Button and Script help please

Hello, can someone help me create a simple stationary that will have a drop down list of items that will paste into a format: Black, 14 pt, default san serif on the left and will pre populate blue on the right?

List Dropdown | State: Open

Enter “text” | Issue: Loss of all AS400s

Current Date Button | Date/Time: 01/17/2009 12:30 PT

List Dropdown | Platform: AS400

Enter “text” | Ticket: 111222

List Dropdown 1-10 | Adjusted Severity: 3

Subject: Button and Script help please

try and code something and paste the problems here.No one is going to do the work for you.