Configure php form and form processor

This should be a very quick and easy project. I've got a form on a very small website that is built in PHP. I've attached a screenshot of the fields that the form contains. The form looks ok and it submits the information, but it does not send all the information. It only sends the subject and the comments. I need this form fixed to where it sends all the information that is filled out. It should also validate and contain required fields (the ones with the stars). You are free to use the current processor, use a new one, or rebuild the form from scratch if you prefer. I just need it to work. I'd like you to test this on your own server for functionality then send me the files and I'll install them myself. I'll be sending you the current files, if you need them, once you are selected.