I pasted it below– I replaced a couple URLs and values with # for privacy.

Also, I’m trying to insert the code inside an avia text block element, inside a 1/2 column.

<form action=”#” method=”POST”>
<input type=hidden name=”oid” value=”00D50000000JNNK”>
<input type=hidden name=”retURL” value=”#”>
<label for=”first_name”>First Name</label><input id=”first_name” maxlength=”40″ name=”first_name” size=”20″ type=”text” /><br>
<label for=”last_name”>Last Name</label><input id=”last_name” maxlength=”80″ name=”last_name” size=”20″ type=”text” /><br>
<label for=”email”>Email</label><input id=”email” maxlength=”80″ name=”email” size=”20″ type=”text” /><br>
<label for=”phone”>Phone</label><input id=”phone” maxlength=”40″ name=”phone” size=”20″ type=”text” /><br>
<label for=”description”>Description</label><textarea name=”description”></textarea><br>
<input type=”submit” name=”submit”>
</form>