padding: 0 15px 0 165px;
    width: 100%;
    font-size: 15px;
    height: 46px;
    line-height: 1;
    width: 100%;
}

.checkbox label {
    overflow: visible;
    background-color: white;
    border: 0;
}