please help

i have a list of names each with a button next to it and when pressed i
would like to open a form with their name in it. also in this form i would
like a drop down list with
FDA 1, OTDR 1, FDA 2, INTERIM, FDA 3, OTDR 2, FDA 4, SUMMARY.
next to this is it possible to have a date picker so to make it easier for
the inputter.
now when they press ok i want the date placing below the relevant item
for instance:

if they chose fda 3 and date 15-mar-06 and pressed ok.

cell g5 is the space for the date of fda 3
and this is where 15-mar-06 would appear

thanks in advance