&lt;form id=&quot;form-app&quot; enctype=&quot;multipart/form-data&quot;&gt;
&lt;fieldset&gt;

&lt;!-- Heading --&gt;
&lt;h3 class=&quot;legend&quot;&gt;Address Book&lt;/h3&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_0&quot;&gt;Name&lt;/label&gt;
    &lt;input type=&quot;text&quot; id=&quot;text_0&quot; name=&quot;text_0&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- File --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;file_0&quot;&gt;Photo&lt;/label&gt;
    &lt;input type=&quot;file&quot; id=&quot;file_0&quot; name=&quot;file_0&quot; accept=&quot;.gif, .jpg, .png&quot;&gt;
&lt;/div&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_1&quot;&gt;Address&lt;/label&gt;
    &lt;input type=&quot;text&quot; id=&quot;text_1&quot; name=&quot;text_1&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group col-xs-4&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_2&quot;&gt;City&lt;/label&gt;
    &lt;input type=&quot;text&quot; id=&quot;text_2&quot; name=&quot;text_2&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group col-xs-4&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_3&quot;&gt;State&lt;/label&gt;
    &lt;input type=&quot;text&quot; id=&quot;text_3&quot; name=&quot;text_3&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Select List --&gt;
&lt;div class=&quot;form-group col-xs-4&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;selectlist_0&quot;&gt;Country&lt;/label&gt;
    &lt;select id=&quot;selectlist_0&quot; name=&quot;selectlist_0[]&quot; class=&quot;form-control&quot;&gt;
        &lt;option value=&quot;&quot; disabled=&quot;&quot; selected=&quot;&quot;&gt;-Select-&lt;/option&gt;
        &lt;option value=&quot;United States&quot;&gt;United States&lt;/option&gt;
        &lt;option value=&quot;United Kingdom&quot;&gt;United Kingdom&lt;/option&gt;
        &lt;option value=&quot;Australia&quot;&gt;Australia&lt;/option&gt;
        &lt;option value=&quot;Canada&quot;&gt;Canada&lt;/option&gt;
        &lt;option value=&quot;France&quot;&gt;France&lt;/option&gt;
        &lt;option value=&quot;----&quot;&gt;----&lt;/option&gt;
        &lt;option value=&quot;Afghanistan&quot;&gt;Afghanistan&lt;/option&gt;
        &lt;option value=&quot;Albania&quot;&gt;Albania&lt;/option&gt;
        &lt;option value=&quot;Algeria&quot;&gt;Algeria&lt;/option&gt;
        &lt;option value=&quot;Andorra&quot;&gt;Andorra&lt;/option&gt;
        &lt;option value=&quot;Angola&quot;&gt;Angola&lt;/option&gt;
        &lt;option value=&quot;Antigua &amp;amp; Deps&quot;&gt;Antigua &amp;amp; Deps&lt;/option&gt;
        &lt;option value=&quot;Argentina&quot;&gt;Argentina&lt;/option&gt;
        &lt;option value=&quot;Armenia&quot;&gt;Armenia&lt;/option&gt;
        &lt;option value=&quot;Austria&quot;&gt;Austria&lt;/option&gt;
        &lt;option value=&quot;Azerbaijan&quot;&gt;Azerbaijan&lt;/option&gt;
        &lt;option value=&quot;Bahamas&quot;&gt;Bahamas&lt;/option&gt;
        &lt;option value=&quot;Bahrain&quot;&gt;Bahrain&lt;/option&gt;
