Help with form CSS positioning...

I sketched up this form for a project, but found difficulty creating it in HTML/CSS due to positioining.

Here is the current working form. How would I position the text above the inputs and the button to the left but keeping the inputs and captcha centred?

Epic visual tool

Epson 5030UB 2D/3D 1080p 3LCD Projector Submitted March 28, 2016 at 07:01AM by M4STER_TROLL http://ift.tt/1RvR39Q