Error in link a sign up form with my database using PHP
<p>Hello guys good morning .</p>

<p>I have an issue , I.m trying to link my Sign up form to my database using PHP , so when someone fill the form all the data should go the database , But the problem is that it's not working , the code pass everything and he go to the ELSE sentence , please let me know what i did wrong and if there is a solve for it explain it so i learn from it .</p>

<p>The code fun the last false sentence .</p>

<p>PHP code : </p>

<pre><code>$hostname="*************"; 
$username="*************";  
$password="*************";       
$database="*************"; 

$connect=mysql_connect($hostname,$username,$password);
if(!$connect)
    {
        die('Connection Failed'.mysql_error());
    }

mysql_select_db($database);

if(isset($_REQUEST['Submit']))
    {
     $username  =   ($_REQUEST['username']); // SANITIZE INPUTS !
     $firstname =   ($_REQUEST['firstname']);
     $pincode   =   ($_REQUEST['pincode']);
     $lastname  =   ($_REQUEST['lastname']);
     $email     =   ($_REQUEST['email']);
     $password  =   ($_REQUEST['password']);
     $website   =   ($_REQUEST['website']);
     $phonenumber   =   ($_REQUEST['phonenumber']);
     $zipcode   =   ($_REQUEST['zipcode']);
     $address1  =   ($_REQUEST['address1']);
     $address2  =   ($_REQUEST['address2']);
     $company   =   ($_REQUEST['company']);
     $sq    =   ($_REQUEST['sq']);
     $country   =   ($_REQUEST['Country']);
     $city  =   ($_REQUEST['city']);


    $sql = "INSERT INTO customers 
            VALUES (0,'$pincode','$username','$firstname','$lastname',
                   '$email','$password', '$sq', '$company', '$website', 
                   '$address1', '$address2', '$city','$zipcode',
                   '$country')";                
    $res=mysql_query($sql);
    if($res)
        {
            echo "Sumbimted";
        }   
    else 
        {
            echo "Something went wrong ";
        }

