<?php
if (isset($_POST['email']) && isset($_POST['message']) && isset($_POST['name']) && isset($_POST['subject']) && isset($_POST['sender']))
{
    $MyEmail = $_POST['email'];
    $EmailMessage = $_POST['message'];
    $SenderName = $_POST['name'];
    $EmailSubject = $_POST['subject'];
    $SenderEmail = $_POST['sender'];
    $Headers = "From: {$SenderName} <{$SenderEmail}>";

    if (empty($email))
    {
        echo "Error";
    } else {
        exit;
    }
}
?>

<form method="post" action="<?=mail($MyEmail,$EmailSubject,$EmailMessage,$Headers);?>">
    <input type="hidden" name="email" value="N/A" />
    <input type="hidden" name="message" value="N/A" />
    <input type="hidden" name="name" value="N/A" />
    <input type="hidden" name="subject" value="N/A" />
    <input type="hidden" name="sender" value="N/A" />
</form>