<form name="eintragen" action="<?php echo $PHP_SELF?>" method="post">
<table cellspacing="0" cellpadding="3" border="0" width="110">
<tr>
<td><input type="checkbox" name="stufe" value="05" style="background-color: #4C77A2;"><b>5</b></td>
<td><input type="checkbox" name="stufe" value="06" style="background-color: #4C77A2;"><b>6</b></td>
<td><input type="checkbox" name="stufe" value="07" style="background-color: #4C77A2;"><b>7</b></td>
</tr>
<tr>
<td><input type="checkbox" name="stufe" value="08" style="background-color: #4C77A2;"><b>8</b></td>
<td><input type="checkbox" name="stufe" value="09" style="background-color: #4C77A2;"><b>9</b></td>
<td><input type="checkbox" name="stufe" value="10" style="background-color: #4C77A2;"><b>10</b></td>
</tr>
<tr>
<td><input type="checkbox" name="stufe" value="11" style="background-color: #4C77A2;"><b>11</b></td>
<td><input type="checkbox" name="stufe" value="12" style="background-color: #4C77A2;"><b>12</b></td>
<td><input type="checkbox" name="stufe" value="99" style="background-color: #4C77A2;"><b>99</b></td>
</tr>
<tr>
<td height="100"> <input type="submit" name="eintrag" value="ein" style="background-color: #FFFFFF; border: 1px #000000 solid; margin-top: 1px; margin-right: 1px; margin-bottom: 1px; margin-left: 1px;"></td>
<td> <input type="reset" name="reset" value="aus" style="background-color: #FFFFFF; border: 1px #000000 solid; margin-top: 1px; margin-right: 1px; margin-bottom: 1px; margin-left: 1px;"></td>
</tr>
</table>
</form>
<?php
if ($eintrag) {
$conn_id=mysql_connect($host,$user,$pwd);
mysql_select_db($database,$conn_id);
mysql_query("insert into $table (stufe) values ('$stufe')");
echo mysql_error();
echo "<b>\" $stufe \"</b> Stufe angemeldet!";}
?>