<div class="row">
	<div class="col-xs-12">
		<div class="form-group">
			<label>Company name</label>
			<?php echo Form::text('name', null, ['class' => 'form-control']); ?>

		</div>

        <div class="form-group">
            <label>PIC</label>
            <?php echo Form::text('pic', null, ['class' => 'form-control', 'required' => 'required']); ?>

        </div>

        <div class="form-group">
            <label>Email</label>
            <?php echo Form::text('email', null, ['class' => 'form-control']); ?>

        </div>

        <div class="form-group">
            <label>Contact no.</label>
            <?php echo Form::text('phone', null, ['class' => 'form-control']); ?>

        </div>

		<div class="form-group pull-right">
			<?php echo Form::submit($submit_text, ['class'=>'btn btn-primary js-btnsubmit-newclient']); ?>

		</div>
	</div>
</div>

