Hi,
You're missing two single-quotes on the first line and the 5th line ... but I assume that was done when you ***'d out your hostname etc.
Apart from that, there doesn't seem to anything wrong with the syntax.
You're going to have to check what is actually being sent to this page (without entering anything in to the db).
You could put the following at the very top of your script ...
echo '<pre>'; var_dump($_POST); echo '</pre>';
exit;
... and see if it is what you expect.
Paul
PS You should think about cleaning up any data sent to this page before inserting into your db (at minimum, use mysql_real_escape_string()).