<div class="form-group">
                <input type="text" name="" placeholder="Enter your Locality">
            </div>
            <div class="form-group">
                <input type="text" name="" placeholder="Enter your Email Id">
            </div>
            <div class="form-group">
                <input type="text" name="" placeholder="Enter your Phone Number">
            </div>
            <button class="btn">Submit </button>
        </form>
    </div>
</body>

</html>