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---
layout: examples
title: Checkout example
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extra_css:
- "form-validation.css"
extra_js:
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- src: "form-validation.js"
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body_class: "bg-light"
---
< div class = "container" >
< div class = "py-5 text-center" >
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< img class = "d-block mx-auto mb-4" src = "/docs/{{< param docs_version >}}/assets/brand/bootstrap-solid.svg" alt = "" width = "72" height = "72" >
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< h2 > Checkout form< / h2 >
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< p class = "lead" > Below is an example form built entirely with Bootstrap’ s form controls. Each required form group has a validation state that can be triggered by attempting to submit the form without completing it.< / p >
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< / div >
< div class = "row" >
< div class = "col-md-4 order-md-2 mb-4" >
< h4 class = "d-flex justify-content-between align-items-center mb-3" >
< span class = "text-muted" > Your cart< / span >
< span class = "badge badge-secondary badge-pill" > 3< / span >
< / h4 >
< ul class = "list-group mb-3" >
< li class = "list-group-item d-flex justify-content-between lh-condensed" >
< div >
< h6 class = "my-0" > Product name< / h6 >
< small class = "text-muted" > Brief description< / small >
< / div >
< span class = "text-muted" > $12< / span >
< / li >
< li class = "list-group-item d-flex justify-content-between lh-condensed" >
< div >
< h6 class = "my-0" > Second product< / h6 >
< small class = "text-muted" > Brief description< / small >
< / div >
< span class = "text-muted" > $8< / span >
< / li >
< li class = "list-group-item d-flex justify-content-between lh-condensed" >
< div >
< h6 class = "my-0" > Third item< / h6 >
< small class = "text-muted" > Brief description< / small >
< / div >
< span class = "text-muted" > $5< / span >
< / li >
< li class = "list-group-item d-flex justify-content-between bg-light" >
< div class = "text-success" >
< h6 class = "my-0" > Promo code< / h6 >
< small > EXAMPLECODE< / small >
< / div >
< span class = "text-success" > -$5< / span >
< / li >
< li class = "list-group-item d-flex justify-content-between" >
< span > Total (USD)< / span >
< strong > $20< / strong >
< / li >
< / ul >
< form class = "card p-2" >
< div class = "input-group" >
< input type = "text" class = "form-control" placeholder = "Promo code" >
< div class = "input-group-append" >
< button type = "submit" class = "btn btn-secondary" > Redeem< / button >
< / div >
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< / div >
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< / form >
< / div >
< div class = "col-md-8 order-md-1" >
< h4 class = "mb-3" > Billing address< / h4 >
< form class = "needs-validation" novalidate >
< div class = "row" >
< div class = "col-md-6 mb-3" >
< label for = "firstName" > First name< / label >
< input type = "text" class = "form-control" id = "firstName" placeholder = "" value = "" required >
< div class = "invalid-feedback" >
Valid first name is required.
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< / div >
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< / div >
< div class = "col-md-6 mb-3" >
< label for = "lastName" > Last name< / label >
< input type = "text" class = "form-control" id = "lastName" placeholder = "" value = "" required >
< div class = "invalid-feedback" >
Valid last name is required.
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< / div >
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< / div >
< / div >
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< div class = "mb-3" >
< label for = "username" > Username< / label >
< div class = "input-group" >
< div class = "input-group-prepend" >
< span class = "input-group-text" > @< / span >
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< / div >
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< input type = "text" class = "form-control" id = "username" placeholder = "Username" required >
< div class = "invalid-feedback" style = "width: 100%;" >
Your username is required.
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< / div >
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< / div >
< / div >
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< div class = "mb-3" >
< label for = "email" > Email < span class = "text-muted" > (Optional)< / span > < / label >
< input type = "email" class = "form-control" id = "email" placeholder = "you@example.com" >
< div class = "invalid-feedback" >
Please enter a valid email address for shipping updates.
< / div >
< / div >
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< div class = "mb-3" >
< label for = "address" > Address< / label >
< input type = "text" class = "form-control" id = "address" placeholder = "1234 Main St" required >
< div class = "invalid-feedback" >
Please enter your shipping address.