    }

else 
    {
        echo "false";
    }


?&gt;  
</code></pre>

<p>My form page Code : </p>

<pre><code> &lt;form role="form" class="signup" action="SignUpPHP.php" method="post"&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Username&lt;/label&gt;
              &lt;input type="text" class="form-control" id="username" name="username" placeholder="Enter a username" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Pin Code&lt;/label&gt;
              &lt;input type="text" class="form-control" id="pincode" name="pincode" placeholder="Pin Code from 4 Digite" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;First Name&lt;/label&gt;
              &lt;input type="text" class="form-control" id="FirstName" name="firstname" placeholder="Enter Your First Name" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Last Name&lt;/label&gt;
              &lt;input type="text" class="form-control" id="FirstName" name="lastname" placeholder="Enter Your First Name" required&gt;
        &lt;/div&gt;
         &lt;div class="form-group"&gt;
          &lt;label for="exampleInputEmail1"&gt;Email address&lt;/label&gt;
          &lt;input type="email" class="form-control" id="exampleInputEmail3" name="email" placeholder="Enter email" required&gt;
        &lt;/div&gt;
          &lt;div class="form-group"&gt;
              &lt;label for="exampleInputPassword1"&gt;Password&lt;/label&gt;
              &lt;input type="password" class="form-control" id="exampleInputPassword3" name="password" placeholder="Password" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Phone Number&lt;/label&gt;
              &lt;input type="text" class="form-control" id="phonenumber" name="phonenumber" placeholder="Your Phone Number" required&gt;
        &lt;/div&gt;
        &lt;br&gt;
        &lt;label class="control-label col-lg-2" for="inputSuccess"&gt;Country&lt;/label&gt;
        &lt;div class="col-lg-10"&gt;
              &lt;select class="form-control m-bot15" value="" name="country" required&gt;
                    &lt;option value="AF"&gt;Afghanistan&lt;/option&gt;
                    &lt;option value="AX"&gt;Aland Islands&lt;/option&gt;
                    &lt;option value="AL"&gt;Albania&lt;/option&gt;
                    &lt;option value="DZ"&gt;Algeria&lt;/option&gt;
                    &lt;option value="AS"&gt;American Samoa&lt;/option&gt;
                    &lt;option value="AD"&gt;Andorra&lt;/option&gt;
                    &lt;option value="AO"&gt;Angola&lt;/option&gt;
                    &lt;option value="AI"&gt;Anguilla&lt;/option&gt;
                    &lt;option value="AQ"&gt;Antarctica&lt;/option&gt;
                    &lt;option value="AG"&gt;Antigua and Barbuda&lt;/option&gt;
                    &lt;option value="AR"&gt;Argentina&lt;/option&gt;
                    &lt;option value="AM"&gt;Armenia&lt;/option&gt;
                    &lt;option value="AW"&gt;Aruba&lt;/option&gt;
                    &lt;option value="AU"&gt;Australia&lt;/option&gt;
                    &lt;option value="AT"&gt;Austria&lt;/option&gt;
                    &lt;option value="AZ"&gt;Azerbaijan&lt;/option&gt;
                    &lt;option value="BS"&gt;Bahamas&lt;/option&gt;
                    &lt;option value="BH"&gt;Bahrain&lt;/option&gt;
                    &lt;option value="BD"&gt;Bangladesh&lt;/option&gt;
                    &lt;option value="BB"&gt;Barbados&lt;/option&gt;
                    &lt;option value="BY"&gt;Belarus&lt;/option&gt;
                    &lt;option value="BE"&gt;Belgium&lt;/option&gt;
                    &lt;option value="BZ"&gt;Belize&lt;/option&gt;
                    &lt;option value="BJ"&gt;Benin&lt;/option&gt;
                    &lt;option value="BM"&gt;Bermuda&lt;/option&gt;
                    &lt;option value="BT"&gt;Bhutan&lt;/option&gt;
                    &lt;option value="BO"&gt;Bolivia, Plurinational State of&lt;/option&gt;
                    &lt;option value="BQ"&gt;Bonaire, Sint Eustatius and Saba&lt;/option&gt;
                    &lt;option value="BA"&gt;Bosnia and Herzegovina&lt;/option&gt;
                    &lt;option value="BW"&gt;Botswana&lt;/option&gt;
                    &lt;option value="BV"&gt;Bouvet Island&lt;/option&gt;
                    &lt;option value="BR"&gt;Brazil&lt;/option&gt;
                    &lt;option value="IO"&gt;British Indian Ocean Territory&lt;/option&gt;
