easy form. -- 2

I need an easyform to be made that customer can fill out with a drop down box. this form then has a submit button. which i should then receive. like below Are you eligible to claim exemption from VAT on this order? (tick box)I or the person I am buying for is eligible for vat relief. There medical condition is (drop box) (tick box)I am claiming vat relief on behalf of a charity. Charity number.................................... (tick box) I am not eligible and cannot claim vat relief. SUBMIT Once its been submitted i will receive the completed form I have such a easy form on one of my pages that when someone fills it out all the information goes to one of my suppliers direct. Link below [login to view URL]