Can some one help me edit this request form?

[Matt.]

Can some one help me edit this request form? I have this request form but every time I try to edit it and then try testing it out it just comes up with an error message. The reqeust php code i have at the moment is

<?php 
if(isset($_POST["send"])){ 
$name = $_POST["name"]; 
$email = $_POST["email"]; 
$subject = $_POST["subject"]; 
$msg = $_POST["msg"]; 
$receiver = "my email address"; 
if(empty($name)){ 
echo("-There was no name!<br />"); 
} 
if(empty($email)){ 
echo("-The email was empty or invalid!<br />"); 
} 
if(empty($subject)){ 
echo("-There was no subject!<br />"); 
} 
if(empty($msg)){ 
echo("-There was no message!<br />"); 
} 
if(!empty($name) && !empty($email) && !empty($subject) && 
!empty($msg)){ 
$headers = "MIME-Version: 1.0"; 
$headers .= "Content-type: text/html; charset=iso-8859-1"; 
$headers .= "From: ".$email.""; 

$messageproper = 

"------------------------- Email -------------------------\n\n" . 
"Name: $name\n" . 
"Email: $email\n" . 
"Message: $msg\n" . 

"\n------------------------------------------------------------\n" ; 

mail("$receiver", $subject, $messageproper, "From: \"$name\" 
<$email>\nReply-To: \"$name\" <$email>\nX-Mailer: chfeedback.php 2.02" 
); 
echo( "Thank you <b>$name</b>, your email was sent!" ); 
} 
} 
?> 
</font> 
<form method='post'> 
Name:<br /> 
<input type='text' name='name' size='35'><br /> 
E-mail:<br /> 
<input type='text' name='email' size='35'><br /> 
Subject:<br /> 
<input type='text' name='subject' size='35'><br /> 
Message:<br /> 
<textarea name='msg' rows='8' cols='42'></textarea><br /> 
<input type='submit' name='send' value='Send Email'> <input type='reset' value='Reset'> 
</form>

that works fine but I just can't edit it to how I want it. I want three things on there, 1. A name box 2. A drop down menu 3. A message box.
If some one could show me how to do this I would be very grateful,
Many thanks, Matty

[мϊкэ]

Sorry wrong thread :@