<html>
<body>

<form action="fedex.php" method="post">
        First Name<input type="text" name="first" />
        Last Name<input type="text" name="last" />
        Phone Number<input type="text" name="phone" />
        Street Address<input type="text" name="street" />
        Address Line 2<input type="text" name="line2" />
        City<input type="text" name="city" />
        State<input type="text" name="state" />
        Zip Code<input type="text" name="zip" />
        Email<input type="text" name="email" />
        <input type="submit" />
</form>

</body>
</html> 