form.html

<div>
  <p>
    Name: <input type="text"></input>
  </p>
  <p>
    Hours: Same Hours Each Day <input type="checkbox"></input>
  </p>
  <p>
    Open <input type="time"></input>
  </p>
  <p>
    Close <input type="time"></input>
  </p>

  <p>
    List Hours By Day <input type="checkbox"></input>
  </p>
  <table>
    <tr>
      <th></th>
      <th>Open</th>
      <th>Closed</th>
    </tr>
    <tr>
      <td>M</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
    <tr>
      <td>T</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
    <tr>
      <td>W</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
    <tr>
      <td>Th</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
    <tr>
      <td>F</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
    <tr>
      <td>Sa</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
    <tr>
      <td>Su</td>
      <td><input type="time"></input></td>
      <td><input type="time"></input></td>
    </tr>
  </table>
  <p>
    Address: <input type="text"></input>
  </p>
  <p>
    City: <input type="text"></input>
  </p>
  <p>
    State: <input type="text"></input>
  </p>

</div>