<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>CadastroDeCliente</legend> <!-- Text input--> <div class="control-group"> <label class="control-label" for="nome">Nome</label> <div class="controls"> <input id="nome" name="nome" type="text" placeholder="-- Digite o nome completo" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="apelido">Apelido</label> <div class="controls"> <input id="apelido" name="apelido" type="text" placeholder="-- Como deseja ser chamado?" class="input-large"> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="tipo">Tipo Endereço</label> <div class="controls"> <select id="tipo" name="tipo" class="input-medium"> <option>Selecione ----</option> <option>Aeroporto</option> <option>Alameda</option> <option>Área</option> <option>Avenida</option> <option>Campo</option> <option>Chácara</option> <option>Côlonia</option> <option>Condomínio</option> <option>Conjunto</option> <option>Distrito</option> <option>Esplanada</option> <option>Estação</option> <option>Estrada</option> <option>Favela</option> <option>Fazenda</option> <option>Feira</option> <option>Jardim</option> <option>Ladeira</option> <option>Lago</option> <option>Lagoa</option> <option>Largo</option> <option>Loteamento</option> <option>Morro</option> <option>Núcleo</option> <option>Parque</option> <option>Passarela</option> <option>Pátio</option> <option>Praça</option> <option>Quadra</option> <option>Recanto</option> <option>Residencial</option> <option>Rodovia</option> <option>Rua</option> <option>Setor</option> <option>Sítio</option> <option>Travessa</option> <option>Trecho</option> <option>Trevo</option> <option>Vale</option> <option>Vereda</option> <option>Via</option> <option>Viaduto</option> <option>Viela</option> <option>Vila</option> </select> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="endereco">Endereço</label> <div class="controls"> <input id="endereco" name="endereco" type="text" placeholder="-- Rua/Av/Qd" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="complemento">Complemento</label> <div class="controls"> <input id="complemento" name="complemento" type="text" placeholder="Completo de endereço, ex: Prox. a" class="input-xlarge"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="bairro">Bairro</label> <div class="controls"> <input id="bairro" name="bairro" type="text" placeholder="--" class="input-xlarge" required=""> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="uf">UF</label> <div class="controls"> <select id="uf" name="uf" class="input-mini"> <option>--</option> <option>AC</option> <option>AL</option> <option>AM</option> <option>AP</option> <option>BA</option> <option>CE</option> <option>DF</option> <option>ES</option> <option>GO</option> <option>MA</option> <option>MG</option> <option>MS</option> <option>MT</option> <option>PA</option> <option>PB</option> <option>PE</option> <option>PI</option> <option>PR</option> <option>RJ</option> <option>RN</option> <option>RO</option> <option>RR</option> <option>RS</option> <option>SC</option> <option>SE</option> <option>SP</option> <option>TO</option> </select> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="cidade">Cidade</label> <div class="controls"> <input id="cidade" name="cidade" type="text" placeholder="--" class="input-medium" required=""> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="datanasc_d">Nascimento Dia</label> <div class="controls"> <select id="datanasc_d" name="datanasc_d" class="input-small"> <option>-- Dia</option> <option>1</option> <option>2</option> <option>3</option> <option>4</option> <option>5</option> <option>6</option> <option>7</option> <option>8</option> <option>9</option> <option>10</option> <option>11</option> <option>12</option> <option>13</option> <option>14</option> <option>15</option> <option>16</option> <option>17</option> <option>18</option> <option>19</option> <option>20</option> <option>21</option> <option>22</option> <option>23</option> <option>24</option> <option>25</option> <option>26</option> <option>27</option> <option>28</option> <option>29</option> <option>30</option> </select> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="datanasc_m">Nascimento Mês</label> <div class="controls"> <select id="datanasc_m" name="datanasc_m" class="input-small"> <option>-- Mês</option> <option>01</option> <option>02</option> <option>03</option> <option>04</option> <option>05</option> <option>06</option> <option>07</option> <option>08</option> <option>09</option> <option>10</option> <option>11</option> <option>12</option> </select> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="datanasc_a">Nascimento Ano</label> <div class="controls"> <select id="datanasc_a" name="datanasc_a" class="input-small"> <option>-- Ano</option> <option>1920</option> <option>1921</option> <option>1922</option> <option>1923</option> <option>1924</option> <option>1925</option> <option>1926</option> <option>1927</option> <option>1928</option> <option>1929</option> <option>1930</option> <option>1931</option> <option>1932</option> <option>1933</option> <option>1934</option> <option>1935</option> <option>1936</option> <option>1937</option> <option>1938</option> <option>1939</option> <option>1940</option> <option>1941</option> <option>1942</option> <option>1943</option> <option>1944</option> <option>1945</option> <option>1946</option> <option>1947</option> <option>1948</option> <option>1949</option> <option>1950</option> <option>1951</option> <option>1952</option> <option>1953</option> <option>1954</option> <option>1955</option> <option>1956</option> <option>1957</option> <option>1958</option> <option>1959</option> <option>1960</option> <option>1961</option> <option>1962</option> <option>1963</option> <option>1964</option> <option>1965</option> <option>1966</option> <option>1967</option> <option>1968</option> <option>1969</option> <option>1970</option> <option>1971</option> <option>1972</option> <option>1973</option> <option>1974</option> <option>1975</option> <option>1976</option> <option>1977</option> <option>1978</option> <option>1979</option> <option>1980</option> <option>1981</option> <option>1982</option> <option>1983</option> <option>1984</option> <option>1985</option> <option>1986</option> <option>1987</option> <option>1988</option> <option>1989</option> <option>1990</option> <option>1991</option> <option>1992</option> <option>1993</option> <option>1994</option> <option>1995</option> <option>1996</option> <option>1997</option> <option>1998</option> <option>1999</option> <option>2000</option> <option>2001</option> <option>2002</option> <option>2003</option> <option>2004</option> <option>2005</option> <option>2006</option> <option>2007</option> <option>2008</option> <option>2009</option> <option>2010</option> <option>2011</option> <option>2012</option> <option>2013</option> <option>2014</option> <option>2015</option> <option>2016</option> </select> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="email">E-mail</label> <div class="controls"> <input id="email" name="email" type="text" placeholder="--" class="input-xlarge"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="tel1">Telefone Fixo</label> <div class="controls"> <input id="tel1" name="tel1" type="text" placeholder="-- Telefone fixo" class="input-medium"> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="tel2">Telefone Cel.</label> <div class="controls"> <input id="tel2" name="tel2" type="text" placeholder="-- Telefone cel." class="input-medium" required=""> </div> </div> <!-- Textarea --> <div class="control-group"> <label class="control-label" for="obscadastro">Observação</label> <div class="controls"> <textarea id="obscadastro" name="obscadastro">Complementos de cadastro e informações adicionais.</textarea> </div> </div> </fieldset> </form>