Need HTML Help...

This script can be customized to suit your needs. I've used it a number of times:

http://worldwidemart.com/scripts/formmail.shtml

For an example of the script in use, you can look at a page my company designed at

http://www.calvaryhome.org/moreinfo.htm. If you fill out the information and click on submit it will send an e-mail to me with the data.