Need PHP'er for simple email form (feedback form)

Hi, I would like to make a simple feedback form, If someone clicks on the Feedback button, there comes a 'lightbox' form. SEE SCREENSHOT: [login to view URL] The user can choose betweens 4 options: IDEA / PROBLEM / QUESTION / PRAISE There is NO NEED to have an ADMIN or CMS, just in the code i would like to fill in the email adres where the form is send to, even as the texts and images/buttons etc. if someone for example chose PROBLEM the mail title have to be like this. [PROBLEM: Feedback given through site.] So basically there is one mailform and which option the user choose have to put in the TITLE of the mail. Let me know your best price