Erm...I got something..It's not exactly right but you uhave to change it abit..
<br />Upload an Profile Image:<br />
<form name="imageuploader" method="post" action="uploadpic.php" enctype="multipart/form-data">
<i>Path of Image:</i> <input type="file" name="imagefile">
<br>
<input type="submit" name="Submit" value="Upload Image">
</form>
<br />(Max 10000 file bytes , Must be file extention gif, jpg, jpeg, png, bmp....)<br />
(Images are resized to 150 x 150)<br />';
Not sure if thats right...but you will have to add the email bit...sorry..thats as much as I can do.