Send html form data to email

<?php

 $to = "jeffbusch@charter.net";
 $from = $_REQUEST['Email'];
 $name = $_REQUEST['FirstName'];
 $headers = "From: $from"; 
 $subject = "Prayer Request"; 

 $fields = array(); 
 $fields{"FirstName"} = "FirstName";
 $fields{"LastName"} = "LastName";
 $fields{"AddressLine1"} = "AddressLine1";
 $fields{"AddressLine2"} = "AddressLine2";
 $fields{"City"} = "City";
 $fields{"State"} = "State";
 $fields{"PostalCode"} = "PostalCode";
 $fields{"Country"} = "Country";
 $fields{"Phone"} = "Phone";
 $fields{"Fax"} = "Fax";
 $fields{"Email"} = "Email";
 $fields{"Title"} = "Title"; 
 $fields{"Comments"} = "Comments"; 

 $body = "We have received the following information:\n\n";
 foreach($fields as $a => $b) {
  $body .= sprintf("%20s: %s\n",$b,$_REQUEST[$a]);
} 

 $headers2 = "From: noreply@mywebsite.net"; 
 $subject2 = "Thank you for contacting us"; 
 $autoreply = "Thank you for contacting me. I will get back to you as soon as possible, usually within 48 hours.";

 if($from == '') {
  print "You have not entered an email, please go back and try again";
} else {
  if($name == '') {
    print "You have not entered a name, please go back and try again";
  } else {
    $send = mail($to, $subject, $body, $headers);
    $send2 = mail($from, $subject2, $autoreply, $headers2);
    if($send) {
      header( "Location: http://www.mywebsite.net/thankyou.html" );
    } else {
      print "I've encountered an error sending your information, please try later.";
    }
 }
}

?>