text box name to a new folder and images uploaded to it.

[eluser]roymayor[/eluser]
so i got ci uploaded and created the uploader using the examples online. i want to be able to have a text box on a page where a person can input their first and last name and it will create a folder with that name and the user can upload his images into that folder. can someone help me create something like that? so like a first and last name text box then a browse button to open the finder dialog box then a submit/upload button. then a success page? help!?