I ran this code sucessfully on my own MySQL server
<html>
<head>
<title>#Softmods Ban Submit</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
</head>
<body>
<?php
$username="root";//put you real stuff here
$password="";//put your real stuff here
$database="angel_test";//put your real stuff here
$connect = mysql_connect("localhost",$username,$password)
or die("Could not connect to server. MySQL said:".mysql_error());
$select = mysql_select_db($database)
or die("Unable to select database. MySQL said: ".mysql_error());
$query = "INSERT INTO ban VALUES ('','name','ban','ip','discrip')";
$result = mysql_query($query)
or die("Query failed. Mysql said:".mysql_error());
mysql_close();
?>
</body>
</html>
You might want to use variables instead of name, ban, ip and discrip because those sound more like field names and not real data. Also what was the error that you got, specifics are needed to help you with this. This is why I included an error check with all database queries.