basic php

[hamfast]

Hello there

I'm under pressure at work to come up with a simple PHP form to get basic information from prospective customers who browse the company website:

Name:

Tel No:

Address:

As well as a radio button section to select Product 1, Product 2 or Product 3.

Could anybody point me in the right direction how to design this because I don't have the time at work to study PHP to get this right. I'd kindly donate a few pounds/dollars to a chose worthy cause of anybody who could help.

Best wishes
Hamfast

[remp]

This might be helpful.