<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 ----------> <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>