[9xakep]

The special one,
тут js не нужен

<?php 
echo "
<form action='page.php' method='post'>
<input type='text' name='a1'>
<input type='text' name='a2'>
<input type='submit' value='send'>
</form>
";
$a1 = $_POST['a1'];
$a2 = $_POST['a2'];
?>