use DBI;

$fn = $Form{'First Name'};
$ln = $Form{'Last Name'};
$ea = $Form{'Email Address'};
$pn = $Form{'Phone Number'};
$add = $Form{'Address'};
$dor = $Form{'Date Of Request'};
$ds = $Form{'submit date'};

$dbh = (DBI->connect ("DBI:ADO:File Name=$database"));



$sql = "INSERT INTO vip (First_Name,Last_Name,Email_Address,Phone_Number,Address,Date_Of_Request,Date_Submit) VALUES ('$fn','$ln','$ea','$pn','$add','$dor','$ds')";

$dbh->Execute($sql);
$dbh->Close();