Comment Box? Options

[boobooxpp]

Hello, i just created my own website + i just wanted to know if anyone can tell me the code to having a comment box.

I was thinking about a:
row for full name
row for state
box for comment
submit button

and when they click submit, their comment will be sent directly to my e-mail

can i make one just like it? or can anyone make something like that for me? pls? thank you