book jacket form

<img src="http://i.imgur.com/5X3Fj98.png" width=400px">
<div style="background:f5f5f5;padding:5px;color:02bdff"><center><span style="font-size:40px"><b>BOOK JACKET</b></span><br>
Title:<BR>
Subtitle*:<BR>
Author:<BR>
Summary for the back:<BR>
Link to cover:<BR>
Ideas(fonts, pictures for the back, etc.):<BR>
Mood/genre:<BR>