        &lt;option value=&quot;Bangladesh&quot;&gt;Bangladesh&lt;/option&gt;
        &lt;option value=&quot;Barbados&quot;&gt;Barbados&lt;/option&gt;
        &lt;option value=&quot;Belarus&quot;&gt;Belarus&lt;/option&gt;
        &lt;option value=&quot;Belgium&quot;&gt;Belgium&lt;/option&gt;
        &lt;option value=&quot;Belize&quot;&gt;Belize&lt;/option&gt;
        &lt;option value=&quot;Benin&quot;&gt;Benin&lt;/option&gt;
        &lt;option value=&quot;Bhutan&quot;&gt;Bhutan&lt;/option&gt;
        &lt;option value=&quot;Bolivia&quot;&gt;Bolivia&lt;/option&gt;
        &lt;option value=&quot;Bosnia Herzegovina&quot;&gt;Bosnia Herzegovina&lt;/option&gt;
        &lt;option value=&quot;Botswana&quot;&gt;Botswana&lt;/option&gt;
        &lt;option value=&quot;Brazil&quot;&gt;Brazil&lt;/option&gt;
        &lt;option value=&quot;Brunei&quot;&gt;Brunei&lt;/option&gt;
        &lt;option value=&quot;Bulgaria&quot;&gt;Bulgaria&lt;/option&gt;
        &lt;option value=&quot;Burkina&quot;&gt;Burkina&lt;/option&gt;
        &lt;option value=&quot;Burundi&quot;&gt;Burundi&lt;/option&gt;
        &lt;option value=&quot;Cambodia&quot;&gt;Cambodia&lt;/option&gt;
        &lt;option value=&quot;Cameroon&quot;&gt;Cameroon&lt;/option&gt;
        &lt;option value=&quot;Cape Verde&quot;&gt;Cape Verde&lt;/option&gt;
        &lt;option value=&quot;Central African Rep&quot;&gt;Central African Rep&lt;/option&gt;
        &lt;option value=&quot;Chad&quot;&gt;Chad&lt;/option&gt;
        &lt;option value=&quot;Chile&quot;&gt;Chile&lt;/option&gt;
        &lt;option value=&quot;China&quot;&gt;China&lt;/option&gt;
        &lt;option value=&quot;Colombia&quot;&gt;Colombia&lt;/option&gt;
        &lt;option value=&quot;Comoros&quot;&gt;Comoros&lt;/option&gt;
        &lt;option value=&quot;Congo&quot;&gt;Congo&lt;/option&gt;
        &lt;option value=&quot;Congo {Democratic Rep}&quot;&gt;Congo {Democratic Rep}&lt;/option&gt;
        &lt;option value=&quot;Costa Rica&quot;&gt;Costa Rica&lt;/option&gt;
        &lt;option value=&quot;Croatia&quot;&gt;Croatia&lt;/option&gt;
        &lt;option value=&quot;Cuba&quot;&gt;Cuba&lt;/option&gt;
        &lt;option value=&quot;Cyprus&quot;&gt;Cyprus&lt;/option&gt;
        &lt;option value=&quot;Czech Republic&quot;&gt;Czech Republic&lt;/option&gt;
        &lt;option value=&quot;Denmark&quot;&gt;Denmark&lt;/option&gt;
        &lt;option value=&quot;Djibouti&quot;&gt;Djibouti&lt;/option&gt;
        &lt;option value=&quot;Dominica&quot;&gt;Dominica&lt;/option&gt;
        &lt;option value=&quot;Dominican Republic&quot;&gt;Dominican Republic&lt;/option&gt;
        &lt;option value=&quot;East Timor&quot;&gt;East Timor&lt;/option&gt;
        &lt;option value=&quot;Ecuador&quot;&gt;Ecuador&lt;/option&gt;
        &lt;option value=&quot;Egypt&quot;&gt;Egypt&lt;/option&gt;
        &lt;option value=&quot;El Salvador&quot;&gt;El Salvador&lt;/option&gt;
        &lt;option value=&quot;Equatorial Guinea&quot;&gt;Equatorial Guinea&lt;/option&gt;
        &lt;option value=&quot;Eritrea&quot;&gt;Eritrea&lt;/option&gt;
