<p>Enter Your Name & Email To:</p>
 
<table class="form-list">
    <tbody>
    <tr>
    <td width="20"><i class="icon-one"></i></td>
    <td>Join Our Worldwide Team</td>
    </tr>
    <tr>
    <td><i class="icon-two"></i></td>
    <td>Take the Pledge & End Bullying</td>
    </tr>
    <tr>
    <td><i class="icon-three"></i></td>
    <td>Get Your FREE Bully Defense Kit</td>
    </tr>
    <tr>
    <td><i class="icon-four"></i></td>
    <td>Get a Ticket to a FREE Workshop </td>
    </tr>
    </tbody>
</table>