Email Me Form Page (Webform) with extras

THIS PROJECT HAS TWO PARTS PART I: The company I now use is [login to view URL] (Free Service) unreliable. I need a web form that a potential client can fill out online and click the submit button and I receive the web form via email. Preferable a cgi script (Folder) to upload to my server. This is the actual web form that I use: [login to view URL] PART II: If there is a way possible for certain input fields on this web form to also be inputted to the autoresponder company that I use [login to view URL] - This company allows me to create a web form but only with 10 questions. My original web form has 22 questions so that's my issue. The [login to view URL] account is what I used to follow up with potential clients so in the follow up process I want to use relevant information for the web form they filled out. Please Inquire if you can do this job or need further explanation.