        &lt;option value=&quot;Estonia&quot;&gt;Estonia&lt;/option&gt;
        &lt;option value=&quot;Ethiopia&quot;&gt;Ethiopia&lt;/option&gt;
        &lt;option value=&quot;Fiji&quot;&gt;Fiji&lt;/option&gt;
        &lt;option value=&quot;Finland&quot;&gt;Finland&lt;/option&gt;
        &lt;option value=&quot;Gabon&quot;&gt;Gabon&lt;/option&gt;
        &lt;option value=&quot;Gambia&quot;&gt;Gambia&lt;/option&gt;
        &lt;option value=&quot;Georgia&quot;&gt;Georgia&lt;/option&gt;
        &lt;option value=&quot;Germany&quot;&gt;Germany&lt;/option&gt;
        &lt;option value=&quot;Ghana&quot;&gt;Ghana&lt;/option&gt;
        &lt;option value=&quot;Greece&quot;&gt;Greece&lt;/option&gt;
        &lt;option value=&quot;Grenada&quot;&gt;Grenada&lt;/option&gt;
        &lt;option value=&quot;Guatemala&quot;&gt;Guatemala&lt;/option&gt;
        &lt;option value=&quot;Guinea&quot;&gt;Guinea&lt;/option&gt;
        &lt;option value=&quot;Guinea-Bissau&quot;&gt;Guinea-Bissau&lt;/option&gt;
        &lt;option value=&quot;Guyana&quot;&gt;Guyana&lt;/option&gt;
        &lt;option value=&quot;Haiti&quot;&gt;Haiti&lt;/option&gt;
        &lt;option value=&quot;Honduras&quot;&gt;Honduras&lt;/option&gt;
        &lt;option value=&quot;Hungary&quot;&gt;Hungary&lt;/option&gt;
        &lt;option value=&quot;Iceland&quot;&gt;Iceland&lt;/option&gt;
        &lt;option value=&quot;India&quot;&gt;India&lt;/option&gt;
        &lt;option value=&quot;Indonesia&quot;&gt;Indonesia&lt;/option&gt;
        &lt;option value=&quot;Iran&quot;&gt;Iran&lt;/option&gt;
        &lt;option value=&quot;Iraq&quot;&gt;Iraq&lt;/option&gt;
        &lt;option value=&quot;Ireland {Republic}&quot;&gt;Ireland {Republic}&lt;/option&gt;
        &lt;option value=&quot;Israel&quot;&gt;Israel&lt;/option&gt;
        &lt;option value=&quot;Italy&quot;&gt;Italy&lt;/option&gt;
        &lt;option value=&quot;Ivory Coast&quot;&gt;Ivory Coast&lt;/option&gt;
        &lt;option value=&quot;Jamaica&quot;&gt;Jamaica&lt;/option&gt;
        &lt;option value=&quot;Japan&quot;&gt;Japan&lt;/option&gt;
        &lt;option value=&quot;Jordan&quot;&gt;Jordan&lt;/option&gt;
        &lt;option value=&quot;Kazakhstan&quot;&gt;Kazakhstan&lt;/option&gt;
        &lt;option value=&quot;Kenya&quot;&gt;Kenya&lt;/option&gt;
        &lt;option value=&quot;Kiribati&quot;&gt;Kiribati&lt;/option&gt;
        &lt;option value=&quot;Korea North&quot;&gt;Korea North&lt;/option&gt;
        &lt;option value=&quot;Korea South&quot;&gt;Korea South&lt;/option&gt;
        &lt;option value=&quot;Kosovo&quot;&gt;Kosovo&lt;/option&gt;
        &lt;option value=&quot;Kuwait&quot;&gt;Kuwait&lt;/option&gt;
        &lt;option value=&quot;Kyrgyzstan&quot;&gt;Kyrgyzstan&lt;/option&gt;
        &lt;option value=&quot;Laos&quot;&gt;Laos&lt;/option&gt;
        &lt;option value=&quot;Latvia&quot;&gt;Latvia&lt;/option&gt;
        &lt;option value=&quot;Lebanon&quot;&gt;Lebanon&lt;/option&gt;
        &lt;option value=&quot;Lesotho&quot;&gt;Lesotho&lt;/option&gt;
