I need a PHP/HTML form Repaired

IN PROGRESS
Bids
11
Avg Bid (USD)
$30
Project Budget (USD)
$30 - $250

Project Description:
I have a form page built, and the php page to send the form. It needs a few more entries on the PHP page to work.. I need it to send the data to an email address.

I am not that good with PHP, but I did design the html form and that works as it should.

I am willing to pay up to 30.00 for the repair of the file,,, you can see the file/s at http://www.heavenlyherbalz.com/order_form.html and the php page is http://www.heavenlyherbalz.com/sendform.php

Please let me know, first bidder that can prove they can do the work gets it,, quick money for the PHP/HTML Wise..

THank you ,,

John V.
HeavenlyHerbalz.com

Skills required:
HTML, PHP
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heavenlyherbalz United States
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