<div id="qode_shortcode_form_wrapper">
    <form id="qode_shortcode_form" name="qode_shortcode_form" method="post" action="">
        <div class="input">
            <label>Style</label>
            <select name="style" id="style">
                <option value="circle">Circle</option>
                <option value="number">Number</option>
            </select>
        </div>
        <div class="input">
            <label>Number Type</label>
            <select name="number_type" id="number_type">
                <option value="circle_number">Circle</option>
                <option value="transparent_number">Transparent</option>
            </select>
        </div>
        <div class="input">
            <label>Animate List</label>
            <select name="animate" id="animate">
                <option value="no">No</option>
                <option value="yes">Yes</option>
            </select>
        </div>
        <div class="input">
            <label>Font Weight</label>
            <select name="font_weight" id="font_weight">                
                <option value="">Default</option>
                <option value="light">Light</option>
                <option value="normal">Normal</option>
                <option value="bold">Bold</option>
            </select>
        </div>
        <div class="input">
            <input type="submit" name="Insert" id="qode_insert_shortcode_button" value="Submit" />
        </div>
    </form>
</div>