<fieldset>
	<legend>Send Activation Code</legend>

	<div class="panel-body">
		<div class="form-group">
			<div class="input-group col-md-3">
				<span class="input-group-addon"><i class="fa fa-envelope fa-fw"></i></span>
				<input type="email" id="email" name="email" value="" placeholder="Email" class="form-control" required />
			</div>
		</div> <!-- /form-group -->
	</div> <!-- /panel-body -->
</fieldset>

<div class="row">
	<div class="col-md-offset-1">
		<button type="submit" class="btn btn-primary">Send</button>
		<button type="button" class="btn btn-default">Cancel</button>
	</div>
</div>
