I'd personally put a table with that image as the background, and put the form fields on the table as normal.
Pretty sure someone with more advanced experience is going to ridicule me and say CSS positioning does it better 
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Hmm, I gotta try that later.
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Why does it need to be in the image? Can't you chop it up?
(Fitting form elements into fixed positions is generally not a good idea since they display inconsistently across browsers).
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What do you mean by chop it up? Slice the banner in little pieces? I thought of doing that but it seemed a bit complicated to me when coding it.
I had some one do it for me (like 2 years ago) tho it looked like shit on IE, I'm not sure how it looked like on other browsers but saddly I lost the files and I don't talk to that guy anymore who did it for me.
I'm open to w/e you guys suggest.
There's nowhere I can't reach.