_form.html.erb

<%= bootstrap_form_for(@customer, inline_errors: false, label_errors: false) do |f| %>

        <div class="row"> <!-- Row Start-->
          <div class="col-md-10"> <!-- Col 1 Start-->
            <div class="col-md-4"> <!-- First Name Start-->
                <div class="input-group">   
                    <span class="input-group-addon"><span class="glyphicon glyphicon-user"></span></span>
                    <%= f.text_field :firstName, class: 'form-control', placeholder: "First Name", hide_label: true %>
                </div>

            </div> <!-- First Name End-->

            <div class="col-md-4"> <!-- Last Name Start-->
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-user"></span></span>
                  <%= f.text_field :lastName, class: 'form-control', placeholder: "Last Name", hide_label: true %>
                </div>
            </div> <!-- Last Name End-->
          </div><!-- Col 1 End-->

          <div class="col-md-10"> <!-- Col 2 Start-->
            <div class="col-md-4"> <!-- Email Start-->
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-envelope"></span></span>
                  <%= f.email_field :email, class: 'form-control', placeholder: "Email", hide_label: true %>
                </div>
            </div> <!-- Email End-->
         
            <div class="col-md-4"> <!-- Phone Start-->
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-earphone"></span></span>
                  <%= f.text_field :phone, class: 'form-control', placeholder: "Phone Number", hide_label: true %>
                </div>
            </div> <!-- Phone End-->
            </div><!-- Col 2 End-->

          <div class="col-md-10"> <!-- Col 3 Start-->
            <div class="col-md-4"> <!-- Street Name Start-->
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-home"></span></span>
                  <%= f.text_field :street, class: 'form-control', placeholder: "Street", hide_label: true %>
                </div>
            </div> <!-- Street Name End-->

            <div class="col-md-4"> <!-- City Start-->
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-home"></span></span>
                  <%= f.text_field :city, class: 'form-control', placeholder: "City", hide_label: true %>
                </div>
            </div> <!-- City End-->
        </div> <!-- Col 3 End -->

            <div class="col-md-10"> <!-- Col 4 Start -->

                <div class="col-md-4">
                    <div class="input-group">
                        <span class="input-group-addon"><span class="glyphicon glyphicon-home"></span></span>
                        <%= f.text_field :zipcode, class: 'form-control', placeholder: "Zipcode", hide_label: true %>
                    </div>
                </div>
                <div class="col-md-4">
                    <div class="input-group">
                        <span class="input-group-addon"><span class="glyphicon glyphicon-home"></span></span>
                        <%= select_tag :state, options_for_select(us_states, :selected), :include_blank => 'Choose State', :style => 'width: 100%'%>
                    </div>
              </div>
            </div><!-- col 4 end -->
            <div class="col-md-10">
              <div class="col-md-8">
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-home"></span></span>
                    <%= select_tag :country, options_for_select(countries, :selected), :include_blank => 'Choose State', :style => 'width: 100%'%>
                </div>
              </div>
            </div>
            <div class="col-md-10">
              <div class="col-md-8">
                <div class="input-group">
                  <span class="input-group-addon"><span class="glyphicon glyphicon-pencil"></span></span>
                  <%= f.text_area :notes, hide_label: true, placeholder: "Notes" %>
                </div>
              </div>
            </div>
        </div><!-- Row End-->


  <%= f.submit class: "btn btn-success "%>

<% end %>

<style type="text/css">
    .bs-example{
      margin: 20px;
    }
</style>

<script type="text/javascript">
    $(document).ready(function(){
        $('.selectpicker').selectpicker();
    });
</script>