        &lt;option value=&quot;Liberia&quot;&gt;Liberia&lt;/option&gt;
        &lt;option value=&quot;Libya&quot;&gt;Libya&lt;/option&gt;
        &lt;option value=&quot;Liechtenstein&quot;&gt;Liechtenstein&lt;/option&gt;
        &lt;option value=&quot;Lithuania&quot;&gt;Lithuania&lt;/option&gt;
        &lt;option value=&quot;Luxembourg&quot;&gt;Luxembourg&lt;/option&gt;
        &lt;option value=&quot;Macedonia&quot;&gt;Macedonia&lt;/option&gt;
        &lt;option value=&quot;Madagascar&quot;&gt;Madagascar&lt;/option&gt;
        &lt;option value=&quot;Malawi&quot;&gt;Malawi&lt;/option&gt;
        &lt;option value=&quot;Malaysia&quot;&gt;Malaysia&lt;/option&gt;
        &lt;option value=&quot;Maldives&quot;&gt;Maldives&lt;/option&gt;
        &lt;option value=&quot;Mali&quot;&gt;Mali&lt;/option&gt;
        &lt;option value=&quot;Malta&quot;&gt;Malta&lt;/option&gt;
        &lt;option value=&quot;Marshall Islands&quot;&gt;Marshall Islands&lt;/option&gt;
        &lt;option value=&quot;Mauritania&quot;&gt;Mauritania&lt;/option&gt;
        &lt;option value=&quot;Mauritius&quot;&gt;Mauritius&lt;/option&gt;
        &lt;option value=&quot;Mexico&quot;&gt;Mexico&lt;/option&gt;
        &lt;option value=&quot;Micronesia&quot;&gt;Micronesia&lt;/option&gt;
        &lt;option value=&quot;Moldova&quot;&gt;Moldova&lt;/option&gt;
        &lt;option value=&quot;Monaco&quot;&gt;Monaco&lt;/option&gt;
        &lt;option value=&quot;Mongolia&quot;&gt;Mongolia&lt;/option&gt;
        &lt;option value=&quot;Montenegro&quot;&gt;Montenegro&lt;/option&gt;
        &lt;option value=&quot;Morocco&quot;&gt;Morocco&lt;/option&gt;
        &lt;option value=&quot;Mozambique&quot;&gt;Mozambique&lt;/option&gt;
        &lt;option value=&quot;Myanmar, {Burma}&quot;&gt;Myanmar, {Burma}&lt;/option&gt;
        &lt;option value=&quot;Namibia&quot;&gt;Namibia&lt;/option&gt;
        &lt;option value=&quot;Nauru&quot;&gt;Nauru&lt;/option&gt;
        &lt;option value=&quot;Nepal&quot;&gt;Nepal&lt;/option&gt;
        &lt;option value=&quot;Netherlands&quot;&gt;Netherlands&lt;/option&gt;
        &lt;option value=&quot;New Zealand&quot;&gt;New Zealand&lt;/option&gt;
        &lt;option value=&quot;Nicaragua&quot;&gt;Nicaragua&lt;/option&gt;
        &lt;option value=&quot;Niger&quot;&gt;Niger&lt;/option&gt;
        &lt;option value=&quot;Nigeria&quot;&gt;Nigeria&lt;/option&gt;
        &lt;option value=&quot;Norway&quot;&gt;Norway&lt;/option&gt;
        &lt;option value=&quot;Oman&quot;&gt;Oman&lt;/option&gt;
        &lt;option value=&quot;Pakistan&quot;&gt;Pakistan&lt;/option&gt;
        &lt;option value=&quot;Palau&quot;&gt;Palau&lt;/option&gt;
        &lt;option value=&quot;Panama&quot;&gt;Panama&lt;/option&gt;
        &lt;option value=&quot;Papua New Guinea&quot;&gt;Papua New Guinea&lt;/option&gt;
        &lt;option value=&quot;Paraguay&quot;&gt;Paraguay&lt;/option&gt;
        &lt;option value=&quot;Peru&quot;&gt;Peru&lt;/option&gt;
        &lt;option value=&quot;Philippines&quot;&gt;Philippines&lt;/option&gt;
