You could do this with a site workflow and edit the start form to capture what you need. Have you ever used nintex site workflows before? 

I haven't used the Nintex site workflow before. I've been piling across all these documentation and form postings and I haven't really been directed to use that for what I need to accomplish. We just started with Nintex within the past month and while its easy to use, its to the point that its so simple it becomes complicated..if that makes any sense.

Yeah it does make sense - it is easy to over complicate it. I'm not at my machine to do you any screen shots but basically what you need to do is:

site settings > nintex workflow > create site workflow

once in designer create some variables for the data you need to capture on the form and tick "show on start form"

then in workflow settings > edit start form

this will open up nintex forms for you to create a capture form with your variables. Once you are happy with that save and close nintex forms to return to workflow designer.

then add a send notification action in your workflow and add the variable values into the notification as required.

publish workflow and exit designer

To run the workflow:

all site contents > site workflows > choose workflow

you should then be presented with your start form and when you enter the data and click start you should get the notification.

i can add some screenshots in the morning if none of this makes any sense... 

I got to play with this last night, this is exactly what i needed. Thank you!

Impressed you understood my blabbing on  

Nintex is pretty straight forward if you know what your looking for, so even if you babble its easy to figure out what you are talking about. Though the directions you gave was more than enough to get me started in the right direction to create a standalone form and use the mail notification workflow to just send. Thank you again!