Google comes to the rescue with the "Forms" area of the free Google Docs application. They make it easy to create a form, with the questions you want. You can even do field validation, meaning checking to make sure that an email field actually ends up with a valid email address in it.
Once you've created your questions, you can instruct Google to inform you immediately by email every time the form is submitted. The results are placed into a spreadsheet for you to view and then use the information. If you need to place this info into another application or mailing/emailing/lead management system, just export the file as a .csv (comma delimited) file, and then import it into the application of your choice. The file can be pulled directly into MS Word as addresses for a mail merge if you want.
Since you have a Google account in order to get to this feature, Google already has an email address for you, though you can designate another for the form notifications. If you blog, especially with WordPress, the insertion of the embed code into a post or page is a ten second job. The possibilities for tracking results are great. You can create a different form for each page where you want one, tracking which pages generate the most responses.
