[MELKY] ini HTML

<div id="buattabel" >
  <div style="border:1pt dashed #0000cc;">
    Kirim Suara Anda
  </div>
  <div style="margin-top:2px;">
    <input class="form-control" placeholder="Nama Depan" type="text" name="nama_depan"><input class="form-control" placeholder="Nama Belakang" type="text" name="nama_belakang">
  </div>
  <div style="margin-top:2px;">
    <input class="form-control2" placeholder="Alamat Email" type="text" name="email">
  </div>
  <div style="margin-top:2px;">
    <input class="form-control2" placeholder="Regional" type="text" name="regional">
  </div>

  <div align="center" style="margin-top:2px;">
    <input class="form-radio" type="radio" name="jawaban" value="Setuju">Setuju
    <input class="form-radio" type="radio" name="jawaban" value="Tidak Setuju">Tidak
  </div>


  <div style="margin-top:2px;">
    <textarea class="buattextarea" placeholder="Komentar" type="text" name="pendapat"></textarea>
  </div>
  <button class="btn" type="submit">KIRIM</button>
</div>