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Adobe pdf creation software has the ability to make a field in a document editable. It is all in the making of the pdf document. Then you put a link to it on the web page. Here is an example form. How you get it to email depends on the pdf reader the user has. Adobe Reader has the capability to email the completed document.
I downloaded a trial version of Adobe Acrobat X Pro it said something about people to make the .pdf document "interactive" What you posted is EXACTLY what I am trying to do make it where you can "fill out the form online" and then send it. Thanks for the reply, PS; The document is already made i just need to make it interactive now...