1 word in more form-rules (white ruled boxes)

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Pardon my grammar, for i am Dutch (not Deutch) from the Netherlands.
I have gogled but did not find anything remoteley answering my question.

I have a page on a local site with a few form-lines people can fill in, and then
search this word(s) on specific sites with google.

What i want to do is that if 1 is filled in, the others take that same text
Preferebaly the first one, and all under it take it over.
The rules are mentioned for search, results open in new window.

So when 1 phrase is typed, all they have to do is click: zoek ('go search') per
site (and rule they normally would have tp ty again...)  to search on.

Page example:

Thanx in advace for any tips, help, or site pages about this.

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