Form implementation


i have one form with some input text with the name = "user_name"  "mob"  "email" and inside this form i have a link for example Plans and end with submit button. Now if user click the link then i want to have all the values of the input text of the same form send to another page to pks.php and if the user click on the submit button then it will work on action confirm.php. For example Check this code


Can you help me out?? How can i achieve this. Thanks in advance