ok amigo jaronu aqui te mando el code
Código PHP:
<form action="envia_form2_php.php" method="post" enctype="multipart/form-data" name="interesados" id="interesados" onsubmit="MM_validateForm('NOMBRE','','R','NOMBRE2','','RisEmail','NOMBRE3','','R','NOMBRE4','','R','pueblo','','R','cantidad de personas','','R');return document.MM_returnValue">
<table width="705" height="430" align="center">
<tr>
<th width="250" height="30" align="left" scope="row"><span class="Estilo123">NOMBRE</span></th>
<td height="30" align="left"><label>
<input name="nombre" type="text" id="nombre" onblur="MM_validateForm('NOMBRE','','R','NOMBRE2','','NisEmail','NOMBRE3','','R','NOMBRE4','','R','pueblo','','R','cantidad de personas','','R');return document.MM_returnValue" size="50" maxlength="50" />
</label></td>
</tr>
<tr>
<th width="250" height="30" align="left" scope="row"><span class="Estilo123">E-MAIL</span></th>
<td height="30" align="left"><input name="email" type="text" id="email" size="50" maxlength="50" /></td>
</tr>
<tr>
<th width="250" height="30" align="left" scope="row"><span class="Estilo123">TELÉFONO</span></th>
<td height="30" align="left"><input name="tel" type="text" id="tel" size="50" maxlength="50" /></td>
</tr>
<tr>
<th width="250" height="40" align="left" scope="row"><div align="center" class="Estilo73">
<div align="left" class="Estilo123">DONDE VIVES</div>
</div></th>
<td width="340" height="40" align="left"><select name="residencia" size="1" id="residencia">
<option>Darién</option>
<option>Panamá</option>
<option>Colón</option>
<option>Coclé</option>
<option>Herrera</option>
<option>Los Santos</option>
<option>Veraguas</option>
<option>Chiriquí</option>
<option>Bocas del Toro</option>
<option selected="selected">-------------------------------</option>
</select></td>
</tr>
<tr>
<th height="40" align="left" scope="row"><span class="Estilo123">OTRO PAÍS </span></th>
<td height="40" align="left"><input name="pais" type="text" id="pais" value="Especifica..." size="50" maxlength="50" /></td>
</tr>
<tr>
<th height="40" align="left" scope="row"><span class="Estilo123">ESCRIBE TU CIUDAD O PUEBLO</span></th>
<td height="40" align="left"><label>
<input name="pueblo" type="text" id="pueblo" value="" size="50" />
</label></td>
</tr>
<tr>
<th height="10" colspan="2" align="center" scope="row"><div align="center" class="Estilo24">
<hr />
</div></th>
</tr>
<tr>
<th width="250" height="40" align="left" scope="row"><span class="Estilo123">COMO DESEAS REALIZAR EL VIAJE </span></th>
<td height="40" align="left"><select name="transporte" size="1" id="transporte">
<option>viajaré hasta Volcán o Boquete por mi cuenta </option>
<option>Plantéeme usted paquetes de viaje</option>
<option selected="selected">-------------------------------</option>
</select></td>
</tr>
<tr>
<th height="10" colspan="2" align="center" scope="row"><div align="center">
<div align="center">
<hr />
</div>
</div></th>
</tr>
<tr>
<th width="250" height="40" align="center" scope="row"><div align="center" class="Estilo73">
<div align="left" class="Estilo123">QUE CAMINO QUIERES TOMAR </div>
</div></th>
<td height="40" align="left"><select name="camino" size="1" id="camino">
<option>Boquete</option>
<option>Volcán</option>
<option>Usted decide</option>
<option selected="selected">-------------------------------</option>
</select></td>
</tr>
<tr>
<th height="10" colspan="2" align="center" scope="row"><div align="center">
<div align="center">
<hr />
</div>
</div></th>
</tr>
<tr>
<th width="250" height="40" align="center" scope="row"><div align="left" class="Estilo123">CANTIDAD DE PERSONAS </div></th>
<td height="40" align="left"><input name="cantidadp" type="text" id="cantidadp" value="" size="50" /></td>
</tr>
<tr>
<th height="10" colspan="2" align="center" scope="row"><div align="center">
<div align="center">
<hr />
</div>
</div></th>
</tr>
<tr>
<th height="40" align="left" scope="row"><div align="left"><span class="Estilo123">PREGUNTA O DUDA </span></div></th>
<th height="40" align="left" scope="row"><label>
<textarea name="pregunta" cols="50" id="pregunta">Escribe tu pregunta aquí...
</textarea>
</label></th>
</tr>
</table>
<p>
<label>
<input type="submit" name="Submit" value="Enviar" />
</label>
<label>
<input name="Restablecer" type="reset" id="Restablecer" value="Restablecer" />
</label>
</p>
<hr align="center" size="5" />
<p> </p>
</form>
gracias