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Is it possible to create custom form like this in picture, and how? I'm using Sharepoint 2013 standard. enter image description here

Thanks!

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Yes. Use SharePoint Designer 2013. Create a New form for your list and write your html in the xslt part.

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You can Use Sharepoint Designer 2013 for it. This tutorial gives you a step by step description on how to create Custom Forms:

http://social.technet.microsoft.com/wiki/contents/articles/23955.sharepoint-2013-building-custom-forms.aspx

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