Contact Form not working

I created a Contact Form with the logic below. It did not send the information from all of the fields I put in. Here is a link to it: http://ericyoffiespeaks.com/cleaning/contact-us/

Could you tell me how to fix it? Thank you.

Amy

[Too much code here – and it’s on your site]

http://wordpress.org/extend/plugins/contact-form-7/