"Formulário de Simulação de Proteção Veicular"
Bootstrap 4.1.1 Snippet by andreluialves

<link href="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/js/bootstrap.min.js"></script> <script src="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class="container"> <div class="row"> <h2>Simule a Proteção do seu Veículo</h2> </div> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Form Name</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="nome">Nome</label> <div class="col-md-4"> <input id="nome" name="nome" type="text" placeholder="Digite o seu nome" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="email">Email</label> <div class="col-md-4"> <input id="email" name="email" type="text" placeholder="Ex.: seunome@email.com.br" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="telefone">Telefone</label> <div class="col-md-4"> <input id="telefone" name="telefone" type="text" placeholder="(00)000000000" class="form-control input-md" required=""> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="estado">Estado</label> <div class="col-md-4"> <select id="estado" name="estado" class="form-control"> <option value="1">RJ</option> <option value="2">SP</option> <option value="">MG</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="cidade">Cidade</label> <div class="col-md-4"> <input id="cidade" name="cidade" type="text" placeholder="Digite sua cidade" class="form-control input-md"> </div> </div> </fieldset> </form> </div>

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