JSFiddle - React, Tailwind, and code Playground

HTML

<link rel="stylesheet" href="http://netdna.bootstrapcdn.com/bootstrap/3.1.1/css/bootstrap.min.css">
<link rel="stylesheet" href="http://netdna.bootstrapcdn.com/bootstrap/3.1.1/css/bootstrap-theme.min.css">
<script src="http://netdna.bootstrapcdn.com/bootstrap/3.1.1/js/bootstrap.min.js"></script>
<a href="#" data-toggle="modal" data-target="#bannerformmodal">Load me</a>

<div class="modal fade bannerformmodal" tabindex="-1" role="dialog" aria-labelledby="bannerformmodal" aria-hidden="true" id="bannerformmodal">
<div class="modal-dialog modal-sm">
        <div class="modal-content">
          <div class="modal-content">
                <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal" aria-hidden="true">&times;</button>
                <h4 class="modal-title" id="myModalLabel">Contact Form</h4>
                </div>
                <div class="modal-body">
                     <form id="requestacallform" method="POST" name="requestacallform">

                                <div class="form-group">
                                    <div class="input-group">                               
                                    <span class="input-group-addon"><i class="fa fa-user"></i></span>
                                    <input id="first_name" type="text" class="form-control" placeholder="First Name" name="first_name"/>
                                    </div>
                              </div>
                              <div class="form-group">
                                    <div class="input-group">                               
                                    <span class="input-group-addon"><i class="fa fa-user"></i></span>
                                    <input id="last_name" type="text" class="form-control" placeholder="Last Name" name="last_name"/>
                                    </div>
                              </div>
                                <div class="form-group">
...