Simple visitor survey in PHP?

Hi

I know this is probably a really dumb question but I'm not a PHP/MySQL guy usually so sorry!

Anyway, I'm looking to test a new market and want to ask PPC visitors for info before giving them a free download (the usual "I'm just finishing off an ebook and want to make sure I've covered everything so what is it you're looking for...?" type question and store the answers in a MySQL db - any suggestions for either a suitable script or pointers on where to locate one please?

Thanks in advnce
RN

I can code one for you if you want. PM me if interested.

Thanks