create action file with php

here is the HTML below

Digital MediaSoftwareSecurityBusinessOther

	Lab 2
	Welcome to become a member of the GGC PHP Club!!!
	Please provide the following information for registration:
	Name*:
	E-mail*:
	Gender: Male
	Female
	Do not want to tell
	Choose your major area of study:
	How many years you have been a member of the GGC PHP Club:
	(If you have been a member for more than 3 years, your annual membership fee is 30% off)
	What type of membership you would like to be: VIP Regular
	(If you choose VIP, your annual membership fee is $200.00, otherwise it is $100)

with an output that looks like this :

Welcome to become a member of the GGC PHP Club!!! Please provide the following information for registration Name: Grizzly E-mail: abcgpc.edu Gender: Male Female Do not want to tell Choose your major area of study: Security How many years you have been a member of the GGC PHP Club 2 (If you have been a member for more than 3 years, your annual membership fee is 30% of What type of membership you would like to be .VIP Regular (If you choose VIP, your armsal membership fee is $200,00, otherwise it is S100) Register Reset Thank you for your registration. Here is your information we collected: Name: Grizzly Email: abc@ggc.edu Gender: Male Major: Security Your annual membership fee is: $70.00