I would like to create a form to be filled out that asks for

Customer Name

Account Number

Job #


Customer Contact Number

Desired Appt Date

Desired Time AM or PM

Rep Name and Location

Supervisor Name

I would like to be able to just fill out a form that asks these questions and than click copy, so I can easily paste the completed information. Preferably I would like it to display in a table with questions on left and answers on the right. I know that this is possible through HTML with Javascript. It has been years since I have tried to do something like this and I could really use some help. Here is the basic HTML form I have now. I would like to have people fill out form, click copy and than be able to paste information to me in an e-mail which shows the questions with the answers.

Customer Name: <input type="text" name="custname"><br>
Account Number: <input type="text" name="account"><br>
Job #: <input type="text" name="job"><br>
Address: <input type="text" name="address"><br>
Customer Contact #: <input type="text" name="contact"><br>
Desired Appt Date: <input type="text" name="date"><br>
Desired Time AM or PM:<br> <input type="radio" name="time" 

<input type="radio" name="time" value="pm">PM<br>
Rep Name and Location: <input type="text" name="repname"><br>
Supervisor Name: <input type="text" name="supname"><br>
<BUTTON onClick="ClipBoard();">Copy to Clipboard</BUTTON>