input name="email" placeholder="Email" type="text"/>
</div>
</div>
<div>
<label>Password</label>
<div>
<input name="password" placeholder="Password" type="password"/>
</div>
</div>
<div>
<label>Confirm Password</label>
<div>
<input name="password_confirmation" placeholder="Confirm Password" type="password"/>
<input name="first_name" type="text"/>
<input name="referred_by"/>
</div>
</div>
<div>
<button type="submit">Sign Up</button>
</div>
</fieldset>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
</body>