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Use a <form> element to process the input. You can learn more about this in our PHP tutorial. Then add inputs for each field, together with a submit button

<form action="action_page.php">
  <div class="container">
    <h2>Subscribe to our Newsletter</h2>
    <p>Lorem ipsum..</p>
  </div>
  <div class="container" style="background-color:white">
    <input type="text" placeholder="Name" name="name" required>
    <input type="text" placeholder="Email address" name="mail" required>
    <label>
      <input type="checkbox" checked="checked" name="subscribe"> Daily Newsletter
    </label>
  </div>
  <div class="container">
    <input type="submit" value="Subscribe">
  </div>
</form>

/* Style the form element with a border around it */
form {
    border: 4px solid #f1f1f1;
}
/* Add some padding and a grey background color to containers */
.container {
    padding: 20px;
    background-color: #f1f1f1;
}
/* Style the input elements and the submit button */
input[type=text], input[type=submit] {
    width: 100%;
    padding: 12px;
    margin: 8px 0;
    display: inline-block;
    border: 1px solid #ccc;
    box-sizing: border-box;
}
/* Add margins to the checkbox */
input[type=checkbox] {
    margin-top: 16px;
}
/* Style the submit button */
input[type=submit] {
    background-color: #4CAF50;
    color: white;
    border: none;
}
input[type=submit]:hover {
    opacity: 0.8;
}