data-placeOrderForm.html

<form class="clearfix " action="data-place-adress.json" method="POST" id="commentForm2" >
	<h2>ADD NEW ADDRESS</h2>
	<div class="name clearfix">
		<div class="fl">							
			<label for="firstname">First name<span class="required"></span></label>
			<input type="text" name="firstname" id="firstname" class="required" title="2 characters at least for your first name." minlength="2">	
		</div>	
		<div class="fr">
			<label for="lastname">Last name<span class="required"></span></label>
			<input type="text" name="lastname" id="lastname" class="required" minlength="2" title="2 characters at least for your last name.">	
		</div>							
	</div>
	<div class="name clearfix">
		<div class="fl">									
			<label for="phonenumber">Phone number<span class="required"></span></label><input type="text" name="number" id="phonenumber" class="required">
		</div>
		<div class="fr"> 
			<label for="email">E-mail address<span class="required "></span></label><input type="text" name="email" id="email" class="required email" title="Please enter a valid email address.">	
		</div>				
	</div>
	<div class="addressline1 clearfix">
		<label for="Line1">Address Line1<span class="required"></span></label><input type="text" name="" id="Line1" class="required" minlength="5" title="Your Address line must contain at least 5 characters.">		
	</div>
	<div class="addressline2">
		<label for="Line2">Address Line2:</label><input type="text" name="" id="Line2" />	
	</div>
	<div class="selectd ">
		<ul class="clearfix">
		    <li class="fl">
		    	<label for="jungle">Country / Region<span class="required"></span></label>
		    	<select id="jungle" name="jungle" title="Please select something!" class="required">
		    		<option></option>
		    	  	<option value ="volvo">Volvo</option>
		    	  	<option value ="saab">Saab</option>
		    	  	<option value="opel">Opel</option>
		    	  	<option value="audi">Audi</option>
		    	</select>
		    </li>
		    <li class="fr">
		    	<label for="fruit">States<span class="required"></span></label>
		    	<select id="fruit" name="fruit" title="Please select something!" class="required">
			    	<option></option>
		    	  	<option value ="volvo">Volvo</option>
		    	  	<option value ="saab">Saab</option>
		    	  	<option value="opel">Opel</option>
		    	  	<option value="audi">Audi</option>
		    	</select>
		    	<input type="text" name="states" class="states required"/>
		    </li>
		</ul>
	</div>
	<div >
    	<label for="city">City<span class="required"></span></label>
    	<input type="text" name="city" id="city" class="city" class="required"/>	
	</div>	  

	<div class=" zip">
		<label>ZIP/Postal Code<span class="required"></span></label><input type="text" name="postalCode" class="required"/>	
	</div>
	<button class="button" type="submit">Submit</button>
	<a href="#" class="privacy privacy_address">Privacy & Security Policy</a>	
</form>