ContactTest.rythm
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Links
https://codepen.io/jaycbrf/pen/iBszr
Rythm template
<html>
<body>
<div class="container">
<form class="well form-horizontal" action=" " method="post" id="contact_form">
<fieldset>
<!-- Form Name -->
<legend>Contact Us Today!</legend>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">First Name</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-user"></i></span>
<input name="first_name" placeholder="First Name" class="form-control" type="text">
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" >Last Name</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-user"></i></span>
<input name="last_name" placeholder="Last Name" class="form-control" type="text">
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">E-Mail</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-envelope"></i></span>
<input name="email" placeholder="E-Mail Address" class="form-control" type="text">
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">Phone #</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-earphone"></i></span>
<input name="phone" placeholder="(845)555-1212" class="form-control" type="text">
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">Address</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span>
<input name="address" placeholder="Address" class="form-control" type="text">
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">City</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span>
<input name="city" placeholder="city" class="form-control" type="text">
</div>
</div>
</div>
<!-- Select Basic -->
<div class="form-group">
<label class="col-md-4 control-label">State</label>
<div class="col-md-4 selectContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-list"></i></span>
<select name="state" class="form-control selectpicker" >
<option value=" " >Please select your state</option>
<option>Alabama</option>
<option>Alaska</option>
<option >Arizona</option>
<option >Arkansas</option>
<option >California</option>
<option >Colorado</option>
<option >Connecticut</option>
<option >Delaware</option>
<option >District of Columbia</option>
<option> Florida</option>
<option >Georgia</option>
<option >Hawaii</option>
<option >daho</option>
<option >Illinois</option>
<option >Indiana</option>
<option >Iowa</option>
<option> Kansas</option>
<option >Kentucky</option>
<option >Louisiana</option>
<option>Maine</option>
<option >Maryland</option>
<option> Mass</option>
<option >Michigan</option>
<option >Minnesota</option>
<option>Mississippi</option>
<option>Missouri</option>
<option>Montana</option>
<option>Nebraska</option>
<option>Nevada</option>
<option>New Hampshire</option>
<option>New Jersey</option>
<option>New Mexico</option>
<option>New York</option>
<option>North Carolina</option>
<option>North Dakota</option>
<option>Ohio</option>
<option>Oklahoma</option>
<option>Oregon</option>
<option>Pennsylvania</option>
<option>Rhode Island</option>
<option>South Carolina</option>
<option>South Dakota</option>
<option>Tennessee</option>
<option>Texas</option>
<option> Uttah</option>
<option>Vermont</option>
<option>Virginia</option>
<option >Washington</option>
<option >West Virginia</option>
<option>Wisconsin</option>
<option >Wyoming</option>
</select>
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">Zip Code</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-home"></i></span>
<input name="zip" placeholder="Zip Code" class="form-control" type="text">
</div>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label">Website or domain name</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-globe"></i></span>
<input name="website" placeholder="Website or domain name" class="form-control" type="text">
</div>
</div>
</div>
<!-- radio checks -->
<div class="form-group">
<label class="col-md-4 control-label">Do you have hosting?</label>
<div class="col-md-4">
<div class="radio">
<label>
<input type="radio" name="hosting" value="yes" /> Yes
</label>
</div>
<div class="radio">
<label>
<input type="radio" name="hosting" value="no" /> No
</label>
</div>
</div>
</div>
<!-- Text area -->
<div class="form-group">
<label class="col-md-4 control-label">Project Description</label>
<div class="col-md-4 inputGroupContainer">
<div class="input-group">
<span class="input-group-addon"><i class="glyphicon glyphicon-pencil"></i></span>
<textarea class="form-control" name="comment" placeholder="Project Description"></textarea>
</div>
</div>
</div>
<!-- Success message -->
<div class="alert alert-success" role="alert" id="success_message">Success <i class="glyphicon glyphicon-thumbs-up"></i> Thanks for contacting us, we will get back to you shortly.</div>
<!-- Button -->
<div class="form-group">
<label class="col-md-4 control-label"></label>
<div class="col-md-4">
<button type="submit" class="btn btn-warning" >Send <span class="glyphicon glyphicon-send"></span></button>
</div>
</div>
</fieldset>
</form>
</div>
</div><!-- /.container -->
<body>
</html>