<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 ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Form Name</legend> <!-- Text input--> <div class="control-group"> <label class="control-label" for="nombrecompleto">Nombre Completo</label> <div class="controls"> <input id="nombrecompleto" name="nombrecompleto" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="rut">RUT</label> <div class="controls"> <input id="rut" name="rut" type="text" placeholder="XXXXXXX-X" class="input-xlarge" required=""> <p class="help-block">Igresar RUT sin puntos.</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="fechanacimiento">Fecha Nacimiento</label> <div class="controls"> <input id="fechanacimiento" name="fechanacimiento" type="text" placeholder="DD/MM/YYYY" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="edad">Edad</label> <div class="controls"> <input id="edad" name="edad" type="text" placeholder="DD/MM/YYY/" class="input-xlarge"> </div> </div> <!-- Multiple Radios (inline) --> <div class="control-group"> <label class="control-label" for="estadocivil">Estado civil</label> <div class="controls"> <label class="radio inline" for="estadocivil-0"> <input type="radio" name="estadocivil" id="estadocivil-0" value="soltero" checked="checked"> soltero </label> <label class="radio inline" for="estadocivil-1"> <input type="radio" name="estadocivil" id="estadocivil-1" value="casado"> casado </label> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="nacionalidad">País de nacionalidad</label> <div class="controls"> <select id="nacionalidad" name="nacionalidad" class="input-xlarge"> <option>Afghanistan</option> <option>Albania</option> <option>Algeria</option> <option>Andorra</option> <option>Angola</option> <option>Antigua & Deps</option> <option>Argentina</option> <option>Armenia</option> <option>Australia</option> <option>Austria</option> <option>Azerbaijan</option> <option>Bahamas</option> <option>Bahrain</option> <option>Bangladesh</option> <option>Barbados</option> <option>Belarus</option> <option>Belgium</option> <option>Belize</option> <option>Benin</option> <option>Bhutan</option> <option>Bolivia</option> <option>Bosnia Herzegovina</option> <option>Botswana</option> <option>Brazil</option> <option>Brunei</option> <option>Bulgaria</option> <option>Burkina</option> <option>Burundi</option> <option>Cambodia</option> <option>Cameroon</option> <option>Canada</option> <option>Cape Verde</option> <option>Central African Rep</option> <option>Chad</option> <option>Chile</option> <option>China</option> <option>Colombia</option> <option>Comoros</option> <option>Congo</option> <option>Congo {Democratic Rep}</option> <option>Costa Rica</option> <option>Croatia</option> <option>Cuba</option> <option>Cyprus</option> <option>Czech Republic</option> <option>Denmark</option> <option>Djibouti</option> <option>Dominica</option> <option>Dominican Republic</option> <option>East Timor</option> <option>Ecuador</option> <option>Egypt</option> <option>El Salvador</option> <option>Equatorial Guinea</option> <option>Eritrea</option> <option>Estonia</option> <option>Ethiopia</option> <option>Fiji</option> <option>Finland</option> <option>France</option> <option>Gabon</option> <option>Gambia</option> <option>Georgia</option> <option>Germany</option> <option>Ghana</option> <option>Greece</option> <option>Grenada</option> <option>Guatemala</option> <option>Guinea</option> <option>Guinea-Bissau</option> <option>Guyana</option> <option>Haiti</option> <option>Honduras</option> <option>Hungary</option> <option>Iceland</option> <option>India</option> <option>Indonesia</option> <option>Iran</option> <option>Iraq</option> <option>Ireland {Republic}</option> <option>Israel</option> <option>Italy</option> <option>Ivory Coast</option> <option>Jamaica</option> <option>Japan</option> <option>Jordan</option> <option>Kazakhstan</option> <option>Kenya</option> <option>Kiribati</option> <option>Korea North</option> <option>Korea South</option> <option>Kosovo</option> <option>Kuwait</option> <option>Kyrgyzstan</option> <option>Laos</option> <option>Latvia</option> <option>Lebanon</option> <option>Lesotho</option> <option>Liberia</option> <option>Libya</option> <option>Liechtenstein</option> <option>Lithuania</option> <option>Luxembourg</option> <option>Macedonia</option> <option>Madagascar</option> <option>Malawi</option> <option>Malaysia</option> <option>Maldives</option> <option>Mali</option> <option>Malta</option> <option>Marshall Islands</option> <option>Mauritania</option> <option>Mauritius</option> <option>Mexico</option> <option>Micronesia</option> <option>Moldova</option> <option>Monaco</option> <option>Mongolia</option> <option>Montenegro</option> <option>Morocco</option> <option>Mozambique</option> <option>Myanmar, {Burma}</option> <option>Namibia</option> <option>Nauru</option> <option>Nepal</option> <option>Netherlands</option> <option>New Zealand</option> <option>Nicaragua</option> <option>Niger</option> <option>Nigeria</option> <option>Norway</option> <option>Oman</option> <option>Pakistan</option> <option>Palau</option> <option>Panama</option> <option>Papua New Guinea</option> <option>Paraguay</option> <option>Peru</option> <option>Philippines</option> <option>Poland</option> <option>Portugal</option> <option>Qatar</option> <option>Romania</option> <option>Russian Federation</option> <option>Rwanda</option> <option>St Kitts & Nevis</option> <option>St Lucia</option> <option>Saint Vincent & the Grenadines</option> <option>Samoa</option> <option>San Marino</option> <option>Sao Tome & Principe</option> <option>Saudi Arabia</option> <option>Senegal</option> <option>Serbia</option> <option>Seychelles</option> <option>Sierra Leone</option> <option>Singapore</option> <option>Slovakia</option> <option>Slovenia</option> <option>Solomon Islands</option> <option>Somalia</option> <option>South Africa</option> <option>South Sudan</option> <option>Spain</option> <option>Sri Lanka</option> <option>Sudan</option> <option>Suriname</option> <option>Swaziland</option> <option>Sweden</option> <option>Switzerland</option> <option>Syria</option> <option>Taiwan</option> <option>Tajikistan</option> <option>Tanzania</option> <option>Thailand</option> <option>Togo</option> <option>Tonga</option> <option>Trinidad & Tobago</option> <option>Tunisia</option> <option>Turkey</option> <option>Turkmenistan</option> <option>Tuvalu</option> <option>Uganda</option> <option>Ukraine</option> <option>United Arab Emirates</option> <option>United Kingdom</option> <option>United States</option> <option>Uruguay</option> <option>Uzbekistan</option> <option>Vanuatu</option> <option>Vatican City</option> <option>Venezuela</option> <option>Vietnam</option> <option>Yemen</option> <option>Zambia</option> <option>Zimbabwe</option> </select> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="domicilio">Domicilio</label> <div class="controls"> <input id="domicilio" name="domicilio" type="text" placeholder="" class="input-xlarge" required=""> <p class="help-block">Calle, Número y departamento</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="ciudad">Ciudad</label> <div class="controls"> <input id="ciudad" name="ciudad" type="text" placeholder="placeholder" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="comuna">Comuna</label> <div class="controls"> <input id="comuna" name="comuna" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="telefonofijo">Telefono fijo</label> <div class="controls"> <input id="telefonofijo" name="telefonofijo" type="text" placeholder="" class="input-xlarge"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="telefonocelular">Teléfono Celular</label> <div class="controls"> <input id="telefonocelular" name="telefonocelular" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> </fieldset> </form>