<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="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script>
<div class="container">
<table class="table table-striped">
<tbody>
<tr>
<td colspan="1">
<form class="well form-horizontal">
<fieldset>
<div class="form-group">
<label class="col-md-4 control-label">Full Name</label>
<div class="col-md-8 inputGroupContainer">
<div class="input-group"><span class="input-group-addon"><i class="glyphicon glyphicon-user"></i></span><input id="fullName" name="fullName" placeholder="Full Name" class="form-control" required="true" value="" type="text"></div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">Address Line 1</label>
<div class="col-md-8 inputGroupContainer">
<div class="input-group"><span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span><input id="addressLine1" name="addressLine1" placeholder="Address Line 1" class="form-control" required="true" value="" type="text"></div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">Address Line 2</label>
<div class="col-md-8 inputGroupContainer">
<div class="input-group"><span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span><input id="addressLine2" name="addressLine2" placeholder="Address Line 2" class="form-control" required="true" value="" type="text"></div>
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label">City</label>
<div class="col-md-8 inputGroupContainer">
<div class="input-group"><span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span><input id="city" name="city" placeholder="City" class="form-control" required="true" value="" type="text"></div>
</div>
</div>
<div class="form-group">
