A simple HTML web form.
Check out the live demo here.
Please note that the form intentionally give out 405 errors. This is to prevent email spamming.
Change the $email_to = "[email protected]"; in the php file to your email address to get the form submissions sent to you.
These html files work independently, so they contain all the css an js in them. They are also designed to be single page forms, but you can also embed them in a page if you want.