                    &lt;option value="BN"&gt;Brunei Darussalam&lt;/option&gt;
                    &lt;option value="BG"&gt;Bulgaria&lt;/option&gt;
                    &lt;option value="BF"&gt;Burkina Faso&lt;/option&gt;
                    &lt;option value="BI"&gt;Burundi&lt;/option&gt;
                    &lt;option value="KH"&gt;Cambodia&lt;/option&gt;
                    &lt;option value="CM"&gt;Cameroon&lt;/option&gt;
                    &lt;option value="CA"&gt;Canada&lt;/option&gt;
                    &lt;option value="CV"&gt;Cape Verde&lt;/option&gt;
                    &lt;option value="KY"&gt;Cayman Islands&lt;/option&gt;
                    &lt;option value="CF"&gt;Central African Republic&lt;/option&gt;
                    &lt;option value="TD"&gt;Chad&lt;/option&gt;
                    &lt;option value="CL"&gt;Chile&lt;/option&gt;
                    &lt;option value="CN"&gt;China&lt;/option&gt;
                    &lt;option value="CX"&gt;Christmas Island&lt;/option&gt;
                    &lt;option value="CC"&gt;Cocos (Keeling) Islands&lt;/option&gt;
                    &lt;option value="CO"&gt;Colombia&lt;/option&gt;
                    &lt;option value="KM"&gt;Comoros&lt;/option&gt;
                    &lt;option value="CG"&gt;Congo&lt;/option&gt;
                    &lt;option value="CD"&gt;Congo, the Democratic Republic of the&lt;/option&gt;
                    &lt;option value="CK"&gt;Cook Islands&lt;/option&gt;
                    &lt;option value="CR"&gt;Costa Rica&lt;/option&gt;
                    &lt;option value="CI"&gt;Côte d'Ivoire&lt;/option&gt;
                    &lt;option value="HR"&gt;Croatia&lt;/option&gt;
                    &lt;option value="CU"&gt;Cuba&lt;/option&gt;
                    &lt;option value="CW"&gt;Curaçao&lt;/option&gt;
                    &lt;option value="CY"&gt;Cyprus&lt;/option&gt;
                    &lt;option value="CZ"&gt;Czech Republic&lt;/option&gt;
                    &lt;option value="DK"&gt;Denmark&lt;/option&gt;
                    &lt;option value="DJ"&gt;Djibouti&lt;/option&gt;
                    &lt;option value="DM"&gt;Dominica&lt;/option&gt;
                    &lt;option value="DO"&gt;Dominican Republic&lt;/option&gt;
                    &lt;option value="EC"&gt;Ecuador&lt;/option&gt;
                    &lt;option value="EG"&gt;Egypt&lt;/option&gt;
                    &lt;option value="SV"&gt;El Salvador&lt;/option&gt;
                    &lt;option value="GQ"&gt;Equatorial Guinea&lt;/option&gt;
                    &lt;option value="ER"&gt;Eritrea&lt;/option&gt;
                    &lt;option value="EE"&gt;Estonia&lt;/option&gt;
                    &lt;option value="ET"&gt;Ethiopia&lt;/option&gt;
                    &lt;option value="FK"&gt;Falkland Islands (Malvinas)&lt;/option&gt;
                    &lt;option value="FO"&gt;Faroe Islands&lt;/option&gt;
                    &lt;option value="FJ"&gt;Fiji&lt;/option&gt;
                    &lt;option value="FI"&gt;Finland&lt;/option&gt;
                    &lt;option value="FR"&gt;France&lt;/option&gt;
                    &lt;option value="GF"&gt;French Guiana&lt;/option&gt;
                    &lt;option value="PF"&gt;French Polynesia&lt;/option&gt;
                    &lt;option value="TF"&gt;French Southern Territories&lt;/option&gt;
                    &lt;option value="GA"&gt;Gabon&lt;/option&gt;
                    &lt;option value="GM"&gt;Gambia&lt;/option&gt;
                    &lt;option value="GE"&gt;Georgia&lt;/option&gt;
                    &lt;option value="DE"&gt;Germany&lt;/option&gt;
                    &lt;option value="GH"&gt;Ghana&lt;/option&gt;
                    &lt;option value="GI"&gt;Gibraltar&lt;/option&gt;
                    &lt;option value="GR"&gt;Greece&lt;/option&gt;
                    &lt;option value="GL"&gt;Greenland&lt;/option&gt;
                    &lt;option value="GD"&gt;Grenada&lt;/option&gt;
                    &lt;option value="GP"&gt;Guadeloupe&lt;/option&gt;
                    &lt;option value="GU"&gt;Guam&lt;/option&gt;
                    &lt;option value="GT"&gt;Guatemala&lt;/option&gt;
                    &lt;option value="GG"&gt;Guernsey&lt;/option&gt;
                    &lt;option value="GN"&gt;Guinea&lt;/option&gt;
                    &lt;option value="GW"&gt;Guinea-Bissau&lt;/option&gt;
