<link href="//netdna.bootstrapcdn.com/bootstrap/3.1.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.1.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Seguro Auto Pessoa Física</legend> <!-- Text input--> <div class="control-group"> <label class="control-label" for="Titulo - Dados Pessoais">Titulo - Dados Pessoais</label> <div class="controls"> <input id="Titulo - Dados Pessoais" name="Titulo - Dados Pessoais" type="text" placeholder="Titulo - Dados Pessoais" class="input-xlarge"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="nome">Nome</label> <div class="controls"> <input id="nome" name="nome" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="CPF">CPF</label> <div class="controls"> <input id="CPF" name="CPF" type="text" placeholder="" class="input-medium" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="email">E-mail</label> <div class="controls"> <input id="email" name="email" type="text" placeholder="" class="input-xlarge"> </div> </div> <!-- Password input--> <div class="control-group"> <label class="control-label" for="Telefone Fixo + DDD">Telefone Fixo + DDD</label> <div class="controls"> <input id="Telefone Fixo + DDD" name="Telefone Fixo + DDD" type="password" placeholder="(xx) xxxx-xxxx" class="input-medium" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="celular">Celular + DDD</label> <div class="controls"> <input id="celular" name="celular" type="text" placeholder="(xx) xxxx-xxxx" class="input-medium"> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="moradia">Moradia</label> <div class="controls"> <select id="moradia" name="moradia" class="input-xlarge"> <option>Casa com frente para rua</option> <option>Casa em condomínio fechado</option> <option>Apartamento SItio, fazenda</option> </select> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="cep-res">CEP Residencial</label> <div class="controls"> <input id="cep-res" name="cep-res" type="text" placeholder="" class="input-small"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="rua">Rua</label> <div class="controls"> <input id="rua" name="rua" type="text" placeholder="" class="input-xlarge"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="Num">Número</label> <div class="controls"> <input id="Num" name="Num" type="text" placeholder="" class="input-mini"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="Data Nascimento">Data Nascimento</label> <div class="controls"> <input id="Data Nascimento" name="Data Nascimento" type="text" placeholder="dd/mm/aaaa" class="input-small"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="textinput">Text Input</label> <div class="controls"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="input-xlarge"> <p class="help-block">help</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="textinput">Text Input</label> <div class="controls"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="input-xlarge"> <p class="help-block">help</p> </div> </div> </fieldset> </form>