A Quick Google Search revealed a site here.
if I were you I would google "Flash PHP Form" (or somethin to that effect)
here is one that uses Name, Email and Message, you could easily convert that to be email1, email2, correct, incorrect.
Although I greatly disagree with the methods used to send e-mail in that tutorial, it may get blocked by spam filters, etc.
I would check out phpMailer or SwiftMailer.
Best of luck...