A simple HTML form with two input fields and one submit button:

Edit code and click me	Your Result (Some examples do not work in Google Chrome):
<html> <head> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> </head> <body> <form action="http://xhtml.co.il/tryit/html/html_form_submit_736.php"> First name: <input type="text" name="fname" value="Mickey" /><br /> Last name: <input type="text" name="lname" value="Mouse" /><br /> <input type="submit" value="Submit" /> </form> <p>Click the "Submit" button and the input will be sent to a page on the server called "html_form_submit_736.php".</p> </body> </html>
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