                                <input class="form-control" id="city" type="text" placeholder="City" required>
                                    </div>
                                </div>
                                <div class="col-sm-4 mb-3">
                                    <label for="state">State</label>
                                    <select class="form-select w-100 mb-0" id="state" name="state" aria-label="State select example">
                                        <option selected