Cloning php forms with some amendments

I need to make a duplicate of this site [login to view URL] with some amemdments listed below. From the residential form to a business form:- 1. Company Name 2. Company Registration Number 3. Company Registered Address 4. Company Phone Number 5. Company Fax Number 6. Name of Authorized Officer (as in NRIC/Passport) 7. NRIC / Passport / FIN of Authorized Officer 8. Date of Birth of Authorized Officer 9. Authorized Officer Office phone number 10. Authorized Officer Mobile Number 11. Authorized Officer Email Address 12. Name of Billling Contact Person 13. Email of Billing Contact Person 14. Physical Billing Address 15. Installation Address If possible can I check to use Company registered address/billing address/installation address. Meaning to say if I fill up registered address, for Billing address I can tick on a checkbox so I do not need to re-enter. Likewise for the Installation address, I can tick to check on registered/billing address. Change 1. There are 6 plans. a. Business 12 $186: up to 100Mbps symmetrical. 99.95% SLA. Optional 1 IP. (12 months contract) b. Business 24 $186: up to 100Mbps symmetrical. 99.95% SLA. Optional 1 IP. (24 months contract) c. Business Plus 12 $499: up to 100Mbps symmetrical. 99.98% SLA. 8 IPs with rDNS. (12 months contract) d. Business Plus 24 $499: up to 100Mbps symmetrical. 99.98% SLA. 8 IPs with rDNS (24 months contract) e. Business Pro 12 $999: Dedicated 20 Mbps, burstable to 100Mbps symmetrical. 99.99% SLA. 16 IPs with rDNS. (12 months contract) f. Business Pro 12 $999: Dedicated 20 Mbps, burstable to 100Mbps symmetrical. 99.99% SLA. 16 IPs with rDNS. (24 months contract) Indicate in this form i. For all contracts, Free ASUS N56U Router and free upgrade to advertised promotions. ii. For all 12 months contracts, One-Time Service Activation, Equipment Setup of $460 and installation of Terminal Point (TP) up to $533 apply. iii. For all 24 months contracts, One-Time Equipment Deposit (ONT Modem) of $500 and full amount reinbursed upon contract termination. iv. For all 24 months contracts, One-Time Installation of the Terminal Point (TP) up to $533 is waived v. For all 24 months contracts, One-Time Service Activation and Equipment Setup of $460 is waived but option to pay and get $300 on the 12th and 24th months of the contract. Total $600 2. Router -- > ASUS N56U 3. Upgrade to Cisco RV220W Upgrade to Ubiquiti EdgeMax 4. Remove Teleport, BrainPOP and HomeVoice. Marital Status 5. Static IP (For only Business 12 and Business 24) Payment method add Cheque Disclaimer All pricings payable to MyRepublic is subjected to 7% GST Lastly change the mailer to use phpmailer? [login to view URL] The form send me a notification after someone submit it. Name your price and also provide estimated delivery. Thank you regards nic