
<form action="createFanpage.php" method="post">
  First Name: <input type="text" name="fname" /><br />
  Last Name: <input type="text" name="lname" /><br />
  Email Address: <input type="text" name="email" /><br />
  Fanpage Name: <input type="text" name="fbname" /><br />
  <input type="submit" value="Submit" />
</form>