How can I build a mixed-columns form in PHP using bootstrap 3?

I'm trying to make a 1 column form in bootstrap with some rows sharing a second column. It's for making an employee profile editing page in an intranet so I don't really care about medium or small screen sizes.

I'm trying to make it using an example I found here but the result is not what I need. I'm used to work with CSS style sheets but to be honest, bootstrap grid system always confuses me.

Here's a mockup of what I need:
This is the format I need
Here's what I'm getting:
This is what I needIf anyone could give me an empty structure with a couple of lines so I can start from there... it would be awesome!!!

Thanks in advance!
LVL 6
Cesar AracenaPHP EnthusiastAsked:
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ResQTek NancyPresident @ ResQTekCommented:
With a second row spanning the two columns in the first row, I achieved your layout (give or take some details). I hope this is helpful!

<div class="container">
<div class="row">
    <div class="col-md-4">
      First Name<br/>
      <p><input type="text" /></p>
      <p><input type="text" /></p>
      <p><input type="text" /></p>
      <p><input type="text" /></p>
    </div>
    <div class="col-md-4">
      <img src="http://www.aal-europe.eu/wp-content/uploads/2014/10/green.jpg" height="275"/>
    </div>
</div>
<div class="row">
  <div class="col-md-8">
    <p><input type="text" /></p>
    <p><input type="text" /></p>
  </div>
</div>
<style>
  p {
    margin: 5px 5px 40px 5px;  
  }
  input {
    width: 100%;
  }
</style>

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Cesar AracenaPHP EnthusiastAuthor Commented:
Perfect! Thanks a lot !!!
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