Code a form on my landing page

The form on my site doesn´t work. The forms has 2 pages. All entries should appear in a MySQL database. Also the user should receive a conformation email, copy to me. both forms: [login to view URL] [login to view URL] the code looks like this: <?php $to = "email"; $from = $_REQUEST['email']; $name = $_REQUEST['name']; $headers = "From: $from"; $subject = "Sie haben eine Nachricht von "; $fields = array(); $fields{"title"} = "Anrede"; $fields{"name"} = "Name"; $fields{"email"} = "E-Mail"; $fields{"phone"} = "Telefon"; $body = "Neuer Bezieher:\n\n"; foreach($fields as $a => $b){ $body .= sprintf("%20s: %s\n",$b,$_REQUEST[$a]); } $send = mail($to, $subject, $body, $headers); if ($send){ mail($from, $subject, $body, "From: <$from>"); } $connect = mysql_connect(“[login to view URL]”, “mexxxxxxxxxxxe”, “xxxxxxxxxx); if (!connect) { die('Connection Failed: ' . mysql_error()); { mysql_select_db(“meinen_tarif_vergleichen_de”, $connect); $user_info = “INSERT INTO table_name (title, name, email, phone) VALUES ('$_POST[title]', '$_POST[name]', '$_POST[email]', '$_POST[phone]')”; if (!mysql_query($user_info, $connect)) { die('Error: ' . mysql_error()); } mysql_close($connect); ?> Your job is to make the form working propperly!