Customizing contact form

Hi, trying to setup a contact form which obtains two forms of information;
a ‘your details’ section and ‘your friends details’.

An example of what i wish to do is here:
http://www.simplyenergy.com.au/Refer-A-Friend/Refer-a-friend.aspx

I don’t want/need the complex “remove/add friend” function, merely just want to have the text fields for customers to fill out, so we can receive these details and the friend they are trying to refer. Is there a contact form which allows this, and particularly the layout where it is double?