Forum:Input fields

Would it be possible to create an inputbox that creates a page and then have fields to change the preloaded content. So something like:

Join type:

Game type:

Start date:

Start time:

End time:

Levels:

Where saved:

IP:

Minimum players:

Campaign?:

Mature?:

Game ID:

And then it puts the following in the page:

And adds in the variables. Is this possible? Similar to the language select when requesting a wiki at c:requests:Request Wiki:Request a Wikia but it's an input box instead. --Leon (talk ) 22:53, 29 January 2007 (UTC)
 * This would be used on nwn. --Leon  (talk ) 23:01, 29 January 2007 (UTC)


 * I think this would require an extension (such as this thing) or some Javascript (for a javascript example of something similar, see requests, like this thing). --Splarka (talk) 00:15, 30 January 2007 (UTC)