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You will need the HTML markup. It'll look something like this:
<form action='http://example.com/form.php' method='post'><input type='text' name='name' value='Name here' />
<input type='submit' value='Go' /></form>
Once you've got that, open your landing page (click "Edit Draft") and simply copy and paste the form markup into the page where you want it to appear.
Thank you, Alan!!