Booking form for my website.

I require a simple "Book a appointment form" for my website the page is already created i just need a form when submitted it will be sent to a dedicated email address, there will be a total of 10 fields, with with 2 drop down menu, 1 drop down has 5 fields and 1 drop down has 3 fields, i will provide page file and css file, i already have a contact form which is powered by a [login to view URL] file. thank you.......