# Urgent Help!

**URL:** <https://forum.kirupa.com/t/urgent-help/47341>\
**Category:** flash\
**Created:** [April 2, 2004, 8:48pm UTC](https://forum.kirupa.com/t/urgent-help/47341 "2004-04-02T20:48:19Z")\
**Posts on this page:** 1\
**Page:** 1

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**Author:** ![mdempsey](https://avatars.discourse-cdn.com/v4/letter/m/ecb155/32.png) [@mdempsey](https://forum.kirupa.com/u/mdempsey)\
**Post date:** [April 2, 2004, 8:48pm UTC](https://forum.kirupa.com/t/urgent-help/47341/1 "2004-04-02T20:48:19Z")

</div>

I would like to make, something which im not sure how to do. I have a form, which is the picture attached. I need to create it somehow with text fields for each option, and the text written needs to be sent to an email address. I need the format in the email to be something like this [but the person who enters the info must not have to go through any email stages]

Driver : [what they write]  
Date : [what they write]  
Address : [what they write]

etc etc, can anyone help me!

[type this in browser]

[http://uk.geocities.com/mattdempsey@btinternet.com/form1.jpg](http://uk.geocities.com/mattdempsey@btinternet.com/form1.jpg)

Matt