applyinggg form

<div style="background:fff;height:300px"><div style="margin:10px 0 0 125px;border: solid 943D47 3px;width:180px;height:50px"/><div style="margin:-40px 0 0 -10px;color:FA7080;text-align:center;font-size:30px"><I><b>applying</I></DIV><div style="border-left: dotted 6B5053 3px;border-right:dotted 6B5053 3px;border-top:dotted 6B5053 3px;height:180px;margin:40px 0 0 125px;width:180px"/><div style="margin:-170px 0 0 130px;text-align:justify;line-height:12px;font-size:11px;letter-spacing:-1px;width:160px"><b>name:</b>text<br>
<br><b>dedication:</b>text<br>
<Br><b>examples:</b>text<br>
<Br><b>what you would like to learn:</b>text<br>
<Br><b>anything else:</b>text<Br><Br><br><br>