Html browser side need to convert into php server side

I have this as part of my client browser side webpage but I need to convert over to php.mail format and come across in email format.

There is an option of the client browser also to receive a copy of the same email of the details below they fill in.

Please could some assist with the correct format php for this to work ?
Thanks in advance. :slight_smile:

:o

    <p>Title: <br> <input type="text" name="title" /><br />       
<br> First name:<br/><input type ="text" Name="fname" /> <br/> 
<br/>   Surname :<br/> <input type="text" Name="surname" /><br/>
  <br > Address:<br/> <input Name="add" type="text" size="40" maxlength="50" /> 
 <br/>
  <br >  Address 1:<br/><input Name="add1" type="text" size="40" maxlength="50" /><br/> 
  <br>  Address 2:<br/><input Name="add2" type="text" size="40"maxlength="50" /> <br/>
     <br>  Address 3:<br/><input Name="add3" type="text" size="40" maxlength="50" /> <br/>
    <br>   Postcode :<br/><input type="text" Name="pcode"/><br/>
   <br>    Home Tel :<br/><input type="text" Name="hometel"/><br/>
   <br> 	Work Tel :<br/><input type="text" Name="worktel"/><br/>
   <br> 	Mob Tel :<br/> <input type="text" Name="mobtel"/><br/>


Email :



Date of Alleged cold call:



Who contacted you?


Have you ever had an accident?

Yes No


If yes, who did you make a claim through?


Are you registered with the Telephone Preference Service (TPS)

Yes No



Additional comments






Please tick if you require a copy of details filled in on this complaint form 1
Yes



Please tick YES below before proceeding

Yes




        I confirm that I have read and understood the terms and conditions relating to this complaints procedure.  I accept that if my complaint is found to not be valid that I may be responsible for an administration fee for dealing with this complaints procedure.
        <br/>
        <br/>
        <br/>
        

          <input name="submit value=" type="submit" value="Submit"send info />
          <input type="reset" name="reset value="resent />
          <br/><br/>
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