Can this work?????

hey guys

i need to make this

<form action="http://www.regencycoins.co.uk/listmessenger-light-2.1.0/public/listmessenger.php" method="post">
<input type="hidden" name="group_ids[]" value="ENTER_GROUP_ID_HERE" />
<table style="width: 100%" cellspacing="0" cellpadding="1" border="0">
<tbody>
	<tr>
		<td style="color: #CC0000"><label for="email_address">E-Mail Address:</label></td>
		<td><input type="text" id="email_address" name="email_address" value="" maxlength="128" /></td>
	</tr>
	<tr>
		<td><label for="firstname">Firstname:</label></td>
		<td><input type="text" id="firstname" name="firstname" value="" maxlength="32" /></td>
	</tr>
	<tr>
		<td><label for="lastname">Lastname:</label></td>
		<td><input type="text" id="lastname" name="lastname" value="" maxlength="32" /></td>
	</tr>
	<tr>
		<td style="vertical-align: top; color: #CC0000"></td>
		<td>
			<input type="text" id="newsletter" name="newsletter" value="" maxlength="30" />
	</td>
</tr>
	<tr>
		<td style="color: #CC0000"><label for="action">Subscriber Action:</label></td>
		<td>
			<select id="action" name="action">
			<option value="subscribe">Subscribe</option>
			<option value="unsubscribe">Unsubscribe</option>
			</select>
		</td>
	</tr>
	<tr>
		<td colspan="2" style="text-align: right">
			<input type="submit" value="Submit" />
		</td>
	</tr>
</tbody>
</table>
</form>

Code (markup):

into this or atleast make it work

<form method="post" action="/cgi-bin/example.cgi">
                                                    	<span class="c1">Site Search
                                                        </span>

												<div class="c2">
													<table border="0" cellspacing="0" cellpadding="2">
														<tr>
															<td bgcolor="#F1EFEF">
                                                            	<input type="text" size="19" maxlength="30" />
                                                                	</td>
															<td bgcolor="#F1EFEF" valign="middle">
                                                            	<input type="image" name="submit" src="go.gif" />
                                                                	</td>
														</tr>
													</table>
												</div>
												</form>

Code (markup):

 

I am not getting what you are saying.

Can you show us by url or example page?