<!-- Begin MailChimp Signup Form -->
<div id="optin">

<form action="http://costinionut.us7.list-manage.com/subscribe/post?u=1bae378e10c83bf4435734112&id=3d88029c67" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form"
class="validate" target="_blank">

<input type="email" size="30" value="Enter your email" name="EMAIL"
class="required email" id="mce-EMAIL" onfocus="if(this.value==this.defaultValue)this.value='';" onblur="if(this.value=='')this.value=this.defaultValue;">

<input type="text" size="30" value="Enter your name" name="FNAME" class="name" id="mce-FNAME" onfocus="if(this.value==this.defaultValue)this.value='';" onblur="if(this.value=='')this.value=this.defaultValue;">

<div id="mce-responses" class="clear">

<div class="response" id="mce-error-response" style="display:none"></div>

<div class="response" id="mce-success-response" style="display:none"></div>
</div>

<div class="clear">

<input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button">

</div>
</form>
</div>
<!--End mc_embed_signup-->

CSS:

#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }

#optin {
background: #efefef;

border: 1px solid #ccc;
padding: 20px 15px;

text-align: center
}
#optin input {

background: #fff;

border: 1px solid #ccc;

font-size: 15px;

margin-bottom: 10px;

padding: 8px 10px;

border-radius: 3px;

-moz-border-radius: 3px;

-webkit-border-radius: 3px;

box-shadow: 0 2px 2px #ddd;

-moz-box-shadow: 0 2px 2px #ddd;

-webkit-box-shadow: 0 2px 2px #ddd
}

#optin input.name { background: #fff url(http://www.costinionut.com/poze/newsletter/name.png) no-repeat 10px center; padding-left: 35px }

#optin input.email { background: #fff url(http://www.costinionut.com/poze/newsletter/email.png) no-repeat 10px center; padding-left: 35px }

#optin input[type="submit"] {
background: #217b30 url(http://www.costinionut.com/poze/newsletter/green.png) repeat-x top;

border: 1px solid #137725;
color: #fff;
cursor: pointer;

font-size: 18px;

font-weight: bold;

padding: 8px 0;

text-shadow: -1px -1px #1c5d28;

width: 100%
}

#optin input[type="submit"]:hover { color: #c6ffd1 }