Code:
#!/usr/bin/perl
use strict;
use warnings;
use Net::SMTP;
use CGI;
my $cgi = new CGI;
#
# instantiate smtp object
#
my $smtp = Net::SMTP->new('smtp.my.domain', Timeout => 60);
$smtp->mail('mymail@nanzan-u.ac.jp');
$smtp->recipient('mymail@nanzan-u.ac.jp');
#
# assign form fields to variables
#
my $firstname = $cgi->param( -name => 'firstname');
my $familyname = $cgi->param( -name => 'familyname');
#
# send data
#
$smtp->data();
$smtp->datasend("From: heisig\@nanzan-u.ac.jp\n");
$smtp->datasend("To: heisig\@nanzan-u.ac.jp\n");
$smtp->datasend("Subject: Special-order book\n");
$smtp->datasend("\n");
#
# data assigned to variables from form fields
#
$smtp->datasend("$firstname $familyname") ;
$smtp->datasend("\n") ;
$smtp->dataend();
$smtp->quit;
#
# display response
#
print $cgi->header();
print $cgi->start_html() .
'All done' .
$cgi->end_html();
exit(0);