--- layout: examples title: Checkout example extra_css: - "checkout.css" extra_js: - src: "checkout.js" body_class: "bg-body-tertiary" ---

## Checkout form

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.

#### Your cart 3

- ###### Product name

  Brief description
  $12

- ###### Second product

  Brief description
  $8

- ###### Third item

  Brief description
  $5

- ###### Promo code

  EXAMPLECODE
  −$5
- Total (USD) $20

#### Billing address

First name
Valid first name is required.
Last name
Valid last name is required.
Username
@
Your username is required.
Email (Optional)
Please enter a valid email address for shipping updates.
Address
Please enter your shipping address.
Address 2 (Optional)
Country
Please select a valid country.
State
Please provide a valid state.
Zip
Zip code required.

Shipping address is the same as my billing address
Save this information for next time

#### Payment

Credit card
Debit card
PayPal
Name on card Full name as displayed on card
Name on card is required
Credit card number
Credit card number is required
Expiration
Expiration date required
CVV
Security code required