Setting Up Input Form

The Server / DB that I am trying to connect to is local.Everything is in place, except I do not know what to put in the "data_source" and "Server.MapPath" fields in the 'form_ac.asp' file.It seems like no matter what I put in there (I have tried several different connection strings), that I always get a '500 Internal Server' error as soon as I 'submit' the form. Its like something else is out of place, because it doesn't even seem to check the DB strings (just based on how quickly the 500 error shows up)

You can see the 'test' form I am working with here: URL...And here is the file the form posts to (form_ac.asp):

Code:
<%
' Declaring variables
Dim first, last, account, email, state, comments, data_source, con, sql_insert
' A Function to check if some field entered by user is empty
Function ChkString(string)
ChkString = Replace( Trim(string) , "'", "''")
End Function

[code]....

The bold is where I am having issues. No matter what connection string I try, I keep getting the 500 error in my browser.I have created the Database in SQL Server Management Studio, and created the table.