Edit in JSFiddle

<div class="container-fluid">

<div class="row-fluid">

<div class="span8">
<p>Some Content.</p>
</div>

<div class="span4">
  <div class="well">    
    <div class="control-group">
      <label class="control-label" for="name">Your Name</label>
      <div class="controls">
      <input type="text" class="span4" name="name" id="name" maxlength="100" />
      </div>
    </div>
  </div>
</div>

</div>

</div>