create a form in hotspot login page and save input data in database

hi every body
i want to create a hot spot login page with 5 textbox. 2 of them are username and password that i 3 of then are name, last name and ID that users must be input them.
i want name, last name and ID save in database in/out of mikrotik (does not matter).
please help me
thanks

Hi …
I have same need with iauit.
I have tried using Google Form from Google Docs, but the form not working properly when loading on Android Popup Login Hotspot. I have allready setting IP Walled Garden to docs.google.com, but i can click the SUBMIT button to send the form.

Please help me … too. Thank you