<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>
<div class="container">
<div class="row">
<div class="col-sm-6">
<div class="alert alert-info" role="alert">
<p>Please enter your card details below.</p>
</div>
<hr/>
<div class="form-group">
<label class="control-label" for="username">Card Holder's Name</label>
<div class="controls">
<input type="text" id="username" name="username" placeholder="" class="form-control">
</div>
</div>
<div class="form-group">
<label class="control-label" for="card_number">Card Number</label>
<div class="controls">
<input type="text" id="card_number" name="card_number" placeholder=""
class="form-control">
</div>
</div>
<hr/>
<div class="form-group">
<label class="control-label" for="expiry_month">Card Expiry Date</label>
<div class="row">
<div class="col-sm-4">
