<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 ----------> <link rel="stylesheet" href="https://fonts.googleapis.com/icon?family=Material+Icons"> <form> <legend><span class="glyphicon glyphicon-send"></span> Envio rápido de SMs</legend> </form> <div class="container"> <div class="row"> <div class="col-md-8"> <div class="well well-sm"> <form> <div class="row"> <div class="col-md-6"> <div class="form-group"> <label for="name"> Name</label> <input type="text" class="form-control" id="name" placeholder="Enter name" required="required" /> </div> <div class="form-group"> <label for="email"> Email Address</label> <div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-envelope"></span> </span> <input type="email" class="form-control" id="email" placeholder="Enter email" required="required" /></div> </div> <div class="form-group"> <label for="subject"> Subject</label> <select id="subject" name="subject" class="form-control" required="required"> <option value="na" selected="">Choose One:</option> <option value="service">General Customer Service</option> <option value="suggestions">Suggestions</option> <option value="product">Product Support</option> </select> </div> </div> <div class="col-md-6"> <div class="form-group"> <label for="name"> Message</label> <textarea name="message" id="message" class="form-control" rows="9" cols="25" required="required" placeholder="Message"></textarea> </div> </div> <div class="col-md-12"> <button type="submit" class="btn btn-primary pull-right" id="btnContactUs"> Enviar SMS</button> </div> </div> </form> </div> </div> </div> </div>