<div class="form-area"> <form role="form" method="post" action="" id="registerform"> <br style="clear:both"> <h3 style="margin-removed 25px; text-align: center;">Registration Form</h3> <div class="form-inline"> <label class="radio"> <input value="property" type="radio" name="whatneed" checked=""> Property Loan </label> <label class="radio"> <input value="automobile" type="radio" name="whatneed"> Automobile Loan </label> </div> <br> <div class="form-group"> <div class="input-group"> <input type="text" class="form-control" placeholder="Your Budget" name="budget" required> <span class="input-group-addon">.00</span> </div> </div> <div class="form-group"> <input type="text" class="form-control" name="whenneed" placeholder="When are you planing to buy" required> </div> <div class="form-group"> <input type="text" class="form-control" name="location" placeholder="Location" required> </div> <div class="form-group"> <input type="text" class="form-control" id="name" name="name" placeholder="Name" required> </div> <div class="form-group"> <textarea class="form-control" type="textarea" name="address" placeholder="Your Address" maxlength="140" rows="7"></textarea> </div> <div class="form-group"> <input type="text" class="form-control" id="mobile" name="mobile" placeholder="Mobile Number" required> </div> <div class="form-group"> <input type="text" class="form-control" name="landline" placeholder="Landline Number" required> </div> <div class="form-group"> <input type="email" class="form-control" id="email" name="email" placeholder="Email" required> </div> <button type="submit" id="submit" name="submit" class="btn btn-primary pull-right">Submit Form</button> </form> </div>
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