Start with this and expand to suit:
Code:
<form method="post" action="javascript:void(0);" onsubmit="DoIt();">
<div class="form">
<label for="Name">Name:</label>
<input type="text" size="20" value="name" name="Name" id="Name" alt="input 1" onfocus="this.select();" />
<br />
<input type="submit" value="Submit" title="Submit" />
<input type="reset" value="Reset" title="Reset" />
</div>
</form>
<script type="text/javascript">
/*<![CDATA[*/
function DoIt() {
nam=document.forms[0].Name.value;
alert(nam);
return true;
}
/*]]>*/
</script>