Contact Form with Selectable Receipents

I need a simple contact form, with a drop down menu with contact names, a user selects the person from the list and the data captured from the form is sent to the contact. I also need a confirmation to the user. There are tons of free php scripts on the web that can process a form I just need one that can handle multiple receipents. This should be a quick job. I have all the info you need and would like the job done today if possible.