Need help with putting form on page

<?php if (!defined('BASEPATH')) exit('No direct script access allowed');?>
<div id="members-account-page" class="span12">
    <div class="row">
        <div class="span8">
        <div class="breadcrumbs">
            <ul class="breadcrumb">
                <li><a href="<?=base_url()?>"><?=$this->lang->line('home')?></a><span class="divider">/</span></li>
                <li><a href="<?=base_url('members')?>"><?=$this->lang->line('members_dashboard')?></a><span class="divider">/</span></li>
                <li class="active"><?=$this->lang->line('account_details')?></li>
            </ul>
        </div>   
        <div id="ajax"><?=$show_message?></div>
        <h3><?=$this->lang->line('account_information')?></h3>
        <div class="account-form">
        <form action="<?=base_url('members')?>account" method="post" id="account-form" class="form-horizontal capitalize">
            <ul class="nav nav-tabs">


    <?php if (!empty($custom_fields)) : ?>
                  <li class="active">
                    <a href="#tab1" data-toggle="tab">
                        <span class="hidden-phone"><?=$this->lang->line('custom_info')?></span>
                        <span class="visible-phone"><?=$this->lang->line('custom')?></span>

</a></li>

 <?php endif; ?> 



        <?php if (!empty($billing_form_fields)) : ?>
                  <li class="active">
                    <a href="#tab2" data-toggle="tab">
                        <span class="hidden-phone"><?=$this->lang->line('billing_info')?></span>
                        <span class="visible-phone"><?=$this->lang->line('billing')?></span></a></li>
          
                  
                  <?php endif; ?> 
                  <?php if (!empty($show_affiliate)) : ?>
                  <li><a href="#tab3" data-toggle="tab">
                        <span class="hidden-phone"><?=$this->lang->line('affiliate_info')?></span>
                        <span class="visible-phone"><?=$this->lang->line('affiliate')?></span></a></li>
                  <?php endif; ?>
                <?php if ($sts_affiliate_enable_profile_description == '1'): ?>
                <li><a href="#tab4" data-toggle="tab">
                        <span class="hidden-phone"><?=$this->lang->line('profile_info')?></span>
                        <span class="visible-phone"><?=$this->lang->line('profile')?></span></a></li>


 </ul>
            <div class="tab-content">

<?php if ($show_custom_fields == 1): ?>
<div class="tab-pane fade active in" id="tab1">
<?php foreach ($custom_fields as $b): ?>
<div class="control-group form-fields">
<label class="control-label"><?=$b['check_required']?> <?=$b['form_field_description']?></label>
<div class="controls">
<p class="custom-fields-<?=$b['form_field_name']?>">
<?=$b['form_field']?></p>
</div>
</div>
<?php endforeach; ?>
</div>
            </div>

<?php endif; ?>



</ul>

<?php endif; ?>

            <div class="tab-content">
                


            <?php if (!empty($billing_form_fields)) : ?>
            <div class="tab-pane fade active in" id="tab2">
                <div class="account-info">
                <?php foreach ($billing_form_fields as $b): ?>
                <div class="control-group form-fields">
                <label class="control-label"><?=$b['form_field_description']?></label>
                <div class="controls">  
                       <p class="billing-field-<?=$b['form_field_name']?>"><?=$b['form_field']?></p>
                </div>
                </div>
               
                <?php endforeach; ?>
                </div>
            </div>
            <?php endif; ?>
          
          

          
          <?php if (!empty($show_affiliate)) : ?>
          <div class="tab-pane fade" id="tab3">
              <div class="affiliate-info">
                <?php foreach ($payment_form_fields as $b): ?>
                <div class="control-group form-fields">
                    <label class="control-label"><?=$b['form_field_description']?></label>
                    <div class="controls">
                        <p class="payment-field-<?=$b['form_field_name']?>"><?=$b['form_field']?></p>
                    </div>
                </div>
                <?php endforeach; ?>       
            </div>
         </div>
         <?php endif; ?>

        
         <?php if ($sts_affiliate_enable_profile_description == '1'): ?>
          <div class="tab-pane fade" id="tab4">
              <div class="profile-description well">
                <p><textarea name="profile_description" class="input-block-level" rows="10"><?=$profile_description?></textarea></p>
            </div>
         </div>
         <?php endif; ?>
         
