<?php
$username="********";
$password="*************";
$database="zymexx_******";

$field1-name=$_POST['Value1'];
$field2-name=$_POST['Value2'];
$field3-name=$_POST['Value3'];
$field4-name=$_POST['Value4'];
$field5-name=$_POST['Value5'];

mysql_connect(localhost,$username,$password);
@mysql_select_db($database) or die( "Unable to select database");

$query = "INSERT INTO tablename VALUES
('','$field1-name','$field2-name','$field3-name','$field4-name','$field5-name');

mysql_query($query);

mysql_close();
?>