<form action='insertappform.php' method='post'>

        <tr>
             <td>Title:</td>
     <td><input type="text" name="tl"><br></td>
       </tr>
        <tr>
             <td>First Name:</td>
     <td><input type="text" name="ftn"><br></td>
       </tr>
       <tr>
             <td>Last Name:</td>
     <td><input type="text" name="ltn"><br></td>
       </tr>
<tr>
             <td>Date of Birth: </td>
             <td><input type="text" name="dob"><br></td>
       </tr>
        <tr>
             <td>Address 1:</td>
             <td><input type="text" name="a1"><br></td>
       </tr>
        <tr>
             <td>Address 2:</td> 
     <td><input type="text" name="a2"><br></td>
       </tr>
        <tr>
             <td>Town/City:</td> 
             <td><input type="text" name="tc"><br></td>
       </tr>
        <tr>
             <td>Postcode:</td> 
             <td><input type="text" name="psc"><br></td>
       </tr>
        <tr>
             <td>Phone:</td>
             <td><input type="text" name="phone"><br></td>
       </tr>
        <tr>
             <td>Email:</td> 
             <td><input type="text" name="email"><br></td>
       </tr>
        <tr>
             <td>Type of request:</td>
             <td><select name="typerequest">
         <option selected>Please Select
         <option>Equipment for home
        <option>Medical
         <option>Transport
                </select><br></td>
       </tr>
        <tr>
             <td>Amount of grant required:</td>
             <td><select name="grant">
         <option selected>Please Select
         <option>Up to - £1000
         <option>Up to - £3000
         <option>Up to - £5000
               </select><br></td>
       </tr>
        <tr>
            <td>Brief outline of disability:</td>
            <td><textarea name="outlinerequest"></textarea><br></td>
       </tr>
        <tr>
            <td>Details of request:</td> 
            <td><textarea name="detailsrequest"></textarea><br></td>
       </tr>
          </table>
        <tr>     

            <td><br><b>Section 2</b><br>Relationship to person/people above 
                <select name="relate">
        <option selected>Please Select
        <option>Carer
        <option>Friend
        <option>Therapist
                <option>Representative of institution
                <option>Other
              </select><br></td>
       </tr> 
        <tr>
         <table width="100%" height="270" border="1">
        <tr>
             <td>Title:</td>
     <td><input type="text" name="tl2"><br></td>
       </tr>
         <tr>
            <td><br>First Name:</td>
            <td><input type="text" name="ftn2"><br></td>
       </tr>
        <tr>
            <td>Last Name:</td>
    <td><input type="text" name="ltn2"><br></td>
       </tr>
        <tr>
            <td>Address 1:</td>
            <td><input type="text" name="a12"><br></td>
       </tr>
        <tr>
            <td>Address 2:</td>
            <td><input type="text" name="a22"><br></td>
       </tr> 
        <tr>
            <td>Town/City:</td>
            <td><input type="text" name="tc2"><br></td>
       </tr>
        <tr>
            <td>Postcode:</td>
            <td><input type="text" name="psc2"><br></td>
       </tr>
        <tr>
            <td>Phone:</td>
            <td><input type="text" name="phone2"><br></td>
       </tr>
        <tr>
            <td>Email:</td> 
            <td><input type="text" name="email2"><br></td>
       </tr>   
<tr>
   <td><input type="submit" value="Submit"></td>
        </tr>     
        </form>