This is really rough, and not the best way, but may help a bit:
Code:
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<title>Experiment</title>
<style media="all">
* {margin: 0; padding: 0;}
body {font-family: arial, sans-serif;}
.subs_heading {color:#fff; font-family:Tahoma; font-size:16px; padding-left:20px; font-weight:bolder; height:20px; width:250px; text-align:center;}
label{font-size: 1.125em; width: 64px; clear: left;display:block; padding:5px 0 0 0px; border:solid 0px #000; margin:0 0 0 0px; float:left; color:#fff; text-align:left;}
input{margin:0 0 10px 0px; padding:5px; color:#bbbbbb; float:left; border: none;}
.submit{position:absolute; left: 350px; top: 30px; width: 75px; height: 35px; border-radius: 12px; background: white; }
form {position:relative; background: #4b5360; border-radius: 12px; overflow: hidden; width: 400px; padding: 4px 30px; }
input[type="text"] {width: 230px;}
</style>
</head>
<body>
<form action="" name="subscribe" id="subscribe">
<p class="subs_heading">Subscribe our News Letter </p>
<label>Name:</label> <input type="text" /> <br />
<label>Email: </label> <input type="text" />
<input type="image" value="submit" src="submit.png" class="submit" />
</form>
</body>
</html>
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