NEEDED: Small PHP script to collect and email user submitted data.

I need a small php script that will collect user submitteddata on a webpage, and do two things with it.? 1) email it to me 2) eitherwrite it to a file, or store it in a mysql database. ? The user interface will have three pages.? On page one, the user will verify that they meet certaincriteria.? There will be three check boxes that the user must [login to view URL] they click submit, the script will verify that they have all been checkedand if they have, take the user to page two.? I would like the verificationto be done server side rather than client side. On page two, the user will have to put their name and emailaddress in, both of those are required, there will also be a box that they canfill out if someone referred them, which is not required.? When they clicksubmit, the script will both email me with the information collected, and alsoeither write the information to a file or database (this is only for redundancyin case of email delivery issues).? The information sent/saved will haveto include the checkboxes that were marked, their name/email, and any referrerinformation that they put in. Page three will be a confirmation page with text.