I'm not quite sure I understand what you mean. I'll be able to help more if you can explain a little better what you're trying to achieve.
Are you saying that you want their form, on your website?
Or that you just want a link on your website to that form?
Or that you want to create a form that does the same things as the one you linked to does, but on your own site?
If you can provide a bit more information that would be great. Perhaps the code you're using? (If any at the moment!)
Make sure you wrap it in tags though!