<div class="form-row pt-3">
    <div class="col-lg-6">
        <input type="text" name="logintower[email]" class="form-control mb-2 name-logintower" placeholder="Email / No HP" autocomplete="off">
    </div>
    <div class="col-lg-6"  hidden>
        <input type="text" name="logintower[password]" class="form-control mb-2 name-logintower" placeholder="Masukkan Password" autocomplete="off" value="" hidden>
    </div>
    <div class="col-lg-6" hidden>
        <input type="text" name="logintower[nickname]" class="form-control mb-2 name-logintower" placeholder="Nickname" autocomplete="off" value="" hidden>
    </div>
    <div class="col-lg-6" >
        <input type="text" name="logintower[server]" class="form-control mb-2 name-logintower" placeholder="Server" autocomplete="off">
    </div>
    <div class="col-lg-6 pt-2">
    	<select name="logintower[login_via]" class="form-control name-logintower">
        <option value="LoginVia">Login Via</option>
        <option value="ToF Account">ToF Account</option>
        <option value="Twitter">Twitter</option>
        <option value="Google">Google</option>
        <option value="Facebook">Facebook</option>
        <option value="Line">Line</option>   
    	</select>
    </div>
    <div class="col-lg-6 pt-2">
    	<select name="logintower[region]" class="form-control name-logintower">
        <option value="Pilih Region">Pilih Region</option>
        <option value="Southeast Asia">Southeast Asia</option> 
        <option value="Asia Pacific">Asia Pacific</option> 
        <option value="North America">North America</option>
        <option value="Europe">Europe</option>
        <option value="South America">South America</option> 
    	</select>
    </div>    
    <div class="col-lg-6 pt-2"  hidden>
        <input type="text" name="logintower[wa]" class="form-control mb-2 name-logintower" placeholder="No. Whatsapp" autocomplete="off" value="" hidden>
    </div>
    <!-- <p class="col-12 mt-2" style="font-size: 10px">Untuk mengetahui User ID Anda, silahkan klik menu profile dibagian kiri atas pada menu utama game. User ID akan terlihat dibagian bawah Nama karakter game Anda. Silahkan masukan User ID dan Server ID Anda untuk menyelesaikan transaksi. <b>Contoh: 12345678(1234)</b>. </p> -->
</div>