For any of you php guru's out there

1

For any of you php guru’s out there… I have a bit of a delema. I have a php display page that displays my companies interested clients, We qualify them by address so we are using a third party form to do this is ther any way to set up my display page to include the form already filled out so all we have to do is hit go to get the results? Below is my php code as well as the form information

I know my form is very basic…

<?php
// Make a MySQL Connection
mysql_connect("xxx", "xxx", "xxx") or die(mysql_error());
mysql_select_db("xxx") or die(mysql_error());
// Get all the data from the "example" table
$result = mysql_query("SELECT * FROM Invitation_Request") 
or die(mysql_error());  

// keeps getting the next row until there are no more to get
while($row = mysql_fetch_array( $result )) {
 // Print out the contents of each row into a table
 echo "<br>
"; 
 echo "<B>ID: </B>", $row['ID_Number'];
 echo "<br>
"; 
 echo "<B>Type: </B>", $row['Type'];
 echo "<br>
"; 
 echo "<B>First Name: </B>", $row['First_Name'];
 echo "<br>
"; 
 echo "<B>Last Name: </B>", $row['Last_Name'];
 echo "<br>
";
 echo "<B>Company: </B>", $row['Company'];
 echo "<br>
";
 echo "<B>Address: </B>", $row['Address'];
 echo "<br>
";
 echo "<B>City: </B>", $row['City'];
 echo "<br>
";
 echo "<B>State: </B>", $row['State'];
 echo "<br>
";
 echo "<B>Zip: </B>", $row['Zip'];
 echo "<br>
";
 echo "<B>Country: </B>", $row['Country'];
 echo "<br>
";
 echo "<B>Phone: </B>", $row['Phone'];
 echo "<br>
";
 echo "<B>E-Mail: </B>", $row['Email'];
 echo "<br>
"; 
 echo "<B>Ports of Interest: </B>", $row['Ports_of_Interest'];
 echo "<br>
";
 echo "<B>Collector Level: </B>", $row['Collector_Level'];
 echo "<br>
";
 echo "<B>Collector Type: </B>", $row['Collector_Type'];
 echo "<br>
";
 echo "<B>Designer Specialty: </B>", $row['Designer_Specialty'];
 echo "<br>
"; 
 echo "<B>Designer Preferences: </B>", $row['Designer_Preferences'];
 echo "<br>
"; 
 echo "<B>Designer Visit with Client: </B>", $row['Designer_Visit_with_Client'];
 echo "<br>
"; 
 echo "<B>Designer Preview: </B>", $row['Designer_Preview'];
 echo "<br>
"; 
 echo "<B>Designer Name to Dealers: </B>", $row['Designer_Name_to_Dealers'];
 echo "<br>
"; 
 echo "<B>Consultant Specialty: </B>", $row['Consultant_Specialty'];
 echo "<br>
"; 
 echo "<B>Consultant Type: </B>", $row['Consultant_Type'];
 echo "<br>
"; 
 echo "<B>Dealer Type: </B>", $row['Dealer_Type'];
 echo "<br>
"; 
 echo "<B>Dealer Fairs: </B>", $row['Dealer_Fairs'];
 echo "<br>
"; 
 echo "<B>Dealer Which Ones: </B>", $row['Dealer_Other'];
 echo "<br>
"; 
 echo "<B>Curator Title: </B>", $row['Curator_Title'];
 echo "<br>
"; 
 echo "<B>Press Title: </B>", $row['Press_Title'];
 echo "<br>
"; 
 echo "<B>Press Media Type: </B>", $row['Press_Media_Type'];
 echo "<br>
"; 
 echo "<B>Gallery Specialty: </B>", $row['Gallery_Specialty'];
 echo "<br>
"; 
 echo "<B>Gallery Handle: </B>", $row['Gallery_Handle'];
 echo "<br>
"; 
 echo "<B>Gallery Fairs: </B>", $row['Gallery_Fairs'];
 echo "<br>
"; 
 echo "<B>Gallery Which Ones: </B>", $row['Gallery_Other'];
 echo "<br>
"; 
 echo "<B>Artist Affiliation: </B>", $row['Artist_Affiliation'];
 echo "<br>
"; 
 echo "<B>Date: </B>", $row['Date'];
 echo "<br><hr>
"; 
} 
echo "</table>";
?>

<div id="width">
  <div id="minwidth">
    <div id="container">
      <div id="banner">
        <div id="logo"></div>
      </div>
      <div id="content" class="clearfix" accesskey="2">
        <div id="home">
                   <form method="post" action="http://www.Zillow.com/Home,$search$SearchBar.formSearchBar.sdirect" name="formSearchBar" id="formSearchBar">
            <div style="display:none;">
              <input type="hidden" name="formids" value="inputAddrStrtHood,If,inputCityStateZip,If_0,If_1,If_2,If_3,applySearchFilter"/>
              <input type="hidden" name="submitmode" value=""/>
              <input type="hidden" name="submitname" value=""/>
              <input type="hidden" name="If" value="F"/>
              <input type="hidden" name="If_0" value="F"/>
              <input type="hidden" name="If_1" value="T"/>
              <input type="hidden" name="If_2" value="T"/>
              <input type="hidden" name="If_3" value="F"/>
              <input type="hidden" name="applySearchFilter" id="applySearchFilter" value="F"/>
            </div>
            <div id="inlinesearch">
              <h1>&nbsp;</h1>
              <fieldset id="basic">
              <legend>Value Any Home</legend>
              <div class="first">
                  <label for="inputAddrStrtHood"><span><strong><br />
                  Address</strong> OR <strong>Street</strong> OR <strong>Neighborhood</strong></span></label>
                  <br />
                  <input type="text" name="inputAddrStrtHood" value="" id="inputAddrStrtHood" tabindex="1" maxlength="100" accesskey="4"/>
                  <br />
              </div>
              <div>
                  <label for="inputCityStateZip"><span><strong><br />
                  City, State</strong> OR <strong>ZIP</strong></span></label>
                  <br />
                  <input type="text" name="inputCityStateZip" value="" id="inputCityStateZip" tabindex="2" maxlength="100"/>
                  <br />
                  <br />
                  <input name="image" type="image" class="go" tabindex="3" src="http://www.zillow.com/static/images/btn_go.gif" alt="Go"/>
              </div>
                           </fieldset>
            </div>
          </form>
          <div id="zestdisclaimer">
            <p>&nbsp;</p>
          </div>
        </div>
      </div>
    </div>
  </div>
</div>