Yes, there's definitely <form> element, and I'm a designer not really a programmer, so I'm not sure about validation. I know that it can have required fields and check if an email address is real, if needed...
Here is the code so you can see exactly how its set up (since it does send an email with a custom subject & redirect to a thank you page - I just need the email to have content like "Country: Canada" :
<!-- START OF IMAGE MAP FORM-->
<FORM method="post" action="securerelay.php" name="WorldMapForm">
<input type="hidden" name="recipients" value="usernamejetSetwebsite.com" />
<input type="hidden" name="mail_options" value="Exclude=email;realname;your_good_url,KeepLines" />
<input type="hidden" name="subject" value="New Country Clicked On Site" />
<input type="hidden" name="good_url" value="http://www.website.com/thankyou.html" />
<input type="hidden" name="Country" id="Country" runat="server">
<img src="images/huge_world_map.jpg" alt="world map" id="world_map" name="world_map" style="border-style:none; align:center fixed;" usemap="#world_image_map">
<br><br>
<map id="world_image_map" name="world_image_map">
<area shape=poly alt=Canada id=Canada name=Canada value=Canada onmouseover="this.style.cursor='crosshair'"
onclick="document.WorldMapForm.submit();" onClick="document.forms['WorldMapForm'].Country.value= 'Canada';" coords="182,94,217,59,306,39,343,45,373,42,415,28,402,21,425,
17,490,9,486,16,449,29,423,45,443,56,451,68,429,93,456,150,436,149,422,
149,414,159,392,173,391,158,389,148,369,162,330,178,317,155,290,143,191,
146,175,144,182,135,189,132,187,125,196,103,189,102,182,100" title="Canada">
</map>
</FORM>
<!-- END OF IMAGE MAP FORM-->
THANK YOU AGAIN, SO MUCH FOR YOUR HELP!
[edited by: tedster at 9:32 pm (utc) on Nov 21, 2010]
[edit reason] added line breaks to prevent side scrolling [/edit]