<p><center><img src="https://40.media.tumblr.com/f3481754fd5e2d0f314769fdafec0501/tumblr_ns5a94civY1rc6i7co1_500.jpg" width="440px"><p><center><div style="font-family:arial;"><div style="background-color:91011A;width:435px;height:22px;color:ffffff;padding:3px;padding-top:10px;letter-spacing:3px;font-size:9px;margin-top:1px;margin-top:-0.199cm;text-transform:uppercase">i'm requesting for a picspam</div><div style="line-height:12px;padding:15px;color:000000;text-align:justify;font-size:10px;border: solid 2px 91011A;margin-top:-5px;letter-spacing:1px;text-transform:uppercase">
<center>
<b> number of pictures: [ ] 4 [ ] 6 [ ] 8 </b>
<br> <b> ideas: </b> text here
<br> <b> pictures*: </b> text here
<br> <b> text*: </b> text here
<br> <b> mood: </b> text here
<br> <b> color scheme*: </b> text here
<br> <b> anything else: </b> text here
</div></div><div style="background-color:91011A;width:435px;height:1px;color:fff;padding:3px;padding-top:10px;letter-spacing:3px;font-size:9px;margin-top:-1px;text-transform:uppercase;"> </div>