                    &lt;option value="GY"&gt;Guyana&lt;/option&gt;
                    &lt;option value="HT"&gt;Haiti&lt;/option&gt;
                    &lt;option value="HM"&gt;Heard Island and McDonald Islands&lt;/option&gt;
                    &lt;option value="VA"&gt;Holy See (Vatican City State)&lt;/option&gt;
                    &lt;option value="HN"&gt;Honduras&lt;/option&gt;
                    &lt;option value="HK"&gt;Hong Kong&lt;/option&gt;
                    &lt;option value="HU"&gt;Hungary&lt;/option&gt;
                    &lt;option value="IS"&gt;Iceland&lt;/option&gt;
                    &lt;option value="IN"&gt;India&lt;/option&gt;
                    &lt;option value="ID"&gt;Indonesia&lt;/option&gt;
                    &lt;option value="IR"&gt;Iran, Islamic Republic of&lt;/option&gt;
                    &lt;option value="IQ"&gt;Iraq&lt;/option&gt;
                    &lt;option value="IE"&gt;Ireland&lt;/option&gt;
                    &lt;option value="IM"&gt;Isle of Man&lt;/option&gt;
                    &lt;option value="IL"&gt;Israel&lt;/option&gt;
                    &lt;option value="IT"&gt;Italy&lt;/option&gt;
                    &lt;option value="JM"&gt;Jamaica&lt;/option&gt;
                    &lt;option value="JP"&gt;Japan&lt;/option&gt;
                    &lt;option value="JE"&gt;Jersey&lt;/option&gt;
                    &lt;option value="JO"&gt;Jordan&lt;/option&gt;
                    &lt;option value="KZ"&gt;Kazakhstan&lt;/option&gt;
                    &lt;option value="KE"&gt;Kenya&lt;/option&gt;
                    &lt;option value="KI"&gt;Kiribati&lt;/option&gt;
                    &lt;option value="KP"&gt;Korea, Democratic People's Republic of&lt;/option&gt;
                    &lt;option value="KR"&gt;Korea, Republic of&lt;/option&gt;
                    &lt;option value="KW"&gt;Kuwait&lt;/option&gt;
                    &lt;option value="KG"&gt;Kyrgyzstan&lt;/option&gt;
                    &lt;option value="LA"&gt;Lao People's Democratic Republic&lt;/option&gt;
                    &lt;option value="LV"&gt;Latvia&lt;/option&gt;
                    &lt;option value="LB"&gt;Lebanon&lt;/option&gt;
                    &lt;option value="LS"&gt;Lesotho&lt;/option&gt;
                    &lt;option value="LR"&gt;Liberia&lt;/option&gt;
                    &lt;option value="LY"&gt;Libya&lt;/option&gt;
                    &lt;option value="LI"&gt;Liechtenstein&lt;/option&gt;
                    &lt;option value="LT"&gt;Lithuania&lt;/option&gt;
                    &lt;option value="LU"&gt;Luxembourg&lt;/option&gt;
                    &lt;option value="MO"&gt;Macao&lt;/option&gt;
                    &lt;option value="MK"&gt;Macedonia, the former Yugoslav Republic of&lt;/option&gt;
                    &lt;option value="MG"&gt;Madagascar&lt;/option&gt;
                    &lt;option value="MW"&gt;Malawi&lt;/option&gt;
                    &lt;option value="MY"&gt;Malaysia&lt;/option&gt;
                    &lt;option value="MV"&gt;Maldives&lt;/option&gt;
                    &lt;option value="ML"&gt;Mali&lt;/option&gt;
                    &lt;option value="MT"&gt;Malta&lt;/option&gt;
                    &lt;option value="MH"&gt;Marshall Islands&lt;/option&gt;
                    &lt;option value="MQ"&gt;Martinique&lt;/option&gt;
                    &lt;option value="MR"&gt;Mauritania&lt;/option&gt;
                    &lt;option value="MU"&gt;Mauritius&lt;/option&gt;
                    &lt;option value="YT"&gt;Mayotte&lt;/option&gt;
                    &lt;option value="MX"&gt;Mexico&lt;/option&gt;
                    &lt;option value="FM"&gt;Micronesia, Federated States of&lt;/option&gt;
                    &lt;option value="MD"&gt;Moldova, Republic of&lt;/option&gt;
                    &lt;option value="MC"&gt;Monaco&lt;/option&gt;
                    &lt;option value="MN"&gt;Mongolia&lt;/option&gt;
                    &lt;option value="ME"&gt;Montenegro&lt;/option&gt;
                    &lt;option value="MS"&gt;Montserrat&lt;/option&gt;
                    &lt;option value="MA"&gt;Morocco&lt;/option&gt;
                    &lt;option value="MZ"&gt;Mozambique&lt;/option&gt;
                    &lt;option value="MM"&gt;Myanmar&lt;/option&gt;
                    &lt;option value="NA"&gt;Namibia&lt;/option&gt;
                    &lt;option value="NR"&gt;Nauru&lt;/option&gt;