        &lt;option value=&quot;Poland&quot;&gt;Poland&lt;/option&gt;
        &lt;option value=&quot;Portugal&quot;&gt;Portugal&lt;/option&gt;
        &lt;option value=&quot;Qatar&quot;&gt;Qatar&lt;/option&gt;
        &lt;option value=&quot;Romania&quot;&gt;Romania&lt;/option&gt;
        &lt;option value=&quot;Russian Federation&quot;&gt;Russian Federation&lt;/option&gt;
        &lt;option value=&quot;Rwanda&quot;&gt;Rwanda&lt;/option&gt;
        &lt;option value=&quot;St Kitts &amp;amp; Nevis&quot;&gt;St Kitts &amp;amp; Nevis&lt;/option&gt;
        &lt;option value=&quot;St Lucia&quot;&gt;St Lucia&lt;/option&gt;
        &lt;option value=&quot;Saint Vincent &amp;amp; the Grenadines&quot;&gt;Saint Vincent &amp;amp; the Grenadines&lt;/option&gt;
        &lt;option value=&quot;Samoa&quot;&gt;Samoa&lt;/option&gt;
        &lt;option value=&quot;San Marino&quot;&gt;San Marino&lt;/option&gt;
        &lt;option value=&quot;Sao Tome &amp;amp; Principe&quot;&gt;Sao Tome &amp;amp; Principe&lt;/option&gt;
        &lt;option value=&quot;Saudi Arabia&quot;&gt;Saudi Arabia&lt;/option&gt;
        &lt;option value=&quot;Senegal&quot;&gt;Senegal&lt;/option&gt;
        &lt;option value=&quot;Serbia&quot;&gt;Serbia&lt;/option&gt;
        &lt;option value=&quot;Seychelles&quot;&gt;Seychelles&lt;/option&gt;
        &lt;option value=&quot;Sierra Leone&quot;&gt;Sierra Leone&lt;/option&gt;
        &lt;option value=&quot;Singapore&quot;&gt;Singapore&lt;/option&gt;
        &lt;option value=&quot;Slovakia&quot;&gt;Slovakia&lt;/option&gt;
        &lt;option value=&quot;Slovenia&quot;&gt;Slovenia&lt;/option&gt;
        &lt;option value=&quot;Solomon Islands&quot;&gt;Solomon Islands&lt;/option&gt;
        &lt;option value=&quot;Somalia&quot;&gt;Somalia&lt;/option&gt;
        &lt;option value=&quot;South Africa&quot;&gt;South Africa&lt;/option&gt;
        &lt;option value=&quot;South Sudan&quot;&gt;South Sudan&lt;/option&gt;
        &lt;option value=&quot;Spain&quot;&gt;Spain&lt;/option&gt;
        &lt;option value=&quot;Sri Lanka&quot;&gt;Sri Lanka&lt;/option&gt;
        &lt;option value=&quot;Sudan&quot;&gt;Sudan&lt;/option&gt;
        &lt;option value=&quot;Suriname&quot;&gt;Suriname&lt;/option&gt;
        &lt;option value=&quot;Swaziland&quot;&gt;Swaziland&lt;/option&gt;
        &lt;option value=&quot;Sweden&quot;&gt;Sweden&lt;/option&gt;
        &lt;option value=&quot;Switzerland&quot;&gt;Switzerland&lt;/option&gt;
        &lt;option value=&quot;Syria&quot;&gt;Syria&lt;/option&gt;
        &lt;option value=&quot;Taiwan&quot;&gt;Taiwan&lt;/option&gt;
        &lt;option value=&quot;Tajikistan&quot;&gt;Tajikistan&lt;/option&gt;
        &lt;option value=&quot;Tanzania&quot;&gt;Tanzania&lt;/option&gt;
        &lt;option value=&quot;Thailand&quot;&gt;Thailand&lt;/option&gt;
        &lt;option value=&quot;Togo&quot;&gt;Togo&lt;/option&gt;
        &lt;option value=&quot;Tonga&quot;&gt;Tonga&lt;/option&gt;
        &lt;option value=&quot;Trinidad &amp;amp; Tobago&quot;&gt;Trinidad &amp;amp; Tobago&lt;/option&gt;
