Web signup form graphic

I need a better looking signup form for [login to view URL] I just need a Photoshop graphic, no code of any kind. I can code it myself. There is one that I like at [login to view URL] at the upper right (apart from the cut off corner which I don't like). I don't necessarily want something exactly like this, but it has a good tone for my purposes. The graphic should be as follows... 468 pixels wide Text as the original Audio Masterclass signup All elements on separate layers Text in text layers Suits the tone of the Audio Masterclass site I notice in the example there is some detail towards the lower right. I like this, but I would need the detail to be on a separate layer so that I can replace it with anything I choose later on. This might be a tricky area to get right so the successful bidder will need to be flexible. If you have done signup forms before, sight of some examples would be useful. I expect there will be a few iterations before the result is acceptable, so please consider this in your bid.