<!DOCTYPE html>
<html>

<head>
<style>
form {
    margin:auto;
    position:relative;
    width:550px;
    height:600px;
    font-family: Tahoma, Geneva, sans-serif;
    font-size: 14px;
    font-style: italic;
    line-height: 24px;
    font-weight: bold;
    color: #09C;
    text-decoration: none;
    border-radius: 10px;
    padding:10px;
    border: 1px solid #999;
    border: inset 1px solid #333;
    box-shadow: 0px 0px 8px rgba(0, 0, 0, 0.3);
}
.input {
    width:375px;
    display:block;
    border: 1px solid #999;
    height: 25px;
    box-shadow: 0px 0px 8px rgba(0, 0, 0, 0.3);
}
textarea {
    display:block;
}
textarea#feedback {
    width:375px;
    height:150px;
    display:block;
}
input#button {
    width:100px;
    position:absolute;
    right:20px;
    bottom:20px;
    background:#09C;
    color:#fff;
    font-family: Tahoma, Geneva, sans-serif;
    height:30px;
    border-radius: 15px;
    border: 1p solid #999;
}
input#button:hover {
    background:#fff;
    color:#09C;
}
input:focus, textarea:focus {
    border: 1px solid #09C;
}
</style>
</head>

<body>
<form action="http://workshop.sps.nyu.edu/~sultans/util/form/formProc.cgi">
<div>
<h1>Contact Form</h1>
<label>
<span>Your name</span>      <input type="text" id="name" class=input name="name">
</label>
<label>
<span>Email Address</span>  <input type="text" id="email" class=input name="email">
</label>
<label>
<span>Subject</span>        <input type="text" id="subject" class=input name="subject">
</label>
<label>
<span>Date</span>           <input type="date" id="date" class=input name="date">
</label>
<label>
<span>Gender</span>         <div class=input>
                            <input type="radio" name="gender" value="M"> Male 
                            <input type="radio" name="gender" value="F"> Female
                            </div>
</label>
<span>Residence State</span><select class=input name="state">
                            <option value="00"> --Choose from below--</option>
                            <option value="NY"> New York</option>
                            <option value="NJ"> New Jersey</option>
                            <option value="CT"> Connecticut</option>
                            </select>
</label>
<label>
<span>Message</span>        <textarea id="feedback" name="feedback"></textarea>
</label>
<label>
<input id=button type="submit" class=input value="Submit Form" />
</label>

</div>
</form>
</body>
</html>