<body>
  <div class="row">
	  <div class="column">
		<img src="https://i.pinimg.com/originals/d2/b4/a3/d2b4a3cc6c5e2322b2646c5d06ec197c.png" alt="Book" class="book">
	  </div>
  
	  <div class="column">
		<form class="modal-content animate" action="">     
			<div class="header">
			  <h1>FREE VIDEO:</h1>
			  <h5>5 Steps to Say Yes</h5>
			  <h5>(A Step-by-Step Walk Through of</h5>
			  <h5>a Complementary Coaching Call)</h5>
			</div>
			<div class="modal-body">
			  <input type="modal-text" name="firstName" id="firstName" placeholder="First Name *" required="required">
			  <input type="email" placeholder="Email *" name="email" id="email" placeholder="Email" required="required">        
			  <button type="submit">FREE INSTANT ACCESS</button>
			 </div>
		</form> 
	  
		<div class="copyright">
		  <p><strong> <a href="#">Terms & Conditions</a></strong></p>
		  <p>2019 <strong>The Coach Mindset</strong> All Rights Reserved</p>
		</div>
	  </div>
	</div>
  </body>
</html>
body {
  background: url(https://i.pinimg.com/originals/04/34/29/0434292e2120ed0393b5821e80a4238f.png);
  repeat: none;
  font-family: Arial, sans-serif;
}

h1 {
  text-align: center; 
  font-size: 25px; 
  font-weight: 900;
}

.row {
  display: flex;
}
.column {
  flex: 50%;
  padding: 20px;
  text-align: center; 
}

.book {
  text-align: center;
  width: 350px;
	height:auto;
  margin: 10px;
}

/* Modal Content Box */
.modal-content {
/*     text-align: center; */
    background-color: #fefefe;
    margin: 10%;
    border: 1px solid #888;
    width: 70%; 
	  padding: 5px;
    border-radius: 10px;
}
.modal-body{
  text-align: center; 
}

/* Input fields */
input {
    width: 90%;
    padding: 10px;
    margin: 5px;
    border: 1px solid #ccc;
    box-sizing: border-box;
	  font-size:12px;
    border-radius: 10px;
}

/* Style button */
button {
    background-color: #97e502;
    color: white;
    padding: 10px;
    margin-top: 5px;
    margin-bottom: 20px;
    border: none;
    cursor: pointer;
    width: 90%;
	  font-size:18px;
    font-weight: 900;
    border-radius: 10px;
}
button:hover {
    opacity: 0.8;
}

/* Center the text */
.header {
    text-align: center;
    margin: 24px 0 12px 0;
    position: relative;
}

/* Modal Footer */
.copyright {
  color: fff;
}
.copyright p {
  font-size: 12px;
  color: #fff;
  text-align: center; 
  line-height: .5;
}
.copyright a {
  font-decoration: none;
  color: #fff;
}

/* Add Zoom Animation */
.animate {
    animation: zoom 0.6s
}
@keyframes zoom {
    from {transform: scale(0)} 
    to {transform: scale(1)}
}

External CSS

  1. https://cdnjs.cloudflare.com/ajax/libs/twitter-bootstrap/4.1.3/css/bootstrap.min.css

External JavaScript

This Pen doesn't use any external JavaScript resources.