You do not enter teamspeak server data into this form.
This is a webinstaller, which connects to a LINUX SERVER over a SSH2 LOGIN.
So you need a running LINUX SERVER for this.
The webinstaller helps installing and managing (start,stop,restart,reinstall) bots with a web gui on your own server systems.
If you need a hosted bot (to simply enter an ip and a bot joins), I recommend you using our hosting service at: https://www.musicbot4you.net
Get a bot there, save your ip and a bot will join.