< / div >
< / div >
< div class = "mb-3" >
< label for = "address2" > Address 2 < span class = "text-muted" > (Optional)< / span > < / label >
< input type = "text" class = "form-control" id = "address2" placeholder = "Apartment or suite" >
< / div >
< div class = "row" >
< div class = "col-md-5 mb-3" >
< label for = "country" > Country< / label >
< select class = "custom-select d-block w-100" id = "country" required >
< option value = "" > Choose...< / option >
< option > United States< / option >
< / select >
< div class = "invalid-feedback" >
Please select a valid country.
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< / div >
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< / div >
< div class = "col-md-4 mb-3" >
< label for = "state" > State< / label >
< select class = "custom-select d-block w-100" id = "state" required >
< option value = "" > Choose...< / option >
< option > California< / option >
< / select >
< div class = "invalid-feedback" >
Please provide a valid state.
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< / div >
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< / div >
< div class = "col-md-3 mb-3" >
< label for = "zip" > Zip< / label >
< input type = "text" class = "form-control" id = "zip" placeholder = "" required >
< div class = "invalid-feedback" >
Zip code required.
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< / div >
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< / div >
< / div >
< hr class = "mb-4" >
< div class = "custom-control custom-checkbox" >
< input type = "checkbox" class = "custom-control-input" id = "same-address" >
< label class = "custom-control-label" for = "same-address" > Shipping address is the same as my billing address< / label >
< / div >
< div class = "custom-control custom-checkbox" >
< input type = "checkbox" class = "custom-control-input" id = "save-info" >
< label class = "custom-control-label" for = "save-info" > Save this information for next time< / label >
< / div >
< hr class = "mb-4" >
< h4 class = "mb-3" > Payment< / h4 >
< div class = "d-block my-3" >
< div class = "custom-control custom-radio" >
< input id = "credit" name = "paymentMethod" type = "radio" class = "custom-control-input" checked required >
< label class = "custom-control-label" for = "credit" > Credit card< / label >
< / div >
< div class = "custom-control custom-radio" >
< input id = "debit" name = "paymentMethod" type = "radio" class = "custom-control-input" required >
< label class = "custom-control-label" for = "debit" > Debit card< / label >
< / div >
< div class = "custom-control custom-radio" >
< input id = "paypal" name = "paymentMethod" type = "radio" class = "custom-control-input" required >
< label class = "custom-control-label" for = "paypal" > PayPal< / label >
< / div >
< / div >
< div class = "row" >
< div class = "col-md-6 mb-3" >
< label for = "cc-name" > Name on card< / label >
< input type = "text" class = "form-control" id = "cc-name" placeholder = "" required >
< small class = "text-muted" > Full name as displayed on card< / small >
< div class = "invalid-feedback" >
Name on card is required
< / div >
< / div >
< div class = "col-md-6 mb-3" >
< label for = "cc-number" > Credit card number< / label >
< input type = "text" class = "form-control" id = "cc-number" placeholder = "" required >
< div class = "invalid-feedback" >
Credit card number is required
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< / div >
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< / div >
< / div >
< div class = "row" >
< div class = "col-md-3 mb-3" >
< label for = "cc-expiration" > Expiration< / label >
< input type = "text" class = "form-control" id = "cc-expiration" placeholder = "" required >
< div class = "invalid-feedback" >
Expiration date required
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< / div >
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< / div >
< div class = "col-md-3 mb-3" >
< label for = "cc-cvv" > CVV< / label >
< input type = "text" class = "form-control" id = "cc-cvv" placeholder = "" required >
< div class = "invalid-feedback" >
Security code required
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< / div >
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< / div >
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< / div >
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< hr class = "mb-4" >
< button class = "btn btn-primary btn-lg btn-block" type = "submit" > Continue to checkout< / button >
< / form >
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< / div >
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< / div >
< footer class = "my-5 pt-5 text-muted text-center text-small" >
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< p class = "mb-1" > © 2017-{{< year > }} Company Name< / p >
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< ul class = "list-inline" >
< li class = "list-inline-item" > < a href = "#" > Privacy< / a > < / li >
< li class = "list-inline-item" > < a href = "#" > Terms< / a > < / li >
< li class = "list-inline-item" > < a href = "#" > Support< / a > < / li >
< / ul >
< / footer >
< / div >