Creating a signup for an interest group on an outside webpage?

In GetActive this was very simple, the form we created is on this page:

The code of which was:

<form method=POST action="">

<INPUT type=hidden value=t name=update>

<input type=hidden name=domain value="xxx">

<input type=hidden name=return_url value=""> <br> <table>

<tr> <td><span class="style4">Email Address</span></td> <td><input name=email type=text size=35 maxlength="100"></td></tr>

<tr> <td><span class="style4">First Name</span></td> <td><input name=first_names type=text size=35 maxlength="50"></td></tr>

<tr> <td><span class="style4">Last Name</span></td> <td><input name=last_name type=text size=35 maxlength="50"></td> </tr> <tr> <td><span class="style4">Daily Devotional</span></td> <td> <span class="style2"> <input type="radio" name="radio_lenten" value="t"> Subscribe<br> <

input type="radio" name="radio_lenten" value="f"> Unsubscribe<br /> </span></td> </tr> </table>

Has anyone done a simple form like this in Convio?