Create Submission Form

We have a script that will allow our website ([login to view URL]) to make reservations on another website. We have been provided a script that automatically displays a "check reservation" box. We would like for a simple form to be create to mimic this script while having the necessary input fields editable for us. Below I will paste the code that we use on the site, and a URL that leads to the "reservation destination". <script language="javascript" type="text/javascript" src="[login to view URL]"></script> This bit of code, we believe refers to this website and checks it's database: [login to view URL] In short, we'd like the form that is created to function just as the first script pasted above does. Please note that we will not be responding to all queries. Thank You