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<INPUT TYPE="text" NAME="Firma" VALUE="">
<INPUT TYPE="text" NAME="Name" VALUE="">

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<FORM METHOD="post" ACTION="<?php echo $PHP_SELF ?>">

<?php
 
include("my_database.php");
 
if ($submit) {
 
$sql = "INSERT INTO kunden (Firma, Name) VALUES ('$Firma','$Name')";
$result = mysql_query($sql,$db);
}
?>
<INPUT TYPE="text" NAME="Firma" VALUE="<?php echo $Firma ?>">
<INPUT TYPE="text" NAME="Name" VALUE="<?php echo $Name ?>">
<INPUT TYPE="submit" NAME="submit" VALUE="Eintragen"
</FORM>