"payment test"
Bootstrap 3.3.0 Snippet by jwongc

<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"> <div class="row"> <h2>Create your snippet's HTML, CSS and Javascript in the editor tabs</h2> </div> </div> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Form Name</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Company</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Country">Country</label> <div class="col-md-4"> <input id="Country" name="Country" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="AddressLine1">Address 1</label> <div class="col-md-4"> <input id="AddressLine1" name="AddressLine1" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="AddressLine2">Address 2</label> <div class="col-md-4"> <input id="AddressLine2" name="AddressLine2" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="city">City</label> <div class="col-md-4"> <input id="city" name="city" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="zipCode">Zip/Postal Code</label> <div class="col-md-4"> <input id="zipCode" name="zipCode" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="state">State</label> <div class="col-md-4"> <input id="state" name="state" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="phone">Phone</label> <div class="col-md-4"> <input id="phone" name="phone" type="text" placeholder="" class="form-control input-md" required=""> </div> </div> </fieldset> </form>

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