Custom web form coding

Hello Freelancers. We have a special problem we want fixed with our webform. I want to be able to capture a IP address, and Location from the webform and have it submit the information to a hidden field that is a custom tag for my email and marketing management system. Let me outline it. Name Email Phone number And I also want a hidden field that captures location, IP and submits it to a hidden custom field. Here is the CODE minus my API key - I will work with you to get this done: This is a PHP sidebar that is called to each of my webpages: <script type="text/javascript"> // <![CDATA[ function CheckMultiple20(frm, name) { for (var i=0; i < [login to view URL]; i++) { fldObj = [login to view URL][i]; fldId = [login to view URL]; if (fldId) { var fieldnamecheck=[login to view URL](name); if (fieldnamecheck != -1) { if ([login to view URL]) { return true; } } } } return false; } function CheckForm20(f) { var email_re = /[a-z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&'*+\/=?^_`{|}~-]+)*@(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?/i; if () { alert("Please enter your email address."); [login to view URL](); return false; } return true; } // ]]> </script> <td width="13px"> <!--- spacer ---> </td> <!--- right sidebar ---> <td valign="top" width="291px" align="right"> <table cellpadding="0px" cellspacing="0px" border="0" width="291px"><!--- sidebar ---> <tr> <td style="background-image:url(images/[login to view URL]); background-repeat:no-repeat; background-position:right top;" valign="middle" align="center" height="279px"> <!--- form ---> <center> <form method="post" action="[login to view URL]" id="MY API KEY HERE" onsubmit="return CheckForm20(this);"> <span style="color:#eb1d21; font-size:14px;">Sign up to see the <br /><strong>Six Easy Steps for making <br />9% on your money starting now!</strong></span> <input type="text" name="CustomFields[2]" id="CustomFields_2_20" value="Enter Your First Name" onfocus="if ([login to view URL] == 'Enter Your First Name') {[login to view URL] = '';}" onblur="if ([login to view URL] == '') {[login to view URL] = 'Enter Your First Name';}" style="width:200px; margin-bottom:12px; font-size:16px; color:#333; padding:3px;"/> <br/> <input type="text" name="email" value="Enter Your Email" onfocus="if ([login to view URL] == 'Enter Your Email') {[login to view URL] = '';}" onblur="if ([login to view URL] == '') {[login to view URL] = 'Enter Your Email';}" style="width:200px; margin-bottom:12px; font-size:16px; color:#333; padding:3px;"/> <br/> <input type="text" name="CustomFields[5]" id="CustomFields_5_20" value="Enter Your Mobile Number" onfocus="if ([login to view URL] == 'Enter Your Mobile Number') {[login to view URL] = '';}" onblur="if ([login to view URL] == '') {[login to view URL] = 'Enter Your Mobile Number';}" style="width:200px; margin-bottom:12px; font-size:16px; color:#333; padding:3px;"/> <div style="font-size:12px;color:#999;margin:5px 0;"> <p>By signing up you are granting permission for us to call about our program and email you materials.</p> </div> <div align="center" style="height:45px; width:265px;"> <input type="image" name="submit" height="40" width="264" src="[login to view URL]" /> </div> <input type="hidden" name="format" value="h" /> </form> </center> <!--- end form ---> <div style="margin-top:10px;"></div> </td> </tr> <tr> <td height="10px">