{!! Form::email('email' , '' , ['class' => 'form-control', 'placeholder' => 'Email *']) !!}

{!! Form::text('first_name' , '' , ['class' => 'form-control', 'placeholder' => 'First Name *']) !!}

{!! Form::text('middle_name' , '' , ['class' => 'form-control', 'placeholder' => 'Middle Name *']) !!}

{!! Form::text('last_name' , '' , ['class' => 'form-control', 'placeholder' => 'Last Name *']) !!}

{!! Form::text('phone' , '' , ['class' => 'form-control', 'placeholder' => 'Phone *']) !!}

{!! Form::text('address' , '' , ['class' => 'form-control', 'placeholder' => 'Address *']) !!}

{!! Form::text('city' , '' , ['class' => 'form-control', 'placeholder' => 'City *']) !!}

{!! Form::select('state' , $americanStates, '' , ['class' => 'form-control american_states']) !!}

{!! Form::text('zip' , '' , ['class' => 'form-control', 'placeholder' => 'Zip *']) !!}