Little Help on a FORM

form method="post" action="send.asp">
<p>
 Desired Username: <input type="text" name="Username">
</p>
<p>
 Desired Password: 
<input type="text" name="Password">
</p>
<p>
 Confirm Password: 
<input type="text" name="Password">
</p>
<p>
 Your Message: <br>
 <textarea cols="20" rows="5" name="Message">
</textarea>
</p>
 <input type="hidden" name="URL" 
    value="<%= Request.ServerVariables("HTTP_REFERER")%>
 <input type="submit" value="Register" name="SUBMIT">
 <input type="reset" value="Clear" name="RESET">
</form>