to create form within vbulletin
 

My English is very bad and use translator, I hope that they understand it .

I want to insert a form within vbulletin, where the users select fields that to them the form requests and when completing it it sends an email to him to the administrator and the user.

For example this

http://img450.imageshack.us/img450/1071/sport4vp.jpg

The users select the fields and when him of a to send it also receives an email with his prognoses and the email receives the administrator.

I wait for its aid, thank you very much by its collaboration