<script src="http://api.mygeoposition.com/api/geopicker/api.js" type="text/javascript"></script>
<script type="text/javascript">
  function lookupGeoData() {
    myGeoPositionGeoPicker({
      startAddress     : 'White House, Washington',
      returnFieldMap   : {
      'demoField1' : '<LAT>',
      'demoField2' : '<LNG>',
      'demoField3' : '<STREETNUMBER> <STREET>, <CITY>, <STATE> <ZIP>, <COUNTRY>'
      }
    });
  }
</script>
<input name="demoField1" id="demoField1" size="10" type="text">
<input name="demoField2" id="demoField2" size="10" type="text">
<input name="demoField3" id="demoField3" size="50" type="text">
<button type="button" onclick="lookupGeoData();">GeoPicker</button>