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contact.html
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<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title></title>
</head>
<body>
<!-- your content -->
<!-- //your content -->
<!-- form area -->
<h3>Contact Us</h3>
<form method="post" action="submission.php">
<p><b>Information Request</b><br />Select the items that apply, and then let us know how to contact you.</p>
<p>Please select your service of interest:
<select name="ProductOrService">
<option value="" label="select" selected="selected">- Select One -</option>
<option value="QuoteRequest" label="quote">Quote Request</option>
<option value="GeneralInfo" label="gen">General Info</option>
<option value="Other" label="other">Other</option>
</select></p>
<table>
<tr><td align="right"><em>Name</em>*</td><td><input type="text" name="name" value size="35"></td></tr>
<tr><td align="right"><em>Title</em></td><td><input type="text" name="title" value size="35"></td></tr>
<tr><td align="right"><em>Company</em></td><td><input type="text" name="Company" value size="35"></td></tr>
<tr><td align="right"><em>Address</em></td><td><textarea name="address" rows="3" cols="35"></textarea></td></tr>
<tr><td align="right"><em>E-mail</em>*</td><td><input type="text" name="email" value size="35"></td></tr>
<tr><td align="right"><em>Phone</em></td><td><input type="text" name="phone" value size="35"></td></tr>
<tr><td align="right"><em>Message</em>*</td><td><textarea name="comments" cols="45" rows="5" id="comments"></textarea></td></tr>
</table>
<p><input type="submit" value="Submit Request"> <input type="reset" value="Reset Form"> </p>
<p><span>* is required</span></p>
</form><br />
<!-- //form area -->
<!-- your content -->
<!-- your content -->
</body>
</html>