select form options and submit in iframe (need help)

Question

hi every one - sorry my english is low

please create script in php

i need this form style

# 1.select from dropmenu
# 2.input text
# 3.select from dropmenu
# 4.submit in iframe

mean this option from 1 and put custome text from 2 and select option from another dropmenu from 3 and submit created text submit in iframe load web address. created text mean this

    1+2+3=4
`1option+2text+3option=4submit in adrees bar`
    123= 4.send code in address bar and load iframe

thanks