<div id="smsbox"><p class="smsbox"><form name="smsform" method="post" action="test_sms.php"/>Enter Mobile Number<input type="text" value="mobile #" name="mobile" size="14"/>
<select name="carrier">
    <option>-Select Carrier-</option>
    <option value="@message.alltel.com">Alltel</option>
    <option value="@paging.acswireless.com">Ameritech</option>
    <option value="@txt.att.net">AT&amp;T</option>
    <option value="@sms.bellsouth.com">BellSouth</option>
    <option value="@myboostmobile.com">Boost</option>
    <option value="@mobile.celloneusa.com">CellularOne</option>
    <option value="@sms.edgewireless.com">Edge</option>
    <option value="@mobile.mycingular.com">Cingular</option>
    <option value="@mymetropcs.com">MetroPCS</option>
    <option value="@messaging.nextel.com">Nextel</option>
    <option value="@qwestmp.com">Qwest</option>
    <option value="@pcs.rogers.com">Rogers</option>
    <option value="@messaging.sprintpcs.com">Sprint</option>
    <option value="@msg.telus.com">Telus</option>
    <option value="@tmomail.net">T-Mobile</option>
    <option value="@email.uscc.net">US Cellular</option>
    <option value="@vtext.com">Verizon</option>
    <option value="@vmobl.com">Virgin</option>
</select>
<input type="submit" name="submit" value="send sms"></form></div>

<?
$from = "my@email.com";
$to = $_POST['mobile'];
$carrier = $_POST['carrier'];
$to = $mobile.$carrier;
$subject = "Test mail";
$message = "Hello! This is a simple email message.";
$headers = "From: $from";
mail($to,$subject,$message,$headers);
echo "Mail Sent.";
?>