Users selects where form is posted to... how?

As the subject suggests,
I have a form which covers
three branches of a chain of
businesses.... the information
entered into the form by the user
gets posted to whichever branch
they select in the form itself... this
is done by three radio buttons,
so only one can be selected when
the form is posted... this would also
need some kind of form check, to prompt
the visitor to check that their info is going
to go to their chosen branch!

I've had some experience hacking perl
but not authoring it!

Can anyone help?

thnks

deano.