It's easy to create your own on-line forms using the Form Builder utility. The results of any form can be sent by e-mail as either plain text or a comma delimited list that can be exported into Excel or other programs.

There are multiple form field options including pre-populated state and country drop-down menus, as well as the ability to add a captcha (a challenge/response spam filter) field to your forms. Your form can be laid out in sections and you can choose to have any field required if needed.