form

please copy everything below the line
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<div style="background-color:#fff;border-style:solid dotted;border-width:4px;border-color:#6396A4;font-family:bookman old style;color:#12404D;text-align:right;padding:20px;">
<font face="bookman old style"><font size="6"><b>requesting</b></font></font><br>
Cover Form:<br>
Title:
<br>Subtitle:
<br>Author:
<br>Ideas:
<br>Pictures:
<br>Colors/Mood:
<br>Anything Else: