<div class="container">
<div class="row">
<div class="span8">
<form action="billing" method="post" class="form-horizontal" id="billingform" accept-charset="utf-8">
<div class="control-group">
<label for="email" class="control-label">
Billing E-Mail
</label>
<div class="controls">
<input name="email" type="email" value="" id="email">
<span class="help-inline"> Where should we send invoices?</span>
</div>
</div>
<div class="control-group">
<label for="address" class="control-label">
Street Address
</label>
<div class="controls"><input name="address" placeholder="W 123 Street" type="text" value="" id="address"><span class="help-inline"> Street Name and/or apartment number</span>
</div>
</div>
<div class="control-group">
<label for="zip" class="control-label">
Zip Code
</label>
<div class="controls"><input name="zip" type="text" value="" id="zip">
</div>
</div>
<div class="control-group">
<label for="city" class="control-label">
City
</label>
<div class="controls"><input name="city" type="text" value="" id="city">
</div>
</div>
<div class="control-group">
<label for="country" class="control-label">
Country
</label>
<div class="controls">
<select name="country" id="country">
<option value=""></option>
<option value="AR">Argentina</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BR">Brazil</option>
<option value="BG">Bulgaria</option>
<option value="CA">Canada</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CO">Colombia</option>
<option value="CR">Costa Rica</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark</option>
<option value="DO">Dominican Republic</option>
<option value="EG">Egypt</option>
<option value="EE">Estonia</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="HK">Hong Kong S.A.R., China</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="KZ">Kazakhstan</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Laos</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MK">Macedonia</option>
<option value="MY">Malaysia</option>
<option value="MT">Malta</option>
<option value="MX">Mexico</option>
<option value="MD">Moldova</option>
<option value="MC">Monaco</option>
<option value="ME">Montenegro</option>
<option value="MA">Morocco</option>
<option value="NL">Netherlands</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="KP">North Korea</option>
<option value="NO">Norway</option>
<option value="PK">Pakistan</option>
<option value="PS">Palestinian Territory</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="RO">Romania</option>
<option value="RU">Russia</option>
<option value="SA">Saudi Arabia</option>
<option value="RS">Serbia</option>
<option value="SG">Singapore</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="ZA">South Africa</option>
<option value="KR">South Korea</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="TW">Taiwan</option>
<option value="TH">Thailand</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US">USA</option>
<option value="UZ">Uzbekistan</option>
<option value="VN">Vietnam</option>
</select>
</div>
</div>
<div class="form-actions">
<button type="submit" class="btn btn-large btn-primary">Save Billing Address</button>
</div>
</form>
</div> <!-- .span8 -->
</div>
</div>