         <?php if ($sts_sec_enable_captcha_order_form == 1): ?>
         <div class="control-group">
            <label class="control-label"><?=$lang_captcha_text?></label>
            <div class="controls">
                <p> <?=$captcha_field?></p>
                <p><?=$captcha?></p>
            </div>
        </div>
        <?php endif; ?>
        </div>
        <div class="control-group">
            <label class="control-label"></label>
                <div class="controls">
                    <button name="product_button" type="submit" class="btn btn-large btn-primary" data-loading-text="<?=$this->lang->line('please_wait')?>"><?=$this->lang->line('save_changes')?></button>       
                </div>
            </div>
                <input type="hidden" name="jroxSubmitPForm" value="1" />
         </form>
         </div>
        </div>
        <div class="span4 capitalize">    
            <?php if ($show_upload == 1): ?>
               <form action="<?=base_url('members')?>account/update_photo" method="post" enctype="multipart/form-data">
            <div class="member-photo">
                <div class="well text-center">
                <h3 class="text-left"><?=$this->lang->line('member_photo')?></h3>    
                    <p><img src="<?=base_url('members', true)?><?=$member_photo?>" alt=""/></p>
                    <p><input type="file" name="userfile" size="15"/></p>
                    <p>
                        <?php if (!empty($show_delete_photo)): ?>
                        <a href="<?=base_url('members')?>account/delete_photo/<?=$member_photo_raw?>/<?=$this->session->userdata('userid')?>" class="btn btn-block btn-warning"><?=$this->lang->line('delete_photo')?></a>
                        <?php endif; ?>
                    </p>            
                    <p><button type="submit" class="btn btn-primary btn-block"><?=$this->lang->line('update_photo')?></button>  
                    </p>
                </div>
            </div>
            </form>
            <?php endif; ?>
        
            <div class="quick-stats hidden-phone">
                <div class="well">
                <h3><?=$this->lang->line('dashboard_quickstats')?></h3>
                    <div class="pull-right"><?=$dashboard_unpaid_invoices?></div>
                    <div><a href="<?=base_url('members')?>/invoices/view/unpaid"><?=$this->lang->line('dashboard_unpaid_invoices')?></a></div>
                    <div class="pull-right"><?=$dashboard_paid_invoices?></div>
                    <div><a href="<?=base_url('members')?>/invoices/view/paid"><?=$this->lang->line('dashboard_paid_invoices')?></a></div>
                    <hr />
                    <p><a href="<?=base_url('members')?>invoices/view" class="btn btn-primary btn-block"><?=$this->lang->line('view_invoices')?></a></p>      
                    </p>
                    <?php if ($enable_affiliate_marketing == 1): ?>
                    <hr />
                    <div class="pull-right"><?=$dashboard_unpaid_commissions?></div>
                    <div><a href="<?=base_url('members')?>/commissions/view/unpaid"><?=$this->lang->line('dashboard_unpaid_commissions')?></a></div>
                    <div class="pull-right"><?=$dashboard_paid_commissions?></div>
                    <div><a href="<?=base_url('members')?>/commissions/view/paid"><?=$this->lang->line('dashboard_paid_commissions')?></a></div>
                    <hr />
                    <p><a href="<?=base_url('members')?>commissions/view" class="btn btn-primary btn-block"><?=$this->lang->line('view_commissions')?></a></p>      
                    </p>
                    <?php endif; ?>
                </div>
            </div>
            <?php if ($sts_support_enable == 1): ?>
            <div class="support-tickets hidden-phone">                  
                <div class="well">
                <h3><?=$this->lang->line('dashboard_support_tickets')?></h3>    
                    <div class="pull-right"><?=$dashboard_open_tickets?></div>
                    <div><a href="<?=base_url('members')?>/support/view/open"><?=$this->lang->line('dashboard_open_tickets')?></a></div>
                    <div class="pull-right"><?=$dashboard_closed_tickets?></div>
                    <div><a href="<?=base_url('members')?>/support/view/closed"><?=$this->lang->line('dashboard_closed_tickets')?></a></div>
                    <hr />
                    <p><a href="<?=base_url('members')?>support/add" class="btn btn-primary btn-block"><?=$this->lang->line('create_support_ticket')?></a></p>      
                    </p>
                </div>
            </div>
            <?php endif; ?>
            <?php if ($member_hide_list_box == 0): ?>
            <div class="mailing-lists hidden-phone">
                <div class="well">
                <h3><?=$this->lang->line('dashboard_mailing_lists')?></h3>                      
                <form action="<?=base_url('members')?>mailing_lists/update/account" method="post">
                <?php foreach ($mailing_lists as $m): ?>
                <label class="checkbox">
                  <?=$m['mailing_list_check_box']?> <?=$m['mailing_list_name']?>
                </label>
                <?php endforeach; ?>
                <p>
                <hr />
                <button type="submit" class="btn btn-primary btn-block"><?=$this->lang->line('update_subscriptions')?></button>  
                </p>
                </form>    
                </div>
            </div>
            <?php endif; ?>       
        </div>
    </div>
</div> 

<script language="javascript" src="<?=base_url('members', true)?>js/jquery.validate.js"></script> 
<script>
$("#account-form").validate();
            
function onSelectChange(id, select) {
    var index;
    for(index=0; index<select.options.length; index++)
    if(select.options[index].selected)
    {
        if(select.options[index].value!="")
            cid = select.options[index].value;
            $("."+id+"-field-"+id+"_state").load("<?=base_url('members')?>account/load_regions/" + cid + "/"+id+"_state");         
        }
    }
</script>