christmas to do list [cover + banner form]

<img src="http://24.media.tumblr.com/tumblr_lwkm6aPK9X1qhy6c9o1_500.gif">
<div style="background-color:#FCF0E4;margin-top:-10px;text-align:center;font-family:consolas;font-size:10px;letter-spacing:3px;text-align:center;text-transform:uppercase;color:#4D2A0A;">
I am requesting a
<div style="background-color:#4D2A0A;text-align:center;color:#FEFEFE;line-height:25px;margin-right:120px;margin-left:120px;">cover/banner</div>
<p>
[ ]cover  [ ]banner<br>
<br>+ title :
<br>+ subtitle* :
<br>+ author :
<br>+ mood + genre :
<br>+ ideas :
<br>+ picture/s* :
<br>+ anything else? :
</p>
<div style="background-color:#4D2A0A;text-align:center;color:#FEFEFE;line-height:15px;margin-right:120px;margin-left:120px;">coded by: venustate_</div>
<div style="background-color:#4D2A0A;text-align:center;color:#FEFEFE;line-height:15px;margin-right:50px;margin-left:50px;margin-top:-5px;">what will you do on christmas?</div>