Build form and web database

I am in need of a person to put together a database (either My SQL or PHP) based on a form which we will supply. Once the form and database is built, it will need to be uploaded to our website, which we will supply you with the information to do this. Since this is being used internally only, no web design will be needed, just the form on the page and a submit button. A copy of the information submitted will need to be emailed to an address which we will supply. addtional information: This form is going to be used by people in the field (with a laptop/wireless conection) and in house to imput information supplied by the business. The form will then need to be emailed to our project management team to perform the work. It will be a stand alone website but the only thing on it will be the form and the button to submit the info. It would not need any additional design. The data base need not capture all the information, just the business name, address, and contact info. Once the form and data base is finished, I will expect the coder to ftp the files to the server (GoDaddy) so that it is "ready to use". I will supply the winner of the bid the loggin info. I have attached a excel file of the fields needed for the form. The check boxes are just that, longer boxes will need to be text imput. Some text boxes will need additional space for imput, which you can see on the sheet. Any additional information please ask and we will try to answer for you. Thanks ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables): a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform IE all versions and Firefox