                    &lt;option value="NP"&gt;Nepal&lt;/option&gt;
                    &lt;option value="NL"&gt;Netherlands&lt;/option&gt;
                    &lt;option value="NC"&gt;New Caledonia&lt;/option&gt;
                    &lt;option value="NZ"&gt;New Zealand&lt;/option&gt;
                    &lt;option value="NI"&gt;Nicaragua&lt;/option&gt;
                    &lt;option value="NE"&gt;Niger&lt;/option&gt;
                    &lt;option value="NG"&gt;Nigeria&lt;/option&gt;
                    &lt;option value="NU"&gt;Niue&lt;/option&gt;
                    &lt;option value="NF"&gt;Norfolk Island&lt;/option&gt;
                    &lt;option value="MP"&gt;Northern Mariana Islands&lt;/option&gt;
                    &lt;option value="NO"&gt;Norway&lt;/option&gt;
                    &lt;option value="OM"&gt;Oman&lt;/option&gt;
                    &lt;option value="PK"&gt;Pakistan&lt;/option&gt;
                    &lt;option value="PW"&gt;Palau&lt;/option&gt;
                    &lt;option value="PS"&gt;Palestinian Territory, Occupied&lt;/option&gt;
                    &lt;option value="PA"&gt;Panama&lt;/option&gt;
                    &lt;option value="PG"&gt;Papua New Guinea&lt;/option&gt;
                    &lt;option value="PY"&gt;Paraguay&lt;/option&gt;
                    &lt;option value="PE"&gt;Peru&lt;/option&gt;
                    &lt;option value="PH"&gt;Philippines&lt;/option&gt;
                    &lt;option value="PN"&gt;Pitcairn&lt;/option&gt;
                    &lt;option value="PL"&gt;Poland&lt;/option&gt;
                    &lt;option value="PT"&gt;Portugal&lt;/option&gt;
                    &lt;option value="PR"&gt;Puerto Rico&lt;/option&gt;
                    &lt;option value="QA"&gt;Qatar&lt;/option&gt;
                    &lt;option value="RE"&gt;Réunion&lt;/option&gt;
                    &lt;option value="RO"&gt;Romania&lt;/option&gt;
                    &lt;option value="RU"&gt;Russian Federation&lt;/option&gt;
                    &lt;option value="RW"&gt;Rwanda&lt;/option&gt;
                    &lt;option value="BL"&gt;Saint Barthélemy&lt;/option&gt;
                    &lt;option value="SH"&gt;Saint Helena, Ascension and Tristan da Cunha&lt;/option&gt;
                    &lt;option value="KN"&gt;Saint Kitts and Nevis&lt;/option&gt;
                    &lt;option value="LC"&gt;Saint Lucia&lt;/option&gt;
                    &lt;option value="MF"&gt;Saint Martin (French part)&lt;/option&gt;
                    &lt;option value="PM"&gt;Saint Pierre and Miquelon&lt;/option&gt;
                    &lt;option value="VC"&gt;Saint Vincent and the Grenadines&lt;/option&gt;
                    &lt;option value="WS"&gt;Samoa&lt;/option&gt;
                    &lt;option value="SM"&gt;San Marino&lt;/option&gt;
                    &lt;option value="ST"&gt;Sao Tome and Principe&lt;/option&gt;
                    &lt;option value="SA"&gt;Saudi Arabia&lt;/option&gt;
                    &lt;option value="SN"&gt;Senegal&lt;/option&gt;
                    &lt;option value="RS"&gt;Serbia&lt;/option&gt;
                    &lt;option value="SC"&gt;Seychelles&lt;/option&gt;
                    &lt;option value="SL"&gt;Sierra Leone&lt;/option&gt;
                    &lt;option value="SG"&gt;Singapore&lt;/option&gt;
                    &lt;option value="SX"&gt;Sint Maarten (Dutch part)&lt;/option&gt;
                    &lt;option value="SK"&gt;Slovakia&lt;/option&gt;
                    &lt;option value="SI"&gt;Slovenia&lt;/option&gt;
                    &lt;option value="SB"&gt;Solomon Islands&lt;/option&gt;
                    &lt;option value="SO"&gt;Somalia&lt;/option&gt;
                    &lt;option value="ZA"&gt;South Africa&lt;/option&gt;
                    &lt;option value="GS"&gt;South Georgia and the South Sandwich Islands&lt;/option&gt;
                    &lt;option value="SS"&gt;South Sudan&lt;/option&gt;
                    &lt;option value="ES"&gt;Spain&lt;/option&gt;
                    &lt;option value="LK"&gt;Sri Lanka&lt;/option&gt;
                    &lt;option value="SD"&gt;Sudan&lt;/option&gt;
                    &lt;option value="SR"&gt;Suriname&lt;/option&gt;
                    &lt;option value="SJ"&gt;Svalbard and Jan Mayen&lt;/option&gt;
                    &lt;option value="SZ"&gt;Swaziland&lt;/option&gt;
