<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>
<div class="container">
<form class="form-horizontal" id="form_members" role="form">
<legend>Client Details</legend>
<div class="form-group">
<label for="firstname" class="col-sm-2">Company Name</label></label>
<div class="col-sm-4">
<input type="text" class="form-control" name="companyname" id="companyname" placeholder="Company Name">
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2">Industry Type & Vertical</label>
<div class="col-sm-4">
<input type="text" class="form-control" name="Industry" id="Industry" placeholder="Industry Type & Vertical">
</div>
</div>
<div class="form-group">
<label for="textarea" class="col-sm-2">Brief Description of the Business:</label>
<div class="col-sm-4">
<textarea class="form-control" id="textarea" name="textarea" placeholder="Brief"></textarea>
</div>
</div>
<legend>Address</legend>
<div class="form-group">
<label for="region" class="col-sm-2">Region</label>
<div class="col-sm-4">
<select class="form-control" name="region" id="region">
<option>Select a Region</option>
<option>INDIA</option>
<option>USA</option>
<option>America</option>
<option>Nepal</option>
