JSFiddle - React, Tailwind, and code Playground

HTML

<div class="container">
  <form action="https://7b7a51ccb10c11e19c0a026ba7e239a9:@api.balancedpayments.com/v1/credits" method="POST" id="bank-account-form" class="form-horizontal">
    <fieldset>
      
        <legend>Issue Next-Day ACH Deposit</legend>
      
        <label>Amount
            <input type="text"
                   autocomplete="off"
                   placeholder="Amount"
                   class="cr-amt"
                   name="amount"
                   value="10000">
        </label> 

        <label>Description
            <input type="text"
                   autocomplete="off"
                   placeholder="Description"
                   class="cr-desc"
                   name="description"
                   value="Math lessons">
        </label>           
        <label>Account Holder's Name
            <input type="text"
                   autocomplete="off"
                   placeholder="Bank Account Holder's name"
                   class="ba-name"
                   name="bank_account[name]"
                   value="John Q. TaxPayer">
        </label>
        <label>Routing Number
            <input type="text"
                   autocomplete="off"
                   placeholder="Routing Number"
                   class="ba-rn"
                   name="bank_account[routing_number]"
                   value="121000358">
        </label>
        <label>Account Number
            <input type="text"
                   autocomplete="off"
                   placeholder="Account Number"
                   name="bank_account[account_number]"
                   class="ba-an"
                   value="9900000001">
        </label>                       
        <label>Account Type
            <select name="bank_account[type]">
                <option value='' disabled selected style='display:none;'>
                    Select Account Type
                </option>
                <option value="checking" default>CHECKING</option>
       ...

CSS

@import url('http://twitter.github.com/bootstrap/assets/css/bootstrap.css');
@import url('http://twitter.github.com/bootstrap/assets/css/bootstrap-responsive.css');