Vbscript: Form without input

I want to make a form page with 6 fields where 5 are direct from database.
In the form, i will display 10 fields from the database. But in that only 5 are going to the database.Plus one extra other field that i will have in the form.
I dont want to put the 5 fields from the database in read-only textbox.

I am also curious to know if i can replace the submit buttom with anchored image.

Thanks