<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> <!------ Include the above in your HEAD tag ----------> <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> </select> </div> <label for="address" class="col-sm-2">Address</label> <div class="col-sm-4"> <input type="text" class="form-control" name="address" id="address" placeholder="Street + No"> </div> </div> <div class="form-group"> <label for="city" class="col-sm-2">City</label> <div class="col-sm-4"> <input type="text" class="form-control" list="cities" name="city" id="city" placeholder="City"> <datalist id="cities"> <option value=""> <option value="Nagpur"> <option value="Thane"> <option value="Pune"> <option value="Nasik"> </datalist> </div> <label for="state" class="col-sm-2">State</label> <div class="col-sm-4"> <select class="form-control" name="state" id="state"> <option>Select a Region</option> <option>Maharashtra</option> <option>Rajasthan</option> <option>Punjab</option> <option>Banglaru</option> <option>Delhi</option> </select> </div> </div> <div class="form-group"> <label for="zipcode" class="col-sm-2">ZIP Code</label> <div class="col-sm-4"> <input type="text" class="form-control" name="zipcode" id="zipcode" placeholder="ZIP Code"> </div> </div> <legend>Contact Info</legend> <div class="form-group"> <label for="firstname" class="col-sm-2">Contact Person Name:</label> <div class="col-sm-4"> <input type="text" class="form-control" name="cname" id="cname" placeholder="Name"> </div> </div> <div class="form-group"> <label for="lastname" class="col-sm-2">Designation</label> <div class="col-sm-4"> <input type="text" class="form-control" name="designation" id="designation" placeholder="Designation"> </div> </div> <div class="form-group"> <label for="phone" class="col-sm-2">Phone</label> <div class="col-sm-4"> <input type="tel" class="form-control" name="phone" id="phone" placeholder="Phone Number"> </div> </div> <div class="form-group"> <label for="email" class="col-sm-2">Email</label> <div class="col-sm-4"> <input type="email" class="form-control" name="email" id="email" placeholder="Email"> </div> </div> <div class="form-group"> <label for="skypeid" class="col-sm-2">Skype ID</label> <div class="col-sm-4"> <input type="text" class="form-control" name="skypeid" id="skypeid" placeholder="Skype ID"> </div> </div> <div class="form-group"> <label for="firstname" class="col-sm-2">Website (if any)</label> <div class="col-sm-4"> <input type="text" class="form-control" name="website" id="website" placeholder="www.abcd.com"> </div> </div> <div class="form-group"> <div class="col-sm-offset-2 col-sm-10"> <button type="submit" class="btn btn-warning" name="submit" id="submit">Submit</button> </div> </div> </form> </div>