diff --git a/roles/freemedia/files/FreeMedia-form.html b/roles/freemedia/files/FreeMedia-form.html
index 9afa4ed9ad..13ba6f2b7a 100644
--- a/roles/freemedia/files/FreeMedia-form.html
+++ b/roles/freemedia/files/FreeMedia-form.html
@@ -34,44 +34,44 @@ To request ONE copy of Fedora DVD or Live Media by mail, please fill out
Region
-Asia Pacific Region>
- Europe Region>
- Latin America Region>
- North America Region>
- Africa Region>
+ Asia Pacific Region
+Europe Region
+Latin America Region
+North America Region
+Africa Region
(Where your country belongs to)
-Full Name
-Email
-Release
+Full Name
+Email
+Release
- Fedora 20>
+ Fedora 21>
Media
-i386 DVD>
- x86_64 DVD>
- i386 Live DVD (Gnome)>
- x86_64 Live DVD (Gnome)>
- KDE i386 Live DVD>
- KDE x86_64 Live DVD>
- LXDE i386 Live CD>
- LXDE x86_64 Live CD>
- MATE-Compiz i386 Live CD>
- MATE-Compiz x86_64 Live CD>
- Xfce i386 Live CD>
- Xfce x86_64 Live CD>
+ Workstation 64Bit
+Workstation 32Bit
+Server 64Bit
+Server 32Bit
+KDE i386 Live DVD
+KDE x86_64 Live DVD
+LXDE i386 Live CD
+LXDE x86_64 Live CD
+MATE-Compiz i386 Live CD
+MATE-Compiz x86_64 Live CD
+Xfce i386 Live CD
+Xfce x86_64 Live CD
(If you are unsure, choose i386)
-Address Line1 (Door no, Street name)
-Address Line2 (Locality, City)
-Address Line3 (State, Postal Code/Zipcode)
+Address Line1 (Door no, Street name)
+Address Line2 (Locality, City)
+Address Line3 (State, Postal Code/Zipcode)
Address Line4