Here is part of the source:
<form method="post" action="http://rosemary.umw.edu/cgi-bin/formmailblat.pl">
<!-- VERY IMPORTANT - replace ernie@mwc.edu with your email address -->
<input type=hidden name="recipient" value="ernie@mwc.edu">
<input type=hidden name="required" value="email,name">
Name:
<input type="text" name="name" size="36">
Email address:
<input type="text" name="email" size="36">
State:
<input type="text" name="state" size="2">
Zip:
<input type="text" name="zip" size="10">
Comments about the Web site<br>
<textarea name="comments" cols="50" rows="8"
wrap="VIRTUAL"></textarea>
<input type="submit" name="Submit" value="Submit">
<input type="reset" name="Submit2" value="Reset">