form

<div style="margin:125px 0px 125px 115px;width:200px;background-color:3B3737;border:3px;border-bottom-style:solid;border-color:C9D1D3;font-family:arial;font-size:8.5px;text-align:left;padding:0px 10px 10px 10px;text-transform:uppercase;color:F7F7F7">
<span style="font-size:11px;color:991818;letter-spacing:7px"><center><b>+REQUESTING+</b></center></span>
<br><b>Fake []  Real []
<br><b>title:</b>
<br><b>subtitle:</b>
<br><b>links:</b>
<br><b>colour palette:</b>
<br><b>images:</b>
<br><b>other:</b>