<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/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="row"> <div class="col-md-4 col-md-offset-4"> <form class="form-horizontal" role="form"> <fieldset> <!-- Form Name --> <legend>Address Details</legend> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">Line 1</label> <div class="col-sm-10"> <input type="text" placeholder="Address Line 1" class="form-control"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">Line 2</label> <div class="col-sm-10"> <input type="text" placeholder="Address Line 2" class="form-control"> </div> </div> <div class="form-group"> <div class="col-lg-6"> <div class="input-group"> <span class="input-group-addon"> <input type="checkbox"> </span> <input type="text" class="form-control"> </div><!-- /input-group --> </div> </div> <div class="form-group"> <label for="exampleInputEmail1">Insira a quantidade desejada de cada produto:</label> <div class="checkbox"> <label> <input type="checkbox" value=""> Carvão Mineral Imperador - 2KG </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Carvão Mineral Imperador - 4KG </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Carvão Mineral Imperador - 8KG </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Palitos para Churrasco de 25cm (caixa com 10 mil unidades) </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Palitos para Churrasco de 28cm (caixa com 10 mil unidades) </label> </div> <div class="checkbox"> <label> <input type="checkbox" value=""> Acendedores para Churrasco (pacote com 50 unidades) </label> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">City</label> <div class="col-sm-10"> <input type="text" placeholder="City" class="form-control"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">State</label> <div class="col-sm-4"> <input type="text" placeholder="State" class="form-control"> </div> <label class="col-sm-2 control-label" for="textinput">Postcode</label> <div class="col-sm-4"> <input type="text" placeholder="Post Code" class="form-control"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">Country</label> <div class="col-sm-10"> <input type="text" placeholder="Country" class="form-control"> </div> </div> <div class="form-group"> <div class="col-sm-offset-2 col-sm-10"> <div class="pull-right"> <button type="submit" class="btn btn-default">Cancel</button> <button type="submit" class="btn btn-primary">Save</button> </div> </div> </div> </fieldset> </form> </div><!-- /.col-lg-12 --> </div><!-- /.row -->