340000 Flash/PHP contact form

Hello, I need a simple flash contact form to work on my domain (from [login to view URL]). I will provide all login details to the domain. The form simply needs to send "name", "phone", "email" & "message" fields to the email I provide. I have the form designed, it just needs to send those fields on my domain, so you will need to upload the form and test it. I need it done in flash CS3 or lower as I don't have Flash CS4. Also it would be better if the form sent email using PHP can be used, although ASP is also an option. Thanks.