                                    <input type="text" name="city" class="form-control" data-validation="required" placeholder="City">
                                </div>
                                <div class="col  mb-2">
                                        <input type="text" name="region" class="form-control"
                                            data-validation="required" placeholder="Region">
                                </div>
                                <div class="col  mb-2">
                                    <input type="text" name="country" class="form-control" data-validation="required" placeholder="Country">
                                </div>
                                <div class="col  mb-2">