        &lt;option value=&quot;Tunisia&quot;&gt;Tunisia&lt;/option&gt;
        &lt;option value=&quot;Turkey&quot;&gt;Turkey&lt;/option&gt;
        &lt;option value=&quot;Turkmenistan&quot;&gt;Turkmenistan&lt;/option&gt;
        &lt;option value=&quot;Tuvalu&quot;&gt;Tuvalu&lt;/option&gt;
        &lt;option value=&quot;Uganda&quot;&gt;Uganda&lt;/option&gt;
        &lt;option value=&quot;Ukraine&quot;&gt;Ukraine&lt;/option&gt;
        &lt;option value=&quot;United Arab Emirates&quot;&gt;United Arab Emirates&lt;/option&gt;
        &lt;option value=&quot;Uruguay&quot;&gt;Uruguay&lt;/option&gt;
        &lt;option value=&quot;Uzbekistan&quot;&gt;Uzbekistan&lt;/option&gt;
        &lt;option value=&quot;Vanuatu&quot;&gt;Vanuatu&lt;/option&gt;
        &lt;option value=&quot;Vatican City&quot;&gt;Vatican City&lt;/option&gt;
        &lt;option value=&quot;Venezuela&quot;&gt;Venezuela&lt;/option&gt;
        &lt;option value=&quot;Vietnam&quot;&gt;Vietnam&lt;/option&gt;
        &lt;option value=&quot;Yemen&quot;&gt;Yemen&lt;/option&gt;
        &lt;option value=&quot;Zambia&quot;&gt;Zambia&lt;/option&gt;
        &lt;option value=&quot;Zimbabwe&quot;&gt;Zimbabwe&lt;/option&gt;
    &lt;/select&gt;
&lt;/div&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_4&quot;&gt;Web Site&lt;/label&gt;
    &lt;input type=&quot;text&quot; id=&quot;text_4&quot; name=&quot;text_4&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Email --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;email_0&quot;&gt;Email Address&lt;/label&gt;
    &lt;input type=&quot;email&quot; id=&quot;email_0&quot; name=&quot;email_0&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group col-xs-6&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_5&quot;&gt;Home Phone&lt;/label&gt;
    &lt;input type=&quot;tel&quot; id=&quot;text_5&quot; name=&quot;text_5&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Text --&gt;
&lt;div class=&quot;form-group col-xs-6&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;text_6&quot;&gt;Cell Phone&lt;/label&gt;
    &lt;input type=&quot;tel&quot; id=&quot;text_6&quot; name=&quot;text_6&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Date --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;date_0&quot;&gt;Birthday&lt;/label&gt;
    &lt;input type=&quot;date&quot; id=&quot;date_0&quot; name=&quot;date_0&quot; class=&quot;form-control&quot;&gt;
&lt;/div&gt;

&lt;!-- Text Area --&gt;
&lt;div class=&quot;form-group&quot;&gt;
    &lt;label class=&quot;control-label&quot; for=&quot;textarea_0&quot;&gt;Notes&lt;/label&gt;
    &lt;textarea id=&quot;textarea_0&quot; name=&quot;textarea_0&quot; rows=&quot;3&quot; class=&quot;form-control&quot;&gt;&lt;/textarea&gt;
&lt;/div&gt;

&lt;!-- Button --&gt;
&lt;div class=&quot;form-action&quot;&gt;
    &lt;input type=&quot;submit&quot; id=&quot;button_0&quot; name=&quot;button_0&quot; class=&quot;btn btn-primary&quot; value=&quot;Submit&quot;&gt;
&lt;/div&gt;

&lt;/fieldset&gt;
&lt;/form&gt;