html coding help

[Flasch186]

alrighty guys, I need some help. I'm close but can't get there. Basically I need this form on my website which is a google form (I can switch to strict html coding for the form if its easier or a must to use the get or post functionality):

https://www.roundtablerealty.com/rpr...ress-entry.php

to take the "Home Address" a visitor enters and have that be the query this avm script uses to spit out the final code or result for them to view either on the same page below the form itself or on a new page they go to:


script
var rprAvmWidgetOptions = {
Token: "049C0600-AF9E-42C4-B3AE-221DAA25F16C",
Query: "95 Ninewells Ln, Saint Johns, FL 32259",
CoBrandCode: "btsround",
ShowRprLinks: false
}
/script
script src="//www.narrpr.com/widgets/avm-widget/widget.ashx/script">/script

The 95 Ninewells Ln is just a sample query to make sure it works which it did but now how to get the form to work with it? I'm open to other ideas as well.

TIA