<?php

$mysql_host = 'ephesus.cs.cf.ac.uk';
$mysql_user = 'c1018921';
$mysql_pass = '';

$name = $_POST['name'];
$surname = $_POST['surname']; // Make sure you check both of these for mysql injection if this is proper work.

mysql_connect($mysql_host, $mysql_user, $mysql_pass);

mysql_select_db('c1018921');

mysql_query("INSERT INTO `Info` (`name`, `surname`) VALUES ('{$name}', '{$surname}')");

?>

<form action="" method="post">

<br><label>name</label><br />
<input type="text" name="name" value="" /><br />

<br><label>surname</label><br />
<input type="text" name="surname" value="" /><br />

<input type="submit" name="submit" value="Register" />

</form>