<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<div class="container">
<p class="well">#password has type of text instead of password just for testing purposes</p>
<h3>Registration</h3>
<hr>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<label>Username</label>
<div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-user"></span></span>
<input type="text" class="form-control" name="Username" id="Username" placeholder="Requested Username" required value="SeanWessell">
</div>
</div>
<div class="form-group">
<label>Email</label>
<div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-envelope"></span></span>
<input type="text" class="form-control" name="Email" id="Email" placeholder="Requested Email" required value="Sean.Wessell@gmail.com">
</div>
</div>
<div class="form-group">
<label>Password</label>
<div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-lock"></span></span>
<input type="text" class="form-control" name="password" id="password" placeholder="Password" required data-toggle="popover" title="Password Strength" data-content="Enter Password...">
</div>
</div>
<div class="form-group">
<label>Confirm Password</label>
<div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-resize-vertical"></span></span>
<input type="password" class="form-control" name="confirm" id="confirm" placeholder="Confirm Password" required>
</div>
</div>
<input type="submit" name="submit" id="submit" value="Submit" class="btn btn-primary pull-right">
</div>