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              <html><body>
  <form action="" method="">
    <div class="billing-details">
      <p>Customer Information</p>

      <div class="form-left">
        <label for="name">Name</label>
        <input type="text" name="name" id="name" required/>
      </div>

      <div class="form-right">
        <label for="email">Email</label>
        <input type="email" name="email" id="email" required/>
      </div>

      <label for="address">Address</label>
      <input type="text" name="address" id="address" required/>

      <!--<div class="form-left">
        <label for="city">City</label>
        <input type="text" name="city" id="city" required/>
      </div>

      <div class="form-right">
        <label for="zip">Postcode</label>
        <input type="text" name="zip" id="zip" required/>
      </div>-->

      <!--<div class="form-left">-->
        <label for="country">Country</label>
        <select name="country" id="country">                        
          <option>United Kingdom</option>
          <option>United States</option>
          <option>Germany</option>
        </select>
      <!--</div>-->

     <!--<div class="form-right">
        <label for="phone">Phone</label>
        <input type="text" name="phone" id="phone" prefix="[\+]\d{2}[\(]\d{2}[\)]\d{4}[\-]\d{4}" />
     </div>-->

     <input type="submit" value="Proceed Order" class="button" />
    </div>
      <!-- /billing-details -->                
   </form>
</body></html>
            
          
!
            
              /* global box-sizing */
*, *:after, *:before { -moz-box-sizing: border-box; box-sizing: border-box;
	-webkit-font-smoothing: antialiased; font-smoothing: antialiased; text-rendering: optimizeLegibility;
}

html {  font-size: 62.5%;  }
body {   margin: 0; padding: 0; background: #fefefe; color: #444;
  font: 400 17px/1.7 'Open Sans', Helvetica, Arial, sans-serif;  }
form { max-width: 600px; width: 95%; margin: 0 auto; padding: 0; }
p { font-weight: 700; margin-top: 0.5em; padding: 0; text-align: left; }

input, select, textarea {
  width: 100%;
	margin: 0.5em 0;
	padding: 0.25em;
	border: 1px solid #ccc;
	-webkit-border-radius: 0;
	-moz-border-radius: 0;
	border-radius: 0;
  color: inherit;
  font: inherit;
}

input:focus, select:focus, textarea:focus { outline: #007e65 solid 2px;  }

.button {
  width: 100%;
	margin-top: 0.75em;
	background: #007E65;
	color: #fff;
	text-transform: uppercase;
	padding: 0.5em;
	border: none;
	-webkit-border-radius: 0;
	-moz-border-radius: 0;
	border-radius: 0;
  cursor: pointer;
}

.button:hover, .button:focus {
	outline: 0;
	color: #fff;
	background: #222;
}

@media only screen and (min-width:480px) {
	.form-left, .form-right { width: 48%;	}
	.form-left { float: left; margin-right: 1%;  }
	.form-right { float: right; margin-left: 1%;  } 
}
            
          
!
999px
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