under the stars form

<div style="padding-top:10px;background:f7f7f7;color:CCC372;font-size:9px;text-align:center;line-height:10px;border-bottom:solid 1px"><center style="font-size:7px;margin-top:-1px;letter-spacing:2px">REQUEST<span style="color:CCC372">ING</center><div style="background:fafafa;width:210px;border:858585 1px solid;padding:7px;border-top:CCC372 solid 1px;margin-left:105px;margin-top:5px;color:595d51;text-align:left">
<b>title:</b> text
<br><b>subtitle*:</b> text
<br><b>color scheme:</b> from colourlovers.com
<br><b>requirements:</b> amount of links, columns, directory etc
<br><b>ideas:</b> text
<br><b>anything else?</b> text
</div><br><br>