Multiple Values In Subject Field?

I am setting up an email form & i would like the subject field to hold multiple values, the forrm will be something like this:

Name:Mr A
Date: 01/01/01
Reason:Football

I want the form to send an email without opening an email client & I would like the subject field to look like this: Subject: Mr A, 01/01/01, Football Subject Mr A - 01/01/01 - Football

Can anyone tell me if this is possible, if if is can you please point me in the right direction.