                    &lt;option value="SE"&gt;Sweden&lt;/option&gt;
                    &lt;option value="CH"&gt;Switzerland&lt;/option&gt;
                    &lt;option value="SY"&gt;Syrian Arab Republic&lt;/option&gt;
                    &lt;option value="TW"&gt;Taiwan, Province of China&lt;/option&gt;
                    &lt;option value="TJ"&gt;Tajikistan&lt;/option&gt;
                    &lt;option value="TZ"&gt;Tanzania, United Republic of&lt;/option&gt;
                    &lt;option value="TH"&gt;Thailand&lt;/option&gt;
                    &lt;option value="TL"&gt;Timor-Leste&lt;/option&gt;
                    &lt;option value="TG"&gt;Togo&lt;/option&gt;
                    &lt;option value="TK"&gt;Tokelau&lt;/option&gt;
                    &lt;option value="TO"&gt;Tonga&lt;/option&gt;
                    &lt;option value="TT"&gt;Trinidad and Tobago&lt;/option&gt;
                    &lt;option value="TN"&gt;Tunisia&lt;/option&gt;
                    &lt;option value="TR"&gt;Turkey&lt;/option&gt;
                    &lt;option value="TM"&gt;Turkmenistan&lt;/option&gt;
                    &lt;option value="TC"&gt;Turks and Caicos Islands&lt;/option&gt;
                    &lt;option value="TV"&gt;Tuvalu&lt;/option&gt;
                    &lt;option value="UG"&gt;Uganda&lt;/option&gt;
                    &lt;option value="UA"&gt;Ukraine&lt;/option&gt;
                    &lt;option value="AE"&gt;United Arab Emirates&lt;/option&gt;
                    &lt;option value="GB"&gt;United Kingdom&lt;/option&gt;
                    &lt;option value="US"&gt;United States&lt;/option&gt;
                    &lt;option value="UM"&gt;United States Minor Outlying Islands&lt;/option&gt;
                    &lt;option value="UY"&gt;Uruguay&lt;/option&gt;
                    &lt;option value="UZ"&gt;Uzbekistan&lt;/option&gt;
                    &lt;option value="VU"&gt;Vanuatu&lt;/option&gt;
                    &lt;option value="VE"&gt;Venezuela, Bolivarian Republic of&lt;/option&gt;
                    &lt;option value="VN"&gt;Viet Nam&lt;/option&gt;
                    &lt;option value="VG"&gt;Virgin Islands, British&lt;/option&gt;
                    &lt;option value="VI"&gt;Virgin Islands, U.S.&lt;/option&gt;
                    &lt;option value="WF"&gt;Wallis and Futuna&lt;/option&gt;
                    &lt;option value="EH"&gt;Western Sahara&lt;/option&gt;
                    &lt;option value="YE"&gt;Yemen&lt;/option&gt;
                    &lt;option value="ZM"&gt;Zambia&lt;/option&gt;
                    &lt;option value="ZW"&gt;Zimbabwe&lt;/option&gt;
              &lt;/select&gt;
        &lt;/div&gt;
        &lt;br&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;City&lt;/label&gt;
              &lt;input type="text" class="form-control" id="city" name="city" placeholder="Your City" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Zip Code&lt;/label&gt;
              &lt;input type="text" class="form-control" id="zipcode" name="zipcode" placeholder="Enter Your Zip Code" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Address (1) :&lt;/label&gt;
              &lt;input type="text" class="form-control" id="address1" name="address1" placeholder="" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Address (2) :&lt;/label&gt;
              &lt;input type="text" class="form-control" id="address2" name="address2" placeholder="Optional"&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Security Question :&lt;/label&gt;
              &lt;input type="text" class="form-control" id="sq" name="sq" placeholder="" required&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Website :&lt;/label&gt;
              &lt;input type="text" class="form-control" id="website" name="website" placeholder="Optional"&gt;
        &lt;/div&gt;
        &lt;div class="form-group"&gt;
              &lt;label for="FirstName"&gt;Company :&lt;/label&gt;
              &lt;input type="text" class="form-control" id="company" name="company" placeholder="Optional"&gt;
        &lt;/div&gt;

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              &lt;label&gt;
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              &lt;/label&gt;
          &lt;/div&gt;
          &lt;button type="submit" class="btn btn-primary" name="Submit"&gt;Submit&lt;/button&gt;
    &lt;/form&gt;
</code></pre>