<link href="//netdna.bootstrapcdn.com/twitter-bootstrap/2.3.2/css/bootstrap-combined.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//netdna.bootstrapcdn.com/twitter-bootstrap/2.3.2/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<div class="thumbnail center well well-small text-center">
<h2>Schedule Demo</h2>
<p>Enter Your Details To Get Started</p>
<form action="" method="post">
<div class="input-prepend"><span class="add-on"><i class="icon-user"></i></span>
<input type="text" id="" name="" placeholder="Your Name">
</div>
<div class="input-prepend"><span class="add-on"><i class="icon-envelope"></i></span>
<input type="text" id="" namel="" placeholder="your@email.com">
</div>
<div class="input-prepend"><span class="add-on"><i class="icon-phone"></i></span>
<input type="text" id="" name="" placeholder="555.5555.5555">
</div>
<br />
<input type="submit" value="Submit" class="btn btn-warning btn-large" />
</form>
</div>
