Coding a contact form

This is a small scripting job to code a contact form which will then relay the form contents to a mail box This small form must be completed before this coming Monday, and payment will be made via PayPal or Western Union after the completion of the form please mail me if you can complete the form and I will send the relevant contact form address and FTP info, if you cannot complete by Monday or not willing to except payment until after the form is completed please do not request the job. should be a few hours work for a php coder Regards