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<html>
<body>
<img src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTH77KhuYCfINlReyIQ7iFhoB3O_ZDdiIJmSA&s"><br>
<img src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTH77KhuYCfINlReyIQ7iFhoB3O_ZDdiIJmSA&s">
<br><hr><img src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTH77KhuYCfINlReyIQ7iFhoB3O_ZDdiIJmSA&s"width=" "607" height="607"
<form action="/action_page.php">
<label for="fname">First name:</label>
<input type="text" id="fname" name="fname"><br><br>
<label for="lname">Last name:</label>
<input type="text" id="lname" name="lname"><br><br>
<input type="submit" value="Submit">
</form>
</body>
</html>