It is easy to ask a question like this, but to accomplish this seemingly simple task, you will need to have some minimal knowledge of the following areas:
1. HTML
2. PHP
3. MySQL
In order not to stuck with the similar problems in the future, why not help yourself by starting your learning journey right away. The following links should give you a good head start:
Learn HTML[
^]
Learn PHP+MySQL[
^]
If you encounter any problems with your learning or coding, then come here to post your question again and preferably show some code.