<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<form class="form-horizontal">
<fieldset>
<legend>Form Name</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="destination">Destination</label>
<div class="col-md-4">
<input id="destination" name="destination" type="text" placeholder="" class="form-control input-md" required="">
<span class="help-block">The destination of your travel</span>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="reason">What was the purpose of your trip?</label>
<div class="col-md-4">
<div class="radio">
<label for="reason-0">
<input type="radio" name="reason" id="reason-0" value="Culture" checked="checked">
Culture
</label>
</div>
<div class="radio">
<label for="reason-1">
<input type="radio" name="reason" id="reason-1" value="Business">
Business
</label>
</div>
<div class="radio">
