<link href="//netdna.bootstrapcdn.com/twitter-bootstrap/2.3.2/css/bootstrap-combined.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/twitter-bootstrap/2.3.2/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>Pedidos</legend> <!-- Text input--> <div class="control-group"> <label class="control-label" for="nome">Nome Completo</label> <div class="controls"> <input name="nome" class="input-xlarge" id="nome" required="" type="text" placeholder="Seu Nome"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="telefone">Telefone</label> <div class="controls"> <input name="telefone" class="input-xlarge" id="telefone" required="" type="text" placeholder="Ex.: (99) 9999-9999"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="endereco">Endereço</label> <div class="controls"> <input name="endereco" class="input-xlarge" id="endereco" required="" type="text" placeholder="Seu Endereço"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="bairro">Bairro</label> <div class="controls"> <input name="bairro" class="input-xlarge" id="bairro" type="text" placeholder="Seu Bairro" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="cidade">Cidade</label> <div class="controls"> <input name="cidade" class="input-xlarge" id="cidade" type="text" placeholder="Sua Cidade" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="cep">CEP</label> <div class="controls"> <input name="cep" class="input-xlarge" id="cep" required="" type="text" placeholder="Seu CEP"> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="produto">Produto</label> <div class="controls"> <select name="produto" class="input-xlarge" id="produto" required=""> <option>Gás</option> <option>Gás Industrial</option> <option>Agua Mineral</option> </select> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="pagamento">Pagamento</label> <div class="controls"> <select name="pagamento" class="input-xlarge" id="pagamento" required=""> <option>Dinheiro</option> <option>Cartão de Debito</option> <option>Cartão de Credito</option> </select> </div> </div> <!-- Button --> <div class="control-group"> <label class="control-label" for="enviar"></label> <div class="controls"> <button name="enviar" class="btn btn-primary" id="enviar">Enviar</button> </div> </div> </fieldset> </form>