Flash CDOSYS contact form

Hi, I need a simple contact form for my website. My webhost said that I need to use CDOSYS script. They do not support PHP. Basically all i want the contact form to do is to send an email to my personal account whenever someone sends the form with all the info they put into the form. I've attached an example contact form that my webhost sent to me for how the script should be, hopefully that should be some help. I want the contact form to be simple, its gona be on a white background so I as long as I can edit the .fla file later I don't mind how it looks and I would like the flash actionscript set to 2.0. For the form, it should be something like this:
subject
name
e-mail
telephone
message
and send/reset button.