requesting form for jennifer thread

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<div style="color: ED5A68;font-size:40px;letter-spacing:1px;margin-top:10px"><center><b>requesting</div>

<b>check one:</b> manipulated [] simple []<br>
<b>title:</b> text here <br>
<b>subtitle:</b> text here <br>
<b>author:</b> text here <br>
<b>mood/genre:</b> text here <br>
<b>ideas/pictures:</b> text here <br>
<b>anything else:</b> text here