More question/Help

Ok im in need of a page that will allow people to fill out some stuff and send to another 1 of my members email address without given away his email address and i only know basic html and im looking to see if anyone can help me or inform me of what i should do
I tried the whole MHTML thing on word doc but it wouldnt work.
I need something that would look like this
Clan Name: Enter text here Maps wanted to play: enter text here
Rules(may or may not be accepted): enter text here
Your email or Your clans Contacting information: Enter text here
Send! <-- button

If anyone knows how to do this please inform me !

possible/not possible ?

Here comes another bump

another freakin bump

You can create a form on wufoo.com and thenn post a link to it, but it will send results to that account, so whoever its being sent to has to do it.