<label for="dbserver">DATABASE SERVER:</label>
  <input name="dbserver" type="text" id="dbserver" value="<?php echo DB_HOST ?>" />
  <br />
  <label for="dbname">DATABASE NAME:</label>
  <input name="dbname" type="text" id="dbname" value="<?php echo DB_NAME ?>" />
  <br />
  <label for="dbuser">DATABASE USER:</label>
  <input type="text" name="dbuser" id="dbuser" value="<?php echo DB_USER ?>" />
  <br />
  <label for="dbpassword">USER PASSWORD:</label>
  <input type="text" name="dbpassword" id="dbpassword" value="<?php echo DB_PASSWORD ?>" />
  <br />

<p>
  <input type="submit" name="submit" id="submit" value="Submit Now" />
  |
  <input type="reset" name="reset" id="reset" value="Reset" />
</p>