A family of Microsoft word processing software products for creating web, email, and print documents.
What you see in the image is one way to approach something like this:
I positioned your image in the Header/Footer layer of the document, scaled to fit within the margins. The Text Wrap of the image is set to None with both Horizontal & Vertical Alignment set to Centered. Because it is in the H/F the rectangle graphic appears gray when viewed on screen but prints at full intensity.
In the Text layer I drew a Text Box within the left rectangle area & set its Text Wrap to square, then pasted a duplicate into the other rectangle area. The 2 Text Boxes are aligned based on Top. I have both Text Boxes selected so you can better see how they're placed.
I also Bookmarked the content in the left text Box (which is why the [ ] characters are visible but do not print) & inserted a REF field in the right Text Box. In that way content need be added only to the left Text Box. Updating the field in the right Text Box will insure that its content is identical to the Bookmarked content. Otherwise, the content would have to be copied/pasted which presents more opportunity to disturb the layout... There is no provision in Word for 'locking' the position of the Text Boxes.
The filler text is simply for illustration -- it can remain in the template & replaced in each new document or carefully deleted from the template... as long as you avoid deleting the [ ] that identify the Bookmark location. Replacement content should be inserted within those brackets.
If you aren't already quite familiar with Word I'd recommend that you spend a fair amount of time exploring Word 2011 Help on the subjects I've referred to.