<div class="form-group"> <input type="text" class="form-control" placeholder="Technician Name" name="repairtech" id="repairtech" /> </div> <div class="form-group"> <input type="number" class="form-control" placeholder="IMEI number" name="repairIMEI" id="repairtech" /> </div> <div class="form-group"> <input type="text" class="form-control" placeholder="Customer Name" name="cusname" id="cusname" /> <!--<select class="" name="cusid"> <?php $db = new Database(); $db->connectToDB(); foreach ($db->getCustomers() as $customer) { print_r("<option value='" . $customer['cusid'] . '>' . $customer['cusname'] . '</option>'); } ?> </select>--> </div> <div class="form-group"> <input type="number" class="form-control" placeholder="Customer phone #" name="cusphone" id="cusphone" /> </div> <div class="form-group"> <input type="email" class="form-control" placeholder="Customer Email Address" name="cusemail" id="cusemail" /> <span id="check-e"></span> </div>