class="col-md-7">
										<input type="text" id="first-name2" required="required" class="form-control col-md-7 ">
									</div>
								</div>
								<div class="form-group row">
									<label class="control-label col-md-3" for="last-name">Last Name <span class="required">*</span>
									</label>
									<div class="col-md-7">
										<input type="text" id="last-name2" name="last-name" required="required" class="form-control col-md-7 ">
									</div>
								</div>
							</form>


							<h4>