На всякий случай html такой:
<form>
<table>
<tr>
<td>$row[0]</td>
<td>$row[1]</td>
<td>$row[2]</td>
<td>$row[3]</td>
<td>$row[4]</td>
</tr>
<tr>
<td><p>Текст</p></td>
<td><select class='span1' id='1' name='conn'>
<option selected='selected'></option>
<option>Текст</option>
<option>Текст</option>
<option>Текст</option>
</select></td>
<td><p>Текст</p></td>
<td><select class='span1' id='2' name='tv'>
<option selected='selected'></option>
<option>Текст</option><option>Текст</option>
<option>Текст</option></td>
<td><p>Текст</p></td>
<td><select class='span1' id='3' name='inet'>
<option selected='selected'></option>
<option>Текст</option>
<option>Текст</option>
<option>Текст</option>
</select>
</td>
<td><button type='submit' id='continue' name='submit'>Готово</button>
</td>
</tr>
</form>