index.html

<head>
    <style>
        body {
            background-image: url('formbg.png')
        }
    </style>
</head>
<body>
<form>
    <label for="date">Date and time of inspection: </label>
    <input type="datetime-local" id="date" name="date" />
    
    <label for="weatherinput">Weather of the inspection: </label>
    <input type ="text" id="weatherinput" size="20" ="Weather">
    
    <ul>
        <input type="checkbox" name="Queen Cells with Egg, Larve, or Pupa seen" value="Yes" /> Queen Cells with Egg, Larve, or Pupa seen<br />
        
        <input type="checkbox" name="Swarm" value="Yes" /> Swarm<br />

        <input type="checkbox" name="Spotty Drone Brood" value="Yes"/> Spotty Drone brood<br />

        <input type="checkbox" name="Compact brood pattern" value="Yes"/> Compact brood pattern<br />

        <input type="checkbox" name="Worker brood in all stages " value="Yes"/> Worker brood in all stages <br />
    </ul>
    <textarea id="Notes" name="Notes" rows="4" cols="50">Notes for your inspection</textarea>

    <input type="submit" value="Submit">
</form>
</body>