HEA Book Jacket Form

<div align=center><div style="background-image:url(http://i.imgur.com/r8mwsIB.png);background-repeat: no-repeat;padding-top:250px;padding-right:30px;padding-left:160px;font-family:'consolas';font-size:12px;letter-spacing:-3px;color #000000;">
<div align="center"><span style="font-family: sans-serif;font-size:40px;letter-spacing:-3x;margin-top:30px;color #000000;text-transform:uppercase;"> <B>Requesting A Book Jacket</b></span>
<div style="font-family: Helvetica;letter-spacing:1px; font-size:11px; text-align:center;color #000000;text-transform:lowercase;"><br>
<font size="3">Title:
<br>
Subtitle*:
<br>
Author:
<br>
Cover?:
<br>
Brief Summary:
<br>
Mood/Colors:
<br>
Genre:
<br>
Additions (Barcode, "Only on wattpad", etc.):
<br>
Anything Else:
<br>
</font><br>


<br><div style="border-top: #000000  solid 1px;text-align:center;">Thread Design and Coding by: Abyss-of-Crazy</div></div>