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Yeah thats totally possible, with some php or asp. I couldn't tell you the code off the top of my head, but I know for sure in some very basic php books, there is code/tutorials/examples of a very similar action, which Im sure you could modify easily. You just need an action attached to the Submit button that collects the input data, and issues out a specified message to that collected data (email). The message would also have to be coded with tags for the collected data to be inserted.
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