https://www.vendsmith.com.my/subscribe_newsletter.php?lang=

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2<!doctype html>
3<html>
4<head>
5<meta charset="gb2312">
6<title>Subscribe Newsletter</title>
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14body{
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17	font-family:'Roboto Slab','Microsoft Yahei', serif;
18	font-size:14px;
19  width: 400px;
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21h1{
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23	font-size:24px;
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25.header,
26button{
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44button{
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47	padding:10px;
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51.alert-msg{
52	color:#D30000;
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54}
55.success-msg{
56	color:#4F8A10;
57	font-size:14px;
58}
59.success-msg i{
60	font-size:60px;
61}
62#newsletter_design img{
63  max-width: 100%;
64  height: auto !important;
65}
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68<script>
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73</head>
74
75<body>
76<form name="subscribe_newsletter" method="post" action="subscribe_newsletter.php?a=submit&lang=en">
77<table width="100%" cellpadding="10" cellspacing="0">
78  	<tr>
79	  <td colspan="2" align="center" class="header"><h1><i class="fa fa-envelope-o"></i> Subscribe Newsletter</h1></td>
80	</tr>
81    <tr>
82    <td colspan="2" align="center">
83    	            <table cellpadding="3" cellspacing="0" >
84        <tr>
85          <td >Your Name<br></td>
86          <td ><input name="yourname" type="text" value=""></td>
87        </tr>
88        <tr>
89          <td>Your Email<br></td>
90          <td><input name="youremail" type="text" value=""></td>
91        </tr>
92        <tr>
93        	<td>&nbsp;</td>
94        	<td>
95                    <span class="alert-msg"><i class="fa fa-exclamation-circle "></i> All fields are required</span>
96                    </td>
97        </tr>
98        <tr>
99          <td colspan="2" height="60"><button type="submit" name="subscribe">Subscribe</button></td>
100        </tr>
101      </table>
102                </td>
103  </tr>
104</table>
105</form>
106</body>
107</html>