<?php
$ad = $_POST["ad"];
$tel = $_POST["tel"];
$email = $_POST["mail"];
$adet = $_POST["adet"];
$adres = $_POST["adres"];
$mesaj = "Adres:$adres Ad Soyad: $ad Adet: $adet Tel: $tel";
$kime = "mailin@gmail.com";
$headers = "From: $email";
$headers = "Reply-To: $email";
mail($kime, $tel, $mesaj, $headers);
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Sipariş İşlemi</title>
</head>
<body>
<form method="post" action="siparis.php">
  <table width="429" border="0" cellpadding="4" cellspacing="4">
    <tbody>
      <tr>
        <td width="200">Adınız Soyadınız</td>
        <td width="218"><input name="ad" size="35" style="border: 1px solid rgb(128, 0, 0); color: rgb(255, 255, 255); font-size: 8pt; background-color: rgb(21, 160, 221);" type="text" /></td>
      </tr>
      <tr>
        <td>Telefonuz</td>
        <td><input name="tel" size="35" style="border: 1px solid rgb(128, 0, 0); color: rgb(255, 255, 255); font-size: 8pt; background-color: rgb(21, 160, 221);" type="text" /></td>
      </tr>
      <tr>
        <td>Emailiniz</td>
        <td><input name="mail" size="35" style="border: 1px solid rgb(128, 0, 0); color: rgb(255, 255, 255); font-size: 8pt; background-color: rgb(21, 160, 221);" type="text" /></td>
      </tr>
      <tr>
        <td>Adresiniz</td>
        <td><textarea rows="5" name="adres" cols="50" style="border: 1px solid rgb(128, 0, 0); color: rgb(255, 255, 255); font-size: 8pt; background-color: rgb(21, 160, 221);"></textarea></td>
      </tr>
      <tr>
        <td align="left">İstediğiniz <span class="style3">Adet </span></td>
        <td><select size="1" name="adet" style="border: 1px solid rgb(128, 0, 0); color: rgb(255, 255, 255); font-size: 8pt; background-color: rgb(21, 160, 221);">
          <option>1 Adet - 80 YTL</option>
          <option>2 Adet - 150 YTL</option>
          <option>3 Adet - 220 YTL</option>
          <option>4 Adet - 280 YTL</option>
        </select></td>
      </tr>
      <tr>
        <td>&nbsp;</td>
        <td><input value="Siparişi Gönder" name="siparis" style="border: 1px solid rgb(128, 0, 0); color: rgb(255, 255, 255); font-size: 10pt; background-color: rgb(21, 160, 221); font-family: Tahoma; font-weight: bold;" type="submit" /></td>
      </tr>
    </tbody>
  </table>
</form>
</body>
</html>
yukardaki php kodlarını siparis.php diye kaydet html kodlarıda kafana göre kaydet at hostuna çalışır mailinide yazmayı unutma...