John, I think this is probably very doable, but it will take a bit of investigation of the target web page.
When you get to "04- selecting sites" can you do a partial screenshot of the HTML for each form field using the Chrome Inspect tool, and then post here?
For example, right-click on the form field and click "Inspect":
This will open the Chrome Developer Tools window, with the HTML element selected that you just chose to Inspect:
We need one partial screenshot for each form field on the web page.