<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<div class="container">
<div class="row">
<div class="col-xs-12 col-sm-12 col-md-4 well well-sm">
<legend><a href="http://www.jquery2dotnet.com"><i class="glyphicon glyphicon-globe"></i></a> Sign up!</legend>
<form action="#" method="post" class="form" role="form">
<div class="row">
<div class="col-xs-6 col-md-6">
<input class="form-control" name="firstname" placeholder="First Name" type="text"
required autofocus />
</div>
<div class="col-xs-6 col-md-6">
<input class="form-control" name="lastname" placeholder="Last Name" type="text" required />
</div>
</div>
<input class="form-control" name="youremail" placeholder="Your Email" type="email" />
<input class="form-control" name="reenteremail" placeholder="Re-enter Email" type="email" />
<input class="form-control" name="password" placeholder="New Password" type="password" />
<label for="">
Birth Date</label>
<div class="row">
<div class="col-xs-4 col-md-4">
<select class="form-control">
<option value="Month">Month</option>
</select>
</div>
<div class="col-xs-4 col-md-4">
<select class="form-control">
<option value="Day">Day</option>
</select>
</div>
<div class="col-xs-4 col-md-4">
<select class="form-control">
![Sign up form [Validations NOT ACHIEVED]](http://d2d3qesrx8xj6s.cloudfront.net/img/screenshots/085267fd2b785be54d5d05937defdd27ccc633ab.jpg)