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So this is what I want.  I want to take the form shown in the white box, and I want it put into a column, so we can include it on our various pages.  I don’t know how to do that. Do you?

I think that I want the background to be white, and maybe even a border (I’d like to see it with and without a border.)  Can you do that?  Or let’s ask Daljit to do it, OK? It needs to go on a LOT of pages, and if I’m going to touch them anyway, I’d like to put this in.  

BTW, I am creating this as a single block page and then we’ll save it as a block template, so we can just pop it in anywhere.