<div class="newsletter-unsubscribe">
<div class="newsletter-unsubscribe-title"><?php echo $this->__('Submit your email id to unsubscribe newsletter') ?></div>
<form action="<?php echo $newsletterObj->getUnsubscribeFormActionUrl() ?>" method="post" name="unsubscribe-newsletter-validate" id="unsubscribe-newsletter-validate">
<div class="block-content">
<div class="input-box">
<input type="text" name="email" id="newsletter" title="<?php echo $this->__('Unsunscribe newsletter') ?>" class="input-text required-entry validate-email" />
</div>
<div class="actions">
<button type="submit" title="<?php echo $this->__('Submit') ?>" class="button"><span><span><?php echo $this->__('Submit') ?></span></span></button>
</div>
</div>
</form>

<script type="text/javascript" language="javascript">
//<![CDATA[
var newsletterSubscriberFormDetail = new VarienForm("unsubscribe-newsletter-validate");
//]]>
</script>
</div>