bel form-control-label text-muted"></label>
                            <div class="col-lg-6">
                                <input class="form-control" type="text" placeholder="City">
                            </div>
                            <div class="col-lg-4">
                                <select class="form-control">
                                    <option>State</option>
                                    <option>AK</option>
                                    <option